What is Breast Reduction?
Breast reduction, also referred to as reduction mammoplasty, is a surgical procedure in which excess fat, tissue, and skin are removed from the breasts. The surgery is normally sought by women who wish to accomplish an aesthetically pleasing breast contour and size proportionate to their body, and to mitigate the discomfort associated with unusually large breasts (macromastia). Men with gynecomastia (enlarged male breast tissue) may also receive breast reduction surgery.
Indications for Breast Reduction
Breast reduction surgery is indicated for women with abnormally large breasts and the issues related to it, such as the following:
- Persistent neck, shoulder, and back pain requiring medication
- Persistent rash or skin irritation below the breasts
- Activity restrictions
- Nerve pain
- Trouble fitting into clothing, swimsuits, and bras
- Poor self-esteem due to large breasts
Who is Not a Good Candidate for Breast Reduction?
You are not a good candidate for breast reduction surgery if you are in the following categories:
- You are a smoker
- You are extremely obese
- You suffer from heart problems or diabetes
- You do not want scars visible on the breasts
In general, preparation for breast reduction includes the following:
- A thorough examination by your doctor to check for any medical issues that need to be addressed prior to the procedure.
- Depending on your medical history, social history, and age, you may need to undergo tests such as blood work and a mammogram to help detect any abnormalities that could threaten the safety of the procedure.
- You will be asked if you have allergies to medications, anesthesia, or latex.
- Inform your doctor of any medications, vitamins, or supplements that you are taking.
- Refrain from taking any anti-inflammatory drugs, aspirin or supplements, as they may increase the chance of bleeding.
- Refrain from smoking pre- and post-procedure for a specific period of time, as this may hamper proper healing and increase your chances of areolar or nipple damage, tissue necrosis, and other complications.
- A written consent will be obtained from you after the procedure has been explained in detail.
Breast reduction is usually performed under general anesthesia either in an outpatient or hospital setting. The surgery may take 2 to 5 hours. Based on the size and composition of the breasts, your surgeon may employ various techniques to carry out the procedure: liposuction, vertical or “lollipop”, or inverted-T (“Anchor”) breast reduction. In general, your surgeon will take the following steps:
- Use a marker to draw guidelines on the breasts to carry out the incisions
- Make a surgical cut accordingly around the areola and downward on each breast similar to a keyhole
- Remove extra fat, tissue, and skin to decrease the size of each breast
- Reposition the areola and nipple and reshape the breast
- May place a drainage tube under each arm to drain excess fluid or blood
- Close the incisions with sutures and wrap the breasts in a special gauze
Post-Procedure Care and Recovery
Most people can go home the same day of surgery if no complications are noted. In general, postoperative care instructions and recovery involve the following:
- You may experience sensitive, tender, swollen or bruised breasts. Pain and anti-inflammatory medications are provided as needed.
- Your physician will also provide you with antibiotics to prevent the risk of infection.
- An elastic compression bra or a surgical bra is advised to protect the breasts.
- Refrain from any physical activity for at least 2 to 4 weeks to promote healing.
- Avoid heavy lifting or any strenuous activities as you recover.
- Refrain from using any underwire bras for a few months.
- Your doctor will provide you with instructions on diet, bathing, and wound care.
- You may need to take off from work or studies at least a week to facilitate recovery.
- You will be able to resume normal activities within a month but may have certain activity restrictions.
- A periodic follow-up will be scheduled to monitor your overall progress.
Some of the benefits of breast reduction include:
- Improvement of self-image and confidence
- Helps you appear more youthful with a firm and well-positioned breast
- Form-fitting clothing, sports bras, and swimsuits will feel and look better
Risks and Complications
Breast reduction is a relatively safe procedure; however, as with any surgery, the following risks and complications are possible:
- Breast scarring
- Pain in the breasts
- Temporary bruising
- Loss of sensation in the breasts or nipples
- Bleeding under the skin (hematoma)
- Asymmetric appearance of nipples or breasts
- Incomplete healing in the nipple area
- Accumulation of fluids in breast tissue
- Possibility of revision surgery