| Dr. Boris Volshteynas is a plastic surgeon certified by the American Board of Plastic Surgery. Here the Doctor has answered some of the common questions Bizymoms visitors have about Breast Reduction.
Q. What is breast reduction surgery?
A. Breast reduction surgery is a surgical procedure designed to reduce the size of the breasts. In men it is also known as chest reduction, or gynecomastia surgery.
Q. Who is a good candidate for a breast reduction?
A. Most patients who come in desiring breast reduction surgery, complaint of back pain, neck pain, shoulder pain, shoulder grooving, skin irritations and infections underneath the breasts, decreased level of energy, need to support the breasts with forearms, need to support the breast by wearing several pairs of bras. A good candidate for female breast reduction surgery is a person who’s breast size is out of proportion to the body size.
There are several formulas used by insurance companies to determine the specific requirements. Most insurance companies require removal of at least 500 g per side to consider the surgery reconstructive. For patients who are above the ideal weight, they may require more weight to be removed for medical justification. However, the later studies demonstrated that the removal of 250 g or more can result in significant improvement of the patient’s symptoms. The patient is to be realistic about expectations and be ready to accept surgical scars.
Q. What are the benefits of breast reduction surgery?
A. The benefits of breast reduction surgery include smaller breasts, less pain, less pulling on the shoulders, decreased risk of breast cancer, improved breast shape, increased level of overall energy.
Q. What are the risks involved of breast reduction surgery?
A. Breast reduction surgery is a surgical procedure. As such, it carries the same risks associated with other surgical procedures, like infection, bleeding, scarring, lumpiness, bumpiness, irregularity, postoperative discomfort, chronic pains, changes in sensitivity of the nipple, loss of sensitivity of the nipple, possibility of losing the blood supply of the nipple and need for nipple reconstruction.
On a practical level, breast reduction surgery is "the happiest surgery "that we perform. The reason is that the patient experiences significant improvement in energy, decrease in back and neck pain and overall demonstrates positive impact on the patient’s lifestyle.
At the same time this is a surgery where most dis-satisfaction can come from surgical scars. In essence, it is a trade-off between heavy, painful breasts and having scars on the breasts after the surgery. In vast majority of people, the scars heal very well, however, as plastic surgeons, we have a limited degree of control over how the patient’s would eventually heal.
Q. What should one expect after breast reduction surgery?
A. In most cases, there is not much pain associated with the surgery. The patients may feel weak or less energetic for the first several days after the surgery. Depending on complexity of surgery and amount of weight removed, the surgery can be performed on outpatient basis or may require overnight stay at a hospital. In some cases surgical drains may need to be placed after the surgery. The determination of whether the drains need to be placed or not, depends on a surgeon, technique used, amount of tissue removed, amount of postoperative bleeding encountered. Usually, the energy returns within a week or 2. Overall, the patient feels much better by the end of the first week. They also noticed significant increase in overall energy level and decreased and neck or back pain within days after surgery. Some patients will require exercises for posture modification.
Q. How much does a breast reduction cost?
A. In most cases the surgery is covered by medical insurance. If the surgery is performed on the cosmetic basis, the costs can vary from $5000 to $10,000 or more depending on where the surgery is performed.
Q. What type of scarring should I expect?
A. Scarring is one of the main concerns associated with breast reduction surgery. There several techniques for breast reduction surgery.
The least invasive technique is also known as scarless breast reduction surgery. It involves liposculpture of the breasts. The scarring is minimal and involves 2 incisions, each 4 mm to 5 mm long underneath the breasts or in the armpit. However, this technique does not allow any reshaping of the breasts. It is better reserved for younger patients or patients with strong history of keloids.
Traditional technique involves the incisions around the nipple and areola, continuing down underneath the breast and then continuing underneath the breast fold. The overall shape of the incision is an anchor. Therefore, breast reduction scar is known as anchor scar. In most cases, the patient’s heal the scars very well and they’re barely visible. However, in some patients the scars can become wider and much more noticeable. Most surgeons use special sutures to decrease the scarring, or use tissue glue, however, there is no way to absolutely prevent widening of the scars.
For the patients who are suffering from severe neck and back pain, even if the scars are less than perfect, it is still very welcome change to their lifestyle. Most patients feel that even with wider less than perfect scarring, they would do the surgery again knowing the degree of improvement of back pain and neck pain symptoms.
Q. How to contact Dr. Volshteyn if we have further questions?
A. Dr. Volshteyn can be reached at his office, at Sierra Plastic Surgery, at 775-284-0911.
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