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Breast Reduction

Large breasts can cause problems in many aspects of a woman’s life. When they are larger than the usual standards of attractiveness in our society, the breasts are considered aesthetically displeasing.

A full-breasted woman may appear heavier than she really is and she may have difficulty obtaining stylish clothing. In some cases, it may even be difficult to find a properly fitting bra. Often, women with large breasts feel very self-conscious. Teenagers may not develop proper poise and posture as they try to hide the fullness of their breasts, a subject they are unlikely to discuss freely with their parents.

The actual weight and bulk of the breasts may cause physical problems and symptoms that compound the feeling of unattractiveness. There can be a feeling of uncomfortable fullness, neck or back pain, and shoulder grooving. These symptoms may contribute to limited performance in certain occupations and in sports.

Finally, large breasts can also be difficult to assess for lumps or masses, thus making cancer detection much more difficult for the patient or for her physician. This may well be a source of further anxiety in a patient who is already embarrassed about her condition. Because of these medical problems, in many cases, medical insurance may cover some of the cost of breast reduction.

The goal of breast reduction surgery is to reduce, recontour and reshape the breasts. The breasts are made smaller. The nipple areola complex is repositioned upward, and if indicated, reduced in size. Excess skin and breast tissue is removed from the lower and outer portions of the breast.

How is breast reduction surgery performed?

Incisions are made in the lower breast resulting in three scars: one around the nipple, which usually heals very nicely; a vertical incision from the nipple to beneath the breast, which remains visible; and finally, an incision in the fold beneath the breast. Breast tissue is sculpted using a combination of sharp dissection and occasional liposuction.

The nipple remains attached to the deeper breast tissue. The remaining breast is folded around the nipple and its attachments and the incisions are closed. Care is taken to close these incisions as carefully as possible. Nevertheless, patients must realize that resultant scarring is as much a factor of tissue response as it is surgical skill, and occasionally wide scars can form despite a nice overall breast shape.

Minimizing scars following breast reduction

With time, these scars do tend to blend into the normal skin, becoming less noticeable. Sometimes, we can perform a short scar breast reduction technique or vertical mammaplasty technique to limit the incisions used. We will determine if you are a candidate for this at your consultation.

Experience with highly developed and refined techniques of surgery coupled with improvements in the delivery of outpatient care now makes this operation well suited to the ambulatory surgical setting. The procedure generally takes two to three hours and is routinely done in our center.

Although it takes some time for final healing and shaping of the breasts to occur, the initial recovery is typically well tolerated and easier than expected for most patients. There is some soreness after the operation and pain medicine is required, but patients are up and walking the day of surgery. Generally the patient may return to work five to eight days after surgery, although full activity or extremely vigorous exercise should not be undertaken for four to six weeks.

Use of breast implants after breast reduction

In some cases, patients chose to have some of the saggy breast tissue that has been removed replaced with breast implants. This operation helps to provide better fullness in the upper breast. While it may seem strange that a patient who is having surgery to remove breast volume would choose to consider an implant, the combination can work well in patients whose primary concern is sagging related to excess volume.

When considering this operation, patients should carefully read the information on breast augmentation as well as this information. Patients who have extremely large breasts or require reduction for improvement of symptoms such as pain related to their large breast are typically not good candidates for simultaneous placement of implants.

Risks of breast reduction surgery

There are possible complications that must be clearly understood and weighed prior to surgery. Wide scars and slow healing are the most common problems seen postoperatively. Other possible complications are asymmetry of the breasts, hematoma, infection, loss of nipple sensation and scarring or necrosis of the nipple.

Although pain is usually moderate, prolonged pain, soreness or numbness is possible. These risks will be discussed in detail during your consultation. It is important that the patient understand that minor revisions may be necessary after surgery in a significant number of cases.Breast reduction is an operation that is enjoying a rapid increase in popularity. For the proper patient, it is a very gratifying procedure. Not only can it help patients to improve self-esteem, it can be of significant benefit is the treatment of neck, back and shoulder pain related to large heavy breasts.

The vast majority of patients who have had breast reduction surgery will say they are extremely glad they had the procedure and would recommend it to friends and family with the same problem.

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