Reduction mammaplasty is the medical term for breast reduction surgery. Excessively large breasts frequently cause significant problems in my Dallas patients, including neck, back and shoulder pain, inability to find clothes and bras that fit, inability to exercise, deep grooving in the shoulders from bra straps and possibly even rashes under the breasts. In addition, excessively large breasts can make breast self-exams difficult to perform and mammogram results unreliable or difficult to interpret.
In terms of the breast, there are three components that affect its shape and appearance: the skin envelope, glandular tissue, and nipple. When there is an excess of glandular tissue, the skin stretches out, causing the breasts to sag and the position of the nipple to fall.
The goal of breast reduction surgery is to reduce the size of the breasts and relieve symptoms caused by large breasts. In addition, the reduced breasts are repositioned higher on the chest wall in a more attractive, aesthetic position.
To perform a breast reduction, the three main breast components must be addressed and corrected. Excess breast tissue and skin is permanently removed, producing in a tighter, lifted appearance; the nipple areola complex also must be repositioned higher on the chest wall in a more appropriate, aesthetically pleasing position. Breast reduction surgery does result in some scarring of the breasts; during surgery, an incision is made around the nipples, down from the lower point of the nipples to the fold of the breast, and along the crease of the breast. I make every effort to minimize the appearance of scarring during surgery, so long as it does not compromise the final appearance of the breast shape and position.
Your Initial Consultation
During breast reduction consultation, which takes place from the comfort of my Dallas plastic surgery practice, I review the following information with my patients:
- Your personal cosmetic goals and desires
- The symptoms caused by the size of your breasts
- The procedures and techniques that will best help us meet your goals
- Your medical history and the types of medications that you currently use
- Whether or not you smoke (smokers are not good candidates for surgery because it puts patients at risk of injury and skin loss, and it delays healing; smokers must quit for at least six weeks prior to surgery)
- The surgical fees associated with your procedure
- Whether or not you qualify for insurance coverage (this will depend on your height, weight, and the amount of tissue that is to be removed)
Once you make the decision to undergo breast reduction surgery, I will take preoperative photos to assist me in planning, executing, and following up of your treatment.
Your Reduction Mammaplasty or Mastopexy
The day of your surgery, I will meet you in the preoperative area where I make marks on your skin to help guide me when I am performing surgery. Next, we move you to the operating room where you will undergo general anesthesia. The breast reduction procedure will take about two to two-and-a-half hours. Once the appropriate amount of skin and breast tissue has been removed and the nipple has been repositioned, the incision will be closed with absorbable sutures. Steri-strips may also be applied to the incisions to keep them closed; the strips will stick to the skin for about 10 days. After you have awoken from surgery, you will be sent home to rest.
After Breast Reduction Surgery
Following breast reduction surgery, you may experience some swelling, numbness, bruising, and pain. These side effects tend to peak about 36 hours after surgery. These symptoms are normal and should dissipate during the next few weeks.
When you return home from your breast reduction operation, it is important to avoid engaging in any demanding exercise routines for at least three weeks. However, you should gently move and stretch the arms and shoulders as soon as possible to promote and faster recovery. Regaining mobility of the arms, shoulders, and chest will reduce pain and allow the breasts to soften and settle.
Limitations, Risks and Possible Complications
There are risks and side effects associated with breast reduction surgery, which include:
Scarring: One of the biggest concerns faced by women undergoing breast reduction surgery is that it results in scars. Scars will be more noticeable in the year after surgery; after that point, they fade from red and slighty raised to light and flat.
Delayed healing/partial loss of skin: During breast reduction surgery, flaps of skin are elevated off of the breast tissue. If there is poor circulation to this area, healing could be slowed and portions of the skin could be lost. If you notice blistering or crusting of the surface of the skin, contact my Dallas office immediately.
Bleeding under the skin: After the incisions have been closed, about 2 to 3 percent of patients experience bleeding under the skin. The accumulation of blood results in pain, swelling, and bruising. In order to remedy the problem, the incision may need to be opened back up to remove the blood and fluid.
Infection: Although rare, all surgery carries with it the risk of infection. In order to prevent an infection from developing, patients are advised to take prescribed antibiotics for a few weeks after surgery.
Reduced nipple sensitivity: The sensory nerves of the nipples may be affected by surgery, resulting in temporary or permanent loss of feeling in the nipples.
Asymmetry: All patients have some difference in the size and shape of their breasts prior to undergoing breast reduction surgery. Some degree of asymmetry will affect my breast reduction patients, though it is mostly unnoticeable.
Breast reduction surgery is a highly reliable, extremely rewarding procedure in selected patients due to its ability to reduce the size of and/or reposition the breasts. In properly selected patients, these procedures significantly reduce the size, weight and hence the symptoms of excessively large breasts. In addition, they improve the appearance of the breasts, often allowing you to wear clothing without a bra if desired. Most of my Dallas breast reduction patients experience a very positive improvement in self-image, comfort and greater flexibility in clothing selection.
If you have any questions regarding your decision about breast reduction, please do not hesitate to contact my office for further information.