Breast reduction, or reduction mammoplasty, is for a woman experiencing health problems and/or extreme self-consciousness associated with very large, heavy breasts. The goal is to give the woman a more attractive contour with smaller, better-shaped breasts in proportion with the rest of her body.
Often times, my patients who have very large breasts have severe back and neck pain caused by the excessive weight, skin irritation, skeletal deformities, and breathing problems. Bra straps may leave shoulder indentations. Large heavy breasts also contribute to poor posture and can interfere with normal daily activities such as exercise. After surgery, many of my patients feel like they have been given a new life – their overly large breasts no longer weigh them down preventing them from activities they wished they could participate in and they feel lighter and better able to get around.
This patient not only had large breasts causing her significant back pain, but she also had a lot of asymmetry.
Breast reduction is done under general anesthesia in our outpatient surgery center in one of our affiliated hospitals depending on other medical risks factors. The surgery removes fat, glandular tissue, and skin from the breasts, making them smaller, lighter, and firmer. In your surgery, I actually reshape the breast and re-create the skin pocket around it. It can also reduce the size of the areola and make the position of the nipples more symmetric.
Incisions are made around the pigmented nipple-areolar complex and extend vertically below the nipple and in the fold under the breast. The nipple-areolar complex is moved upward to the desired location. The incisions are covered with a light dressing.
Afterward, the breasts are placed in a surgical bra that will hold them symmetrically during initial healing. Initial discomfort subsides daily and can be controlled with oral medications. Many of my patients have almost no pain at all and require only a few pain pills after surgery. Scars will fade in 6-18 months. Surgery will likely reduce, but not eliminate the ability to breast-feed. There is a risk of decreased nipple sensation or changes in nipple color, but these rarely happen.
Recovery: What to Expect
When performed by a qualified plastic surgeon, breast reduction is a safe procedure. Nevertheless, as with any surgery, there is always a possibility of complications, including bleeding, infection, or reaction to the anesthesia. Some patients develop small sores around their nipples after surgery; these can be treated with antibiotic creams.
Much of the swelling and bruising disappears in the first few weeks following the surgery. Breasts may appear slightly mismatched, or have unevenly positioned nipples. Their new shape will be apparent within 6 months to a year, and will depend on hormonal fluctuations, weight changes, and pregnancy.
Although your surgeon will make your scars as inconspicuous as possible, some permanent scarring is inevitable. Smokers and patients who are overweight are more likely to experience poor healing and wider scars. The scars will be red and lumpy in the months following the surgery, but the redness will fade and in time the scars will be less obvious. The good news is, your bra or bathing suit will cover whatever scars remain, and most likely, the scars will not prevent you from wearing low-cut tops.
Because the surgery removes many of the milk ducts leading to the nipples, breast-feeding may no longer be an option. However, a significant portion of the milk ducts remain so there is still the possibility of breast feeding and many of my patients have been able to breast feed after their surgery.
Some patients may experience a permanent loss of feeling in their nipples or breasts. None of my patients have had this happen to them and some patients actually have slightly increased sensitivity! Rarely, the nipple and areola may lose their blood supply and the tissue will die. (The nipple and areola can usually be rebuilt, however, using skin grafts from elsewhere on the body.) These are rare complications that (knock on wood) have never happened to any of my patients but have been reported in the literature.
The End Result
Breast reduction produces the most dramatic results of all plastic surgeries. It ends the physical discomfort of large breasts and makes your body appear more evenly proportioned, and clothes fit better. Some of my happiest patients are breast reduction patients. This is personally one of my favorite procedures to perform because it is often life changing for patients.