| Dr. Semlacher is a plastic surgeon certified by the Canadian Royal College Of Physicians & Surgeons and a member of The American Society of Plastic Surgery. Here the Doctor has answered some of the common questions bizymoms visitors have about Breast Reduction Surgery.
Q. What is Breast Reduction Surgery?
A. Also known as reduction mammaplasty, breast reduction surgery removes excess breast fat, glandular tissue and skin to achieve a breast size in proportion with your body and to alleviate the discomfort associated with overly large breasts.
Q. Who is a good candidate for a breast reduction?
A. Breast reduction surgery is a highly individualized procedure and you should do it for yourself, not to fulfill someone else’s desires or to try to fit any sort of ideal image.
Breast reduction is a good option for you if:
- You are physically healthy
- You have realistic expectations
- You don’t smoke
- You are bothered by the feeling that your breasts are too large
- Your breasts limit your physical activity
- You experience back, neck and shoulder pain caused by the weight of your breasts
- You have regular indentations from bra straps that support heavy, pendulous breasts
- You have skin irritation beneath the breast crease
- Your breasts hang low and have stretched skin
- Your nipples rest below the breast crease when your breasts are unsupported
- You have enlarged areolas caused by stretched skin
Q. What are the benefits of breast reduction surgery?
A. The results of breast reduction surgery will be long lasting. Your new breast size should help relieve you from the pain and physical limitations experienced prior to breast reduction.
Your better-proportioned figure will likely enhance your self-image and boost your self-confidence.
Q. What are the risks involved of breast reduction surgery?
A. The decision to have breast reduction surgery is extremely personal. You will have to decide if the benefits will achieve your goals and if the risks of breast reduction surgery and potential complications are acceptable.
Your plastic surgeon and/or plastic surgery staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks or potential complications.
The risks of breast reduction and breast reduction complications include:
- Unfavorable scarring
- Infection
- Changes in nipple or breast sensation, which may be temporary or permanent
- Anesthesia risks
- Bleeding (hematoma)
- Blood clots
- Poor wound healing
- Breast contour and shape irregularities
- Skin discoloration, permanent pigmentation changes, swelling and bruising
- Damage to deeper structures - such as nerves, blood vessels, muscles, and lungs - can occur and may be temporary or permanent
- Breast asymmetry
- Fluid accumulation
- Excessive firmness of the breast
- Potential inability to breastfeed
- Potential loss of skin/tissue of breast where incisions meet each other
- Potential partial or total loss of nipple and areola
- Deep vein thrombosis, cardiac and pulmonary complications
- Pain, which may persist
- Allergies to tape, suture materials and glues, blood products, topical preparations or injectable agents.
- Fatty tissue deep in the skin could die (fat necrosis)
- Possibility of revisional surgery
You should know that:
- Breast reduction surgery can interfere with certain diagnostic procedures
- Breast and nipple piercing can cause an infection
- Your ability to breastfeed following reduction mammaplasty may be limited; talk to your doctor if you are planning to nurse a baby
- The breast reduction procedure can be performed at any age, but is best done when your breasts are fully developed
- Changes in the breasts during pregnancy can alter the outcomes of previous breast reduction surgery, as can significant weight fluctuations
- The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single breast reduction procedure and another surgery may be necessary.
Be careful
Following your physician’s instructions is key to the success of your surgery. It is important that the surgical incisions are not subjected to excessive force, abrasion, or motion during the time of healing. Your doctor will give you specific instructions on how to care for yourself and minimize breast reduction surgery risks.
Q. What does breast reduction surgery involve?
A. Breast Reduction Procedural Steps
- Breast reduction surgery is usually performed through incisions on your breasts with surgical removal of the excess fat, glandular tissue and skin.
- In some cases, excess fat may be removed through liposuction in conjunction with the excision techniques described below. If breast size is largely due to fatty tissue and excess skin is not a factor, liposuction alone may be used in the procedure for breast reduction.
- The technique used to reduce the size of your breasts will be determined by your individual condition, breast composition, amount of reduction desired, your personal preferences and the surgeon’s advice.
Step 1 - Anesthesia
- Medications are administered for your comfort during breast reduction surgery. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.
Step 2 - The incision
Incision options include:
- A circular pattern around the areola
The incision lines that remain are visible and permanent scars, although usually well concealed beneath a swimsuit or bra.
- A keyhole or racquet-shaped pattern with an incision around the areola and vertically down to the breast crease
- An inverted T or anchor-shaped incision pattern
Step 3 - Removing tissue and repositioning
- After the incision is made, the nipple-which remains tethered to its original blood and nerve supply-is then repositioned. The areola is reduced by excising skin at the perimeter, if necessary.
- Underlying breast tissue is reduced, lifted and shaped. Occasionally, for extremely large pendulous breasts, the nipple and areola may need to be removed and transplanted to a higher position on the breast (free nipple graft).
Step 4 - Closing the incisions
- The incisions are brought together to reshape the now smaller breast. Sutures are layered deep within the breast tissue to create and support the newly shaped breasts; sutures, skin adhesives and/or surgical tape close the skin. Incision lines are permanent, but in most cases will fade and significantly improve over time.
Step 5 - See the results
- The results of your breast reduction surgery are immediately visible. Over time, post-surgical swelling will resolve and incision lines will fade. Satisfaction with your new image should continue to grow as you recover.
Q. What should one expect after breast reduction surgery?
A. Many patients have questions about recovery from breast surgery.
- When your breast reduction procedure is complete, dressings or bandages will be applied to the incisions. An elastic bandage or support bra may be worn to minimize swelling and support the breasts as they heal.
- A small, thin tube may be temporarily placed under the skin to drain any excess blood or fluid that may collect.
- You will be given specific instructions for breast reduction recovery that may include how to care for your breasts following breast reduction surgery, medications to apply or take orally to aid healing and reduce the risk of infection, specific concerns to look for at the surgical site or in your general health, and when to follow up with your plastic surgeon.
- Be sure to ask your plastic surgeon specific questions about what you can expect during your individual recovery period.
- Where will I be taken after my surgery is complete ·
- What medication will I be given or prescribed after surgery? ·
- Will I have dressings/bandages after surgery? When will they be removed?
- Are stitches removed? When?
- When can I resume normal activity and exercise?
- When do I return for follow-up care?
Q. How much does a breast reduction cost?
A. For many patients, the cost of breast reduction and other elective surgeries is a consideration. Breast reduction costs can vary widely. A surgeon’s cost for breast reduction may vary based on factors such as his or her level of experience and geographic office location.
Many plastic surgeons offer patient financing plans, so be sure to ask.
Cost may include:
- Surgeon’s fee
- Hospital or surgical facility costs
- Anesthesia fees
- Prescriptions for medication
- Post-surgery garments, and
- Medical tests
Breast reduction surgery is generally considered a reconstructive procedure and may be covered by health insurance when it is performed to relieve medical symptoms.
Many insurers determine whether to categorize breast reduction surgery as reconstructive surgery based on the amount of tissue that will be removed.
In any case, pre-certification is required for reimbursement or coverage. Insurance policies vary greatly. Carefully review your policy to determine coverage.
Your satisfaction involves more than a fee.
When choosing a plastic surgeon for breast reduction, remember that the surgeon’s experience and your comfort with him or her are just as important as the final breast reduction costs.
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