Breast Reduction

Breast Reduction (Reduction Mammaplasty)

Breast reduction surgery is a commonly performed plastic surgery procedure. The rewards and benefits are dramatic. The surgery involves physical removal of the excess weight from overly large breasts. This can relieve symptoms of back pain, neck pain, shoulder pain, and bra strap shoulder grooving. A woman’s appearance is improved by creating a more balanced, normally proportioned body shape. However, even more dramatic is the improvement of self-image and self-esteem in women who have been embarrassed and self-conscious because of abnormally large breasts.

The Patient

Candidates for reduction mammaplasty include: women who have poor self-images and self–esteem as a result of overly large breasts; women who suffer from neck pain, back pain, and shoulder bra strap grooving as a result of the excess weight of their breasts; and women who are not able to find clothing that fits properly because of their disproportionate body shape.

Most insurance policies cover breast reduction surgery when a sufficient amount of tissue is removed to justify the diagnosis of physical impairment from excess breast tissue weight. Women who have had breast reduction surgery are consistently pleased with their results. Breast reduction surgery creates a smaller, more proportionate breast. It also provides an uplifted breast, with a more normal size of nipple areola area. This area is markedly larger in abnormally large breasts.

The Surgical Procedure

There are numerous variations in the techniques used by plastic surgeons for breast reduction. They all incorporate the principle of removal of excess breast tissue and excess skin to create a smaller, well-proportioned breast mound. Individualized techniques are further modified to accommodate individual conditions of skin tone, size, and degree of sagging in the breasts. In some cases, the ability to breast feed may be preserved; in other instances this function may be lost. Occasionally, it is advisable to completely remove the nipple and areola and replace it as a graft upon the newly created breast mound.

Most surgical procedures produce an incision line around the nipple areola area and an incision running down from the areola to the breast fold and a line along the breast fold. Some techniques produce an incision around the areola and a line from the side of the areola running laterally and downward.

Breast reduction surgery is usually done under general anesthesia and takes from three to four hours to perform. Drains are frequently placed in the breasts at the discretion of the surgeon and are usually removed one to three days after surgery. The patient remains in the hospital one to three days following surgery, although some reduction operations are done as out-patient procedures.

Considerations

The surgical complications of bleeding, hematoma formation, and infection are potential risks in breast reduction surgery. The most frequent problems involve circulation to some areas of the skin or nipple areola areas of the breasts. This may lead to delayed healing or crusting, loss of normal skin coloration after healing, or even loss of skin in some areas. Smoking may contribute to this problem in some cases. There may also be a loss of circulation to some areas of fatty breast tissue within the breast causing prolonged drainage after surgery. Lumpiness of varying degrees may occur in the breast mounds for some time after surgery.

Sensation to the skin and nipple areola areas may be lost to varying degrees following surgery. Some areas of the incision line may become raised and thickened as hypertrophic scaring occurs in some patients. Breasts are not usually symmetrical before surgery and they will not be symmetrical following surgery, however, they are closer in size following surgery. It usually takes about four months from the time of surgery for the breasts to soften and assume their final shape. Pain following reduction mammaplasty surgery is variable but most patients are fairly comfortable after a few days.

Results

The reduction mammaplasty operation is one of the most rewarding surgeries plastic surgeons perform. Patients frequently comment that they only regret waiting so long for the surgery. Often, friends comment that the patient looks thinner, healthier, or “have you changed your hairstyle or lost weight?”