| Dr. Mary Kim 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 or reduction mammaplasty and who is it for?
A. Women with very large, pendulous breasts may experience a variety of medical problems caused by the excessive weight-from back and neck pain and skin irritation to skeletal deformities and breathing problems. Bra straps may leave indentations in their shoulders. And unusually large breasts can make a woman-or a teenage girl-feel extremely self-conscious.
Breast reduction, technically known as reduction mammaplasty, is designed for such women. The procedure removes fat, glandular tissue, and skin from the breasts, making them smaller, lighter, and firmer. It can also reduce the size of the areola, the darker skin surrounding the nipple. The goal is to give the woman smaller, better-shaped breasts in proportion with the rest of her body. Breast reduction is usually performed for physical relief rather than simply cosmetic improvement. Most women who have the surgery are troubled by very large, sagging breasts that restrict their activities and cause them physical discomfort.
In most cases, breast reduction isn't performed until a woman's breasts are fully developed; however, it can be done earlier if large breasts are causing serious physical discomfort. The best candidates are those who are mature enough to fully understand the procedure and have realistic expectations about the results.
Things to consider.
Breast reduction is not recommended for women who intend to breast-feed. In addition, you should be in general good health and close to your ideal body weight as possible given your height. There are strict criteria that need to be adhered to with regard to insurance approval of the procedure.
Q. What does the surgery involve?
A. Breast reduction is performed under general anesthesia.
Techniques for breast reduction vary, but the most common procedure involves an anchor-shaped incision that circles the areola, extends downward, and follows the natural curve of the crease beneath the breast. The excess breast tissue and skin are removed and the nipple and areola are placed into their new position. The skin from both sides of the breast are brought down and around the areola, shaping the new contour of the breast. Liposuction may be used to remove excess fat from the armpit area.
In most cases, the nipples remain attached to their blood vessels and nerves. However, if the breasts are very large or pendulous, the nipples and areolas may have to be completely removed and grafted into a higher position. (This will result in a loss of sensation in the nipple and areolar tissue.)
Stitches are usually located around the areola, in a vertical line extending downward, and along the lower crease of the breast. In some cases, techniques can be used that eliminate the horizontal part of the scar. And occasionally, when only fat needs to be removed, liposuction alone can be used to reduce breast size, leaving minimal scars.
Q. What do I expect after surgery?
A. You will be sore and swollen during the recovery which will be treated with medication. You will be required to wear a surgibra or a sportsbra for a few weeks and also limit your arm movements during the healing phase. Most patients feel close to normal after 10-14 days. Although regular activities like walking and paperwork or cooking can be done in a 2 weeks time, you must avoid strenuous exercise, lifting, or straining for a few weeks. You should get a mammogram approximately one year after surgery for baseline.
Q. What are some of the potential risks?
A. As with any surgery, there is always a possibility of complications, including bleeding, infection, or reaction to the anesthesia. You can reduce your risks by closely following your instructions both before and after surgery.
Q. What are the benefits and risks involved of breast reduction surgery? And what type of scarring should I expect?
A. Breast reduction surgery provides improved contour, shape, and of course, size of your breasts, however, you are trading the scars to achieve that goal. Scars need time to mature and fade. The location of the scars are designed to be in discreet areas so as to be well-hidden under your bra or bathing suit. Smokers and those with conditions that impede wound healing may have a higher chance of developing healing problems or widened scars. Other potential risks include seroma, hematoma, asymmetry, nipple sensory changes, inability to breastfeed. Rarely, some patients with extremely heavy breasts may experience nipple loss which will then subsequently have to be reconstructed with skin graft.
Q. How much does breast reduction cost?
A. You will require preapproval from your insurance plan and it varies from plan to plan whether it is covered. In addition, there are strict weight requirements of the amount of breast tissue removed during the reduction. If the weight requirement can not be met, the surgery is a cosmetic procedure and becomes an out of pocket expense for the patient.
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