Breast Reduction Surgery

Breast reduction surgery, or in its other name reduction mammaplasty, is an operation performed to get rid of excess fat in breasts, glandular tissue, and skin to have a breast size in proportion to your body. Larger breasts than usual may also cause some problems both physically and mentally. This situation is called as macromastia. Patients suffering from macromastia usually experience discomfort due to the weight of their breasts such as neck and back pain and this makes it harder for them to perform their daily routines and restricts some physical activities.

Along with this kind of annoyance, patients may also experience mental distress leading to severe health problems such as depression. Another motivation for breast reduction surgery is to ease such discomforts associated with excessively large breasts and alleviate pains. Thanks to breast reduction surgery, one can improve her/his self-esteem and ability to participate in physical activities.

Even though breast reduction surgery is usually performed on patients having health-related problems due to macromastia, people who simply are not content with their breast size can undergo the operation for aesthetic reasons. As it is major and challenging surgery, if you are considering having the breast reduction surgery you must be aware of the potential complications, what the surgery entails, and recovery conditions. It is also important to choose a skilled plastic surgeon and set realistic expectations.

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Who Can Be Eligible For Breast Reduction Surgery?

The grounds for breast reduction surgery are to correct problems such as the chronic back, neck, and shoulder pain that requires pain medications, chronic rash or skin irritation under the breasts, nerve pain, restricted physical activity, poor self-image, and difficulty finding and fitting into the clothes. The operation is usually performed on women yet it is not meant for them. Any men discontent with their breasts` look can undergo the surgery.

However, both men and women must first meet some requirements to be eligible for breast reduction surgery. Breast reduction surgery generally is not recommended for you if you are very obese, have certain conditions such as diabetes or other heart-related problems, want to avoid scars on your breasts.

Before The Operation

The results, success, and safety of breast reduction surgery depend on the amount of candidness during the consultation with your surgeon before the operation. You will be asked several questions about your health and expectations. Your surgeon will ask you about your and your family’s medical history and overall health condition including whether you have had a lump removed from your breast or have any other medical conditions that may affect your breasts. It is important that you are a hundred percent open and honest with your doctor about your medical history and what do you expect by undergoing breast reduction surgery. You should discuss your desire for breast size, appearance after the surgery, and how your breasts affect you both mentally and physically.

Your surgeon may take pictures of your breasts, measure and examine them, and then decide how much breast tissue she/he needs to remove to meet your expectations. You will also be informed about the preparation, surgery, and recovery processes. You may get a mammogram and take a breast exam test before your breast reduction surgery. Your surgeon will give you a detailed description of the procedure and its risks and benefits, including likely scarring and possible loss of sensation.

You may also be asked about your habits such as whether you smoke and what medications you take. You will have to quit smoking for a period before and after the surgery to ensure proper and quicker healing. You also may have to stop taking certain medications, including aspirin or other anti-inflammatory drugs such as Motrin or Aleve and herbal supplements.

Your surgeon will give you instructions about all of them. The instructions given will also cover what you should do on the day of surgery, post-operative care, and follow-up plans. You will also be provided with information about where your breast reduction surgery will be performed.

Breast reduction surgery may be performed in an accredited office-based surgical center, outpatient/ambulatory surgical center, or a hospital. It is usually done under general anesthesia, either in a hospital or outpatient surgical facility. Your doctor will explain the type of anesthesia used during the surgery.

You need to to your surgeon about whether you will be going home or stay at the hospital after the surgery. If you are allowed to go home, you may need to ask someone to drive you home. When you arrive home, it may be better for you to have some things on hand such as plenty of ice, gauze and clean washcloths and towels, comfortable shirts, specific ointments or creams as recommended by your surgeon for the incision sites.

Apart from these, you may use the following questions as a guide to make sure you ask everything:

  • Do you have breast reduction before-and-after photos I can look at for this procedure? Which results are reasonable for me to expect?
  • What are my options if I am dissatisfied with the outcome?
  • Were you trained specifically in the field of plastic surgery?
  • How many years of plastic surgery training have you had?
  • Where and how will you perform my breast reduction procedure?
  • Do you have hospital privileges to perform this procedure? If so, at which hospitals?
  • Is the office-based surgical facility accredited by a nationally or state-recognized accrediting agency, or is it state-licensed or Medicare-certified?
  • Am I a good candidate for breast reduction?
  • What will be expected of me to get the best results from breast reduction surgery?
  • What surgical technique is recommended for me?
  • How long of a recovery period can I expect, and what kind of help will I need during my recovery?
  • What are the risks and complications associated with my breast reduction procedure?
  • How are breast reduction complications handled?
  • How will breast reduction affect my ability to breastfeed?
  • How can I expect my breasts to look over time? After pregnancy? After breastfeeding?

During The Operation

Whether you will have your breast reduction surgery in an outpatient facility or you may need to stay at the hospital at least one night may change depending on your case. Yet, in either situation will be given general anesthesia. That is to say, you will be sleeping throughout the operation. Breast reduction surgery generally lasts for 2 to 5 hours and in some cases, the duration may be longer. Your surgeon may make use of some different techniques according to the shape and size of your breasts, how much tissue needs to be removed and how do you want your breast to look after the surgery. The techniques that will be used by your surgeon may include liposuction to get rid of the excess fat in your breasts or simply a surgery through incisions.

Breast reduction surgery is usually performed through incisions on your breasts with surgical removal of the excess fat, glandular tissue, and skin. But in some cases, excess fat may need to be removed through liposuction technique. In this procedure, your surgeon will make small incisions in your skin and insert a thin tube connected to a vacuum that absorbs fat and fluids from your breast.

If breast size is larger than usual as a result of fatty tissue and excess skin has nothing to do with it, liposuction alone may be used for breast reduction. As stated before, the technique that will be used during the procedure to reduce the size of your breasts will be determined in line with your condition, breast composition, amount of reduction you desire, your personal preferences, and the surgeon’s advice.

Anesthesia

Anesthesia options are intravenous sedation and general anesthesia. Your specialist will examine and recommend the best one for you. These medications are administered to ensure your comfort throughout the breast reduction process. 

Making The Incisions

Your surgeon makes a circular pattern around the areola, a keyhole, or racquet-shaped pattern with an incision around the areola and vertically down to the breast crease or an inverted T or anchor-shaped incision pattern. Your surgeon will try to achieve symmetry between your breasts, but in some rare cases, variations in breast size and shape may occur. In such an occurrence, the size of the areola may also be reduced. Your incision scars might fade over time but will never completely disappear. Still, they can be well concealed beneath a swimsuit or bra.

Removal Of Breast Tissue

Once the incisions are made, your nipples will be repositioned. Underlying breast tissue will also be reduced, lifted, and shaped. For extremely sagging breasts, the nipple and areola may need to be removed and transplanted to a higher position on the breasts.

Closing The Incisions

The incisions are brought together and closed to reshape the smaller breast. Sutures are layered deep within the breast tissue to help support the newly shaped breasts; sutures, skin adhesives, and/or surgical tape close the skin.

After The Operation

After breast reduction surgery, your breasts will be covered with a gauze dressing or bandages and a tube will be placed under your arms to drain excess blood or fluid. You may be given some medications such as painkillers and antibiotics to refrain from any kind of infection. For the first couple of days after the operation, your breasts may be sensitive, swollen, and bruised.

You may be recommended to wear a surgical bra to protect and support your breasts. For at least a month, you will need to restrict some of your physical actives for your wounds to heal quickly. You should follow the post-operative guidelines to get the best results and visit your doctor to ensure that everything is okay.

What Are The Risks Or Complications Of Breast Reduction Surgery?

Before having the breast reduction surgery you will be informed about all the possible risks and complications and will be asked to sign a consent form for undergoing the surgery. Potential risks during or after the surgery may include adverse reaction to the anesthesia, bleeding (hematoma), infection, blood clots, bruising, poor wound healing, unfavorable scarring, removal of or loss of sensation in the nipples and skin surrounding the nipples, difficulty or inability to breast-feed, differences in the size, shape and symmetry of the surgically altered left and right breasts, which might lead to further surgery to improve your appearance, skin discoloration, permanent pigmentation changes, swelling and bruising, damage to deeper structures—such as nerves, blood vessels, muscles and lungs—(may be temporary or permanent), fluid accumulation, excessive firmness of the breast, loss of skin/tissue of breast where incisions meet each other, partial or total loss of nipple and areola, deep vein thrombosis, cardiac and pulmonary complications, persisting pain, allergies to tape, suture materials and glues, blood products, topical preparations or injectable agents, possibility of an additional surgery.