Any woman interested in minimizing and sculpting the size and shape of her oversized and sagging breasts can undergo surgery for breast reduction.
Large breasts can pose a daily nuisance both from an aesthetic and functional perspective. Discomfort can be caused by pressure from bra straps, back pain due to scoliosis, recurrent inflammation and fungal infection underneath the infra-mammary fold. Most importantly, breast reduction surgery may improve a woman’s overall comfort level and self-confidence.
In breast reduction surgery, excess breast and fat tissue is removed from each breast, and the breast envelope (skin) is reduced accordingly. Every breast reduction surgery is in effect a breast lift surgery, and as such the nipple and surrounding areola is relocated to a higher point. In this surgery it is important to sculpt the breast, preserve symmetry between each side, and carefully situate the nipple so as to achieve an overall pleasing, natural, and symmetric result.
Breast reduction surgery is performed under general anesthesia. Duration of surgery is approximately 2 hours. In most cases, an overnight admission for observation is necessary.
It is recommended that one refrain from smoking at least 3 to 4 weeks prior to surgery. Furthermore, any outstanding values of blood pressure and/or blood sugar levels should be addressed and treated accordingly. Blood thinners should be stopped at least 2 weeks before surgery.
Given that the breasts achieve their final shape and form only after completion of puberty, surgery for breast reduction is not suitable for those under the age of 18. If there are plans for pregnancy after surgery, one must take into consideration that breast size and shape may change after pregnancy and breast-feeding is complete, perhaps necessitating an additional surgery. Any change of weight exceeding 5kg may cause distortion in the shape of the breasts after surgery.
Before surgery, one must check for any existing breast disease and/or breast or ovarian cancer in the family. Furthermore, a breast examination will be performed.
A current mammography check-up is warranted for any woman above the age of 35. In any case of relevant medical history or examination result, the patient is referred to a breast surgeon consultation before any breast surgery is initiated.
Before surgery, overall skin quality, signs of stretching, quality and amount of excess breast tissue, and areola diameter are examined and noted. One of the goals of this surgery is to diminish the breast until the desired size is achieved, all the while maintaining appropriate proportions to the rest of the body.
At the end of surgery, several scars will be evident: One around the areola, one vertical scar from the lower pole of the areola to the inframammary fold, and possibly one along the inframammary fold (depending on the characteristics of the breast prior to surgery). The goal is to minimize any scarring whatsoever. In any case, it will be possible to wear a two-piece bathing or any other revealing clothing without fear of the scars being evident.
The primary goal in this surgery is to achieve maximum symmetry between the breasts, despite the fact that most women possess some asymmetry between the breasts before any surgical intervention.
Note that all breast tissue removed during this surgery is sent to histopathalogical examination.
Closure of the incisions created during this surgery is achieved via usage of absorbable sutures that obviate the need for their removal. It is possible that a draining tube will be left in either breast at the end of surgery. This is decided upon during the surgery and functions to allow drainage of any local secretions. This draining tube is removed in the clinic after a few days time.
In most cases, it is possible to reduce the breast size by 1 to 2 breast cups. The limitation to this amount stems from the fact that proportionality regarding the breasts and the rest of the body should be maintained.
At the end of surgery, the patient exits the operating room “packaged” with a sports bra that she must wear for at least one month.
The initial recovery period lasts approximately 2 weeks. During this time one may experience local tenderness, skin bruising, swelling, edema, and possible reduction in sensation around the breast, nipple, and areola. During this initial healing period, one may notice opening of the inframammary suture line. In such a case, the wound is treated conservatively. It is recommended that one refrain from any physical exertion for at least two weeks, and avoids sleeping on the stomach side of the body for at least one month.
Complete healing of the surgical wounds may take several weeks. The final results of the surgery may be noticeable only after several months, and one must be patient until all swelling subsides and the breasts attain their final shape and size. In about third of the patients operated on, breast-feeding may become compromised to some degree.
The complications of this surgery are very rare, and may include:
1) Bleeding that my necessitate drainage in the operating room
2) Infection, skin compromise around the breast and nipple that may lead to necrosis
– usually treated conservatively
3) Seroma formation- collection of fluid in the area operated on, likely to necessitate drainage within the clinic setting
4) Hypertrophic or keloid scarring
6) Opening of the suture lines
7) Hard lump formation within the fat tissue of the breast
8) Necessity for an additional surgery for repair or improvement
9) Temporary or permanent loss of sensation around the breast and nipple
10) Disruption in the ability to breast-feed.
After breast reduction surgery, one must continue to follow the accepted protocols regarding periodic breast examinations in order to diagnose any early signs of breast cancer (self-examinations, breast surgeon examinations, ultrasound and mammography imaging).
Please take the time to look at “Before and After” pictures.