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Breast Reduction (Reduction Mammoplasty)
San Francisco - Oakland - Santa Rosa
Breast Reduction or reduction mammoplasty is a surgical procedure that reduces the size and shape of the breasts by removing excess skin and underlying breast tissue. It also reduces the size of the nipple-aerola complex which frequently becomes enlarged as the result of breast development. The results are breasts that are higher, smaller, and more shapely.
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If you have large pendulous breasts, a variety of medical conditions can result:
- Shoulder “grooving” due to bra straps.
- Back and neck pain.
- Difficulty breathing.
- Irritation to the crease of the breasts.
- Feeling self-conscious.
- Difficulty with physical activity.
- Postural changes.
- Difficulty fitting in clothes
For these reasons, most insurance plans provide coverage for breast reduction procedures.However, it can be a purely cosmetic procedure for women are self-conscious about their breast size. The procedure is permanent, although breast size can change due to weight gain or loss.
Who is a candidate? Women with disproportionately large breasts are a good candidate for breast reduction. This is done for both cosmetic improvement and symptomatic relief. In general, woman with size DD or greater are the most common candidates. However, for a petite woman, size C or D may be too large for their body frame.While women from any age can benefit from the procedure, it is most commonly performed after the breasts are fully developed, unless a young girl experiences significant deformity.
Fact
97% more breast reductions were performed in 1999 than in 1992, and 11%
more than in 1998. 78,169 breast reductions were performed in 1999.
Before Surgery
A personal consultation is the first step for every patient considering
a breast reduction. During the appointment, Dr. Delgado will ask you to
discuss your concerns about your appearance. He will use computer imaging
to discuss your size, asymmetry, and display the locations of the incisions.
He will also discuss where the aerolas will be positioned; they will be
moved higher during the procedure and should be approximately even with
the crease underneath the breast. He will discuss the variables that will
effect the procedure; such as age, size, the shape of your breast, and
the condition of your skin. He will conduct a routine breast examination
and ask about your medical history. He may ask you to have a mammogram.
He will discuss factors that will determine the possibilities for and
the extent of the surgery. Dr. Delgado provides precise preoperative booklet
that provides pre and post operative instructions, including medications
in advance of your surgery. All aspirin and aspirin containing products,
including anti-inflammatory must be stopped two weeks before and two weeks
after surgery. Dr. Delgado’s preoperative instructions will have
a complete list of these medications to avoid. Tylenol may be taken during
this time. You will also be given a list of homeopathic preparations as
well as vitamins to take prior to and after surgery. This is done to promote
healing and limit bruising.
Anesthesia Breast reduction is done under general anesthesia. The procedure is typically performed in an outpatient surgery center or a hospital.
Operative
Procedure Before anesthesia is given, a surgical marking pen
is used to draw out a detailed “map" on the breasts and chest.
This architectural plan enables the doctor to make the accurate changes
from the sitting to the lying position. After anesthesia is given, incisions
are made around the areola and downward to the crease underneath the breasts.
Regardless of the incisions, the nipple areola complex will be moved upward
and the skin tightened. Dr. Delgado will remove the excess glanular tissue,
fat, and dense skin, shaping and sculpting the breasts to form their new
size and contour. Many times liposuction is used for removing excess fat
around the site of the chest. The latest breast reduction incision is
shaped like a lollipop. The older technique is the inverted T-incision
which produced much larger scars. The other advantage of the lollipop
incision is that the breast tissue is reconstructed in a conical shape
which has a long-lasting effect. The inverted T-incision holds the breast
shape by changing only the skin envelope. In time the skin stretches out
and the shape is lost.The surgery takes approximately three and a half
to four hours. Fine sutures are used to close the incision. Often drains
are placed in to remove any excess fluid over the next few days. The breasts
are wrapped in a compression dressing, and a bra is placed.
After Surgery The first few hours after surgery will
be spent in the recovery room. When you are fully alert, your will be
able to go home with the assistance of a friend or a family member. At
this time, it is important to sleep with the head and back elevated to
reduce the swelling in the area. If drains are placed, they will be removed
in three to five days and at that time, the dressings will be removed
and replaced. Instructions are given in the preoperative pamphlet as to
wound care. The sutures are removed in approximately two weeks.Your breasts
will be uncomfortable for a day or two, but the pain should not be severe.
Pain medications are taken for the first day or two in order to be comfortable
during your recovery. By the third day, pain medications usually are not
needed. However, some patients have a low pain threshold and therefore
may take pain medications up to five days. The swelling and bruising lasts
approximately one week, but the general recovery is approximately two
weeks. Once the bruising and tenderness are gone, the patient can return
to normal activity. It is an absolute priority that patients avoid lifting
objects for at least two weeks post operatively. Most patients may drive
a car and return to work or social activities after one week. Strenuous
exercise is avoided three to four weeks following surgery.You should avoid
sex for the first weeks or so after surgery, since this can increase swelling
and discomfort.
Risks and Complications As with any operation, a breast reduction carries the normal risk of infection, bleeding, and the risk of anesthesia. However, with a highly trained surgical team, these complications are extremely rare.Breast reduction does leave scars from the nipple areola complex down to the base of the breasts. Sometimes sensitivity in the nipple and breast area is reduced. The feeling may not return for as long as six months. Most woman having breast reductions are able to breast feed, however a small minority may be incapable of nursing.On rare occasions there may be a slight difference in size from one breast to the other, or the nipple areola complex will have some differences
Results Even though you can appreciate a significant reduction in breast size after surgery, it takes a couple of months for the breasts to settle into their new shape. This may fluctuate with weight gain, hormone influences, or pregnancy. You will appreciate a better balance with your body and your clothes will fit more proportionally. It is very important to watch the progress of the scars. If there are any rope-like “configuration” to the scars it should be addressed immediately. Even though there are scars with breasts reduction, breast reduction patients are usually the happiest patients who experience plastic surgery.The advantage of having a breast reduction will reduce the weight of the breast, and therefore the body begins to adjust to a lighter gravitational pull. This will reduce the symptoms that a patient experiences, such as the back and neck pain, and the postural changes. The changes brought about by breast reduction are among the most helpful and dramatic.