Breast Reduction Surgery
Breast reduction is a surgical procedure performed in order
to decrease the size of the breasts. Women with very large
breasts (macromastia or mammary hyperplasia) seek breast
reduction for relief of pain in the back, shoulder, and
neck. They may also feel uncomfortable about their breast
size and have difficulty finding clothing that will fit
properly. Additionally, breast reduction may be needed after
reconstructive surgery following the surgical removal of
cancerous breast tissue (mastectomy), to make the breasts
more symmetric. Men who have enlarged breasts (gynecomastia)
may also be candidates for breast reduction. However, excessive
alcohol intake, smoking marijuana, or using anabolic steroids
may cause gynecomastia, and surgery is not recommended for
men who continue to use these products.
The patient with very large breasts may suffer from a variety
of symptoms. The weight of the breast tissue itself would
cause problems; but the woman with large breasts finds that
the position of this weight causes back strain and discomfort.
The bra ultimately becomes an instrument of pain as the
bra straps cut into the shoulders. The pull of gravity is
now transferred to the shoulders and neck muscle resulting
in more pain and muscle spasm. It is not uncommon in the
most severe cases to see permanent grooves in the shoulders
where the bra straps have exerted their pull. Some patients
may even have scars in this area. Even with the best of
bra support there may be some overlap and contact between
the breast skin and the lower chest wall skin. Especially
in the warmer climates this can create a chronic skin irritation
called intertriginous dermatitis.
Patients have often been quite self conscious about their
breast size and may have suffered from a variety of unwanted
attention . This type of suffering is difficult to quantify
but it is present to some degree in many patients with enlarged
breasts. Breast size often interferes with the woman's ability
to exercise. There is often direct interference with arm
motion in certain sports, and there is the pain many of
these women experience during jogging or running inspite
of the support of the best bras available. This degree of
breast hypertrophy(enlargement) may occur from shortly after
the onset of puberty till old age. The operation of reduction
mammaplasty is carried out to relieve the patient's symptoms
and should not be confused with the so called "breast lift"
or mastopexy procedure which is done for cosmetic purposes.
The majority of insurance policies will cover medically
indicated breast reduction but the mastopexy procedure is
not covered since its purpose is cosmetic.
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. Breast reduction is not
recommended for women who intend to breast-feed.
Breast reduction may also be called reduction mammaplasty.
It is most often done in the hospital, under general anesthetic.
However, studies have suggested that an outpatient procedure,
using local anesthetic and mild sedation may be appropriate
for some patients. The operation takes approximately two
to four hours. The most commonly made incision encircles
the areola (darkened area around the nipple) and extends
downward and around the underside of the breast. This produces
the least conspicuous scar. The excess tissue, fat, and
skin are removed, and the nipple and areola are repositioned.
In certain cases, liposuction (fat suctioning) is used to
remove extra fat from the armpit area. A hospital stay of
up to three days may be needed for recovery.
Before the surgery begins, your doctor will measure and
mark on your breasts. Breast reduction surgery usually is
performed under general anesthesia, which means that you
won't be conscious during the procedure. Surgery generally
lasts about three hours. Surgeons use different techniques,
but the most common one involves an anchor-shaped incision
that goes around the areola, down the breast toward the
crease between the breast and abdomen, and then horizontally
in the crease under the breast. The surgeon removes excess
fat, breast tissue and skin to reduce the size of your breast.
In most cases, the nipple and areola remain attached to
the breast. If the breasts are very large and droopy, however,
the surgeon may have to remove the nipple and areola and
reattach them at a higher position. In this case, detaching
the nipple and areola from their blood vessels and nerves
causes them to permanently lose sensation and can result
in the inability to breast-feed. After the surgery, an elastic
bandage or special supportive bra is placed over gauze bandages
and drainage tubes. The bandages and tubes are removed in
a day or two. The bra will need to be worn around the clock
for several weeks. Stitches are removed one to three weeks
after the operation. Normal activities, including sexual
relations may be restricted for several weeks. Scars will
typically remain red, and perhaps lumpy for up to several
months, but will gradually fade and become less noticeable.
It may take up to a year before the breasts achieve their
final position and size.
Breast reduction is a surgical procedure performed in order
to decrease the size of the breasts. Women with very large
breasts (macromastia or mammary hyperplasia) seek breast
reduction for relief of pain in the back, shoulder, and
neck. They may also feel uncomfortable about their breast
size and have difficulty finding clothing that will fit
properly. Additionally, breast reduction may be needed after
reconstructive surgery following the surgical removal of
cancerous breast tissue (mastectomy), to make the breasts
more symmetric. Men who have enlarged breasts (gynecomastia)
may also be candidates for breast reduction. However, excessive
alcohol intake, smoking marijuana, or using anabolic steroids
may cause gynecomastia, and surgery is not recommended for
men who continue to use these products.
The patient with very large breasts may suffer from a variety
of symptoms . The weight of the breast tissue itself would
cause problems; but the woman with large breasts finds that
the position of this weight causes back strain and discomfort.
The bra ultimately becomes an instrument of pain as the
bra straps cut into the shoulders. The pull of gravity is
now transferred to the shoulders and neck muscle resulting
in more pain and muscle spasm. It is not uncommon in the
most severe cases to see permanent grooves in the shoulders
where the bra straps have exerted their pull. Some patients
may even have scars in this area. Even with the best of
bra support there may be some overlap and contact between
the breast skin and the lower chest wall skin. Especially
in the warmer climates this can create a chronic skin irritation
called intertriginous dermatitis.
Patients have often been quite self conscious about their
breast size and may have suffered from a variety of unwanted
attention . This type of suffering is difficult to quantify
but it is present to some degree in many patients with enlarged
breasts. Breast size often interferes with the woman's ability
to exercise. There is often direct interference with arm
motion in certain sports, and there is the pain many of
these women experience during jogging or running inspite
of the support of the best bras available. This degree of
breast hypertrophy(enlargement) may occur from shortly after
the onset of puberty till old age. The operation of reduction
mammaplasty is carried out to relieve the patient's symptoms
and should not be confused with the so called "breast lift"
or mastopexy procedure which is done for cosmetic purposes.
The majority of insurance policies will cover medically
indicated breast reduction but the mastopexy procedure is
not covered since its purpose is cosmetic.
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. Breast reduction is not
recommended for women who intend to breast-feed.
Breast reduction may also be called reduction mammaplasty.
It is most often done in the hospital, under general anesthetic.
However, studies have suggested that an outpatient procedure,
using local anesthetic and mild sedation may be appropriate
for some patients. The operation takes approximately two
to four hours. The most commonly made incision encircles
the areola (darkened area around the nipple) and extends
downward and around the underside of the breast. This produces
the least conspicuous scar. The excess tissue, fat, and
skin are removed, and the nipple and areola are repositioned.
In certain cases, liposuction (fat suctioning) is used to
remove extra fat from the armpit area. A hospital stay of
up to three days may be needed for recovery.
Before the surgery begins, your doctor will measure and
mark on your breasts. Breast reduction surgery usually is
performed under general anesthesia, which means that you
won't be conscious during the procedure. Surgery generally
lasts about three hours. Surgeons use different techniques,
but the most common one involves an anchor-shaped incision
that goes around the areola, down the breast toward the
crease between the breast and abdomen, and then horizontally
in the crease under the breast. The surgeon removes excess
fat, breast tissue and skin to reduce the size of your breast.
In most cases, the nipple and areola remain attached to
the breast. If the breasts are very large and droopy, however,
the surgeon may have to remove the nipple and areola and
reattach them at a higher position. In this case, detaching
the nipple and areola from their blood vessels and nerves
causes them to permanently lose sensation and can result
in the inability to breast-feed.
After the surgery, an elastic bandage or special supportive
bra is placed over gauze bandages and drainage tubes. The
bandages and tubes are removed in a day or two. The bra
will need to be worn around the clock for several weeks.
Stitches are removed one to three weeks after the operation.
Normal activities, including sexual relations may be restricted
for several weeks. Scars will typically remain red, and
perhaps lumpy for up to several months, but will gradually
fade and become less noticeable. It may take up to a year
before the breasts achieve their final position and size.
