What is achieved with a breast reduction?
By reducing the breast volume, a more normal breast size is achieved A 38DDD may be reduced one or two cup sizes. Clothing options are increased and dresses fit more often with correct hip/breast proportions.
What problems are corrected with a breast reduction?
Back and neck pain are some of the symptoms commonly improved. Grooving of the shoulders due to bra straps, rashes under the breast in warm weather, difficulty getting clothing to fit and restricted physical activity may all be alleviated. Some women are able to sleep on their back for the first time in years by having the oppressive weight off their chest. Occasionally, intrinsic pain in the breast is reduced with less breast weight. Poor waistline definition is improved by lifting the breasts back up to a more normal position. Better upper body mechanics are achieved by keeping the breast tissue closer to the body’s center of gravity. This reduces fatigue and improves exercise tolerance.
(Click photo to enlarge.)
How is breast reduction surgery performed?
All breast reductions are done under general anesthesia. Many women go home the same day of surgery. Some stay over one night in the hospital under 23 hour observation without a full hospital admission. Most sutures used are dissolvable. Most women have their nipple areolar complex left attached but just elevated. With very large reductions, the nipple may require grafting to a much higher position than would be safe using a pedicle technique. A free nipple graft is kept under a special dressing for one week. Otherwise with the most common approach, the pedicle technique, the nipple can be checked any time. The breast tissue is removed as well as the excess skin to provide the optimal fit for the new beast volume. In large breasts, the nipple areolar complex diameter may be 10 centimeters (4 inches). A reduction to a more normal 4 to 4.5 centimeters keeps the final result in proportion. All tissue removed is sent for routine pathology examination. Blood transfusions are not used. Crossing and typing for blood transfusions is not required nor do you have to donate blood.
What is required pre-operatively?
Dr. Hobbs will see you for a consultation and discussion of any questions. Our staff will provide you with some written instructions, lab work, requisitions, and prescriptions. Our staff will also coordinate the optimal surgical date that works best for you and do the paper work for insurance covered procedures.
If you are considering weight reduction, it is best done before surgery since loose skin which develops may be removed at the time of surgery. Smoking definitely increases the risk of complications, so it is best to eliminate this three months before surgery.
Mammograms pre-operatively are recommended for women over 35 years of age. A follow up mammogram is recommended one year after a breast reduction. This will document any internal changes since the base line internal image of the breast will now be different. It is a useful comparison to have five to ten years later if needed.
Many herbs and prescription drugs can adversely affect any surgery. Here is a list of supplements and drugs that should not be taken for at least three weeks before surgery.
What about scars after breast reduction surgery?
The quality of scars depends on age and individual skin types. Younger women, between the ages of 17-25 years, tend to have thicker and sometimes more raised scars that take longer to fade and flatten. People with very thin skin may have wider scars than those with thicker skin. All of the scars are confined to the area covered by the bra. Premature tight or underwire bras in the first few weeks may cause irritation and less favorable scares. Non-surgical treatment options are available for problem scars if needed. Most women do not need these options. No one wants a scar bur even plastic surgery generates some scaring. While any scar may be considered a negative feature, most women consider the positive benefits of breast reduction to far exceed any scar concerns.
What is the recovery time?
Approximately one hour after surgery women either go home or to a 23 hour observation unit in the hospital. At home, help is needed with heavy work for four to six weeks. Showers start within seven days or less depending on the case. Light office type work outside the home may be resumed in two to three weeks. Heavy lifting type jobs require six weeks off. The incision will take several months for normal color to return and pinkness to resolve. Most women can sleep on their sides at three to four weeks and on their stomach by six weeks. The first few weeks are best sleeping on their back. Buying new, proper fitting clothing, especially bras, is best done at six weeks. Relief of back pain and neck pain is usually noted within the first week.
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