For many women, the size, shape, and contour of their breasts do not fit their self-image. Women with unusually large, sagging, or uneven breasts are dissatisfied with their physical appearance. Some experience pain and discomfort due to the weight of their breasts and the pressure of bra straps on their shoulders and neck.
Excessively large breasts can affect posture, limit physical activity and exercise, and make it difficult to find properly fitting clothes. Ungainly stares and rude comments may further promote a feeling of self-consciousness, limiting confidence and adding psychological strain to the physical symptoms.
Many plastic offer breast reduction or reduction mammaplasty to reduce and lift overly large and sagging breasts to a more comfortable size and shape. Breast reduction surgery improves body contour, reduces pain, and increases comfort in daily activities and exercise.
Breast reduction is generally performed on women who have fully developed breasts, but occasionally, it is necessary in teenage girls who suffer from the physical and psychological symptoms of overly large breasts. Patient satisfaction with breast reduction is exceedingly high, and a great majority of women who have had this procedure wish they had had the procedure earlier.
An ideal breast reduction candidate is uncomfortable with their large and/or asymmetric breasts. Patients must also be free of medical conditions such as heart disease, hypertension, diabetes, skin/connective tissue disorders, etc. If pregnancy is planned for the "near" future, it is best to wait until well after breast-feeding is complete.
Breast Reduction - The Consultation
During an initial consultation with a plastic surgeon, you will review numerous before and after photos from previous breast reduction procedures. The procedure is explained in complete detail, and treatment variations are discussed to meet your particular needs. Your surgeon may also use this consultation to get to know his patients on a personal level, developing a level of patient-surgeon trust that he feels is necessary for a comfortable surgical process.
The breasts are examined to ensure that expectations can be met, as well as to review the surgical plans and the incision/scar placement. Every patient has different expectations, and your surgeon will formulate a procedure plan to meet your individual needs. The doctor and their staff are always available to answer questions concerning breast reductions.
Following breast reduction surgery, patients report mild to moderate discomfort, which is easily controlled with medication. Varying degrees of swelling, bruising, and firmness subside in several weeks to months. The periareolar-vertical and periareolar breast reduction techniques often result in varying degrees of "pleats" or folds around the incisions, which will resolve in weeks to months.
Sutures (stitches) are removed after seven days. Patients can often return to work after several days to one week. Light exercise may begin after four to six weeks. A support bra is worn for two to three months following the surgery and is encouraged as much as possible thereafter to maintain contour.
Recovery and healing will vary depending on the extent of the surgery. Complete healing takes time and patience, taking up to one year or longer. It can take this amount of time for scars to soften, lighten and fade and for the breast tissue to soften, relax and remodel itself.
As swelling subsides and the effects of gravity and tissue relaxation act on the newly tightened skin envelope, the breasts will the breasts will get slightly smaller and descend to a certain extent as swelling subsides and the effects of gravity and tissue relaxation act on the newly tightened skin envelope, the breasts will shrink slightly and descend to a certain extent.
Most patients find this beneficial because the breasts look more natural. The ability to breast-feed after breast reduction is usually preserved, but cannot be guaranteed.
As with most cosmetic surgical procedures, complications following breast reduction are unlikely when the procedure is performed by a skilled and competent surgeon. Complications include, but are not limited to, anesthesia risks, bleeding, infection, tissue loss, delayed wound healing with obvious wide and/or raised scars, numbness, altered nipple sensation, asymmetry in breasts and/or areolas, enlarged areolas, and need for revisional surgery.
Also, rare but possible are blood clots or emboli (blood clots which dislodge and travel in the blood stream to distant sites) which can be fatal.
Venodyne calf compression devices are often used for every breast reduction surgery (as well as other surgeries). Venodynes are pressure cuffs that fit over each lower leg from the ankle to the knee circulating every one to two minutes to reduce the pooling of blood in the lower extremities and further reduce the possibility of blood clots or emboli.
Also, smokers must stop smoking well in advance of surgery. Smoking seriously decreases blood circulation in the skin, which increases the risks of complications and poor healing.
Breastfeeding With Large Breasts
For women who are physically healthy as well as realistic in their goals, breast augmentation can provide an effective cosmetic enhancement. Breast implants are filled with either saline or silicone. Because of the current restrictions established for silicone implants by the Federal Drug Administration, surgeons are using silicone implants only for women who are participating in controlled studies.
Recent studies from major national and foreign institutions demonstrate no association between auto-immune disease or breast cancer and silicone breast implants. Further studies in progress will provide us with more information on this subject. During your consultation, your surgeon will review all of the medical issues associated with the breast augmentation procedure with you. Many surgeons are currently using saline implants with great success.
There are three possible locations for the incision: under the breast, around or within the areola, which is the pigmented tissue surrounding the nipple, or within the armpit. The implants are placed either under the breast tissue or under the pectoralis major muscle and breast tissue. Incision sites and implant placement depends on a variety of factors, one of which is patient preference.
Surgery is performed with the patient fully asleep under general anesthesia. The procedure itself takes approximately two hours to perform. Sutures are removed in one week. Regular exercise may be resumed after four weeks.
Some patients, however, require neither a breast augmentation nor reduction. They have lost the elasticity of the skin of the breast either after pregnancy or weight loss. For these patients, a breast lift procedure can be a great option to restore size and firmness.
A breast lift, also referred to as mastopexy, is an operation to remove excess skin that has been stretched during pregnancy or weight fluctuation. The amount of skin removed is related to the degree of drooping of the breasts. Breast implants may by used at the same time when the breasts have lost substance due to pregnancy.
Although there is some scarring with this procedure, women are pleased with the restructured shape and size of their breasts as well as with the way they appear in clothing and swimwear. The patient undergoes general anesthesia for the surgery, which itself lasts three to four hours.
Breast reduction serves various purposes for different people. Enlarged, pendulous breasts cause a variety of problems. The medical term for this problem is mammary hyperplasia. The weight of the breasts pulls down on the bra straps which in turn produces indentation of the shoulder skin and discomfort. Along with shoulder and back pain, the surface under the breast may rub against the chest skin producing an irritating rash. Some women even experience difficulty with breathing because of enlarged breasts. Upon the removal of glandular tissue, fat and skin, a lighter, more attractive breast can be created. The lessened pressure on the chest alleviates overall discomfort and improves respiration.
The surgery is performed under general anesthesia. The operation takes about three to four hours to perform. Sutures are removed within one week.
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