Women with very large, pendulous breasts may experience a variety of medical problems caused by the excessive weight of the breasts – from back and neck pain and skin irritation to skeletal deformities and breathing problems. Bra straps may leave indentations in their shoulders. Unusually large breasts can also make a woman – expecially a teenage girl – feel extremely self-conscious.
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Breast reduction, technically known as reduction mammoplasty, 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 that are proportionate to the rest of her body.
If you’re considering breast reduction, this will give you a basic understanding of the procedure–when it can help, how it’s performed, and what results you can expect. It can’t answer all of your questions, since a lot depends on your individual circumstances. Please be sure to ask your doctor if there is anything about the procedure you don’t understand.
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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 is not a simple operation, but it’s normally safe when performed by a qualified plastic surgeon. Nevertheless, as with any surgery, there is always a possibility of complications, including bleeding, infection, or reaction to the anesthesia. Some patients develop small sores around their nipples after surgery; these can be treated with antibiotic creams. You can reduce your risks by closely following your physician’s advice both before and after surgery.
The procedure does leave noticeable, permanent scars, although they’ll be covered by your bra or bathing suit. (Poor healing and wider scars are more common in smokers.) The procedure can also leave you with slightly mismatched breasts or unevenly positioned nipples. Future breast-feeding may not be possible since the surgery removes many of the milk ducts leading to the nipples.
Some patients may experience a permanent loss of feeling in their nipples or breasts. Rarely, the nipple and areola may lose their blood supply and the tissue will die. (The nipple and areola can usually be rebuilt, however, using skin grafts from elsewhere on the body.)
In your initial consultation, it’s important to discuss your expectations frankly with your surgeon, and to listen to his or her opinion. Every patient–and every physician, as well–has a different view of what represents a desirable size and shape for breasts.
The surgeon will examine and measure your breasts, and will probably photograph them for reference during and after surgery. (The photographs may also be used in the processing of your insurance coverage.) He will discuss the variables that may affect the procedure-such as your age, the size and shape of your breasts, and the condition of your skin. You should also discuss where the nipple and areola will be positioned. They’ll be moved higher during the procedure and should be approximately even with the crease beneath your breasts.
Your surgeon will describe the procedure in detail, explaining its risks and limitations and making sure you understand the scarring that will result. He will also explain the anesthesia that will be used, the facility where the surgery will be performed, and the costs. (Some insurance companies will pay for breast reduction if it’s medically necessary; however, they may require that a certain amount of breast tissue be removed. Check your policy, and have your surgeon write a predetermination letter if required.)
Your surgeon may require you to have a mammogram (breast x-ray) before surgery. You’ll also get specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications. Some surgeons suggest that their patients diet before the operation.
Breast reduction doesn’t usually require a blood transfusion. However, if a large amount of breast tissue will be removed, your physician may advise you to have a unit of blood drawn ahead of time. That way, if a transfusion should be needed, your own blood can be used.
While you’re making preparations, be sure to arrange for someone to drive you home after your surgery and to help you out for a few days if needed.
Breast reduction surgery may be performed in a hospital, an outpatient surgery center, or an office-based surgical suite. If you are admitted to the hospital, your stay will be a short one. The surgery itself usually takes two to four hours, but may take longer in some cases.
Breast reduction is nearly always performed under general anesthesia. You’ll be asleep through the entire operation.