Breast Reduction
Breast Reduction
(Reduction Mammoplasty)
Definition
Breast reduction is a common surgical procedure. It is done to decrease the size of one or both breasts. While more common in women, this procedure can also be done in men.
Reasons for Procedure
-
Overly large breasts, resulting in any of the following symptoms:
- Poor self-body image
- Back, neck, or shoulder pain
- Posture problems
- Grooving and/or abrasions from bra straps
- Rash under the lower portion of the breasts
- Large breasts—due to genetics or following pregnancy
- Breast asymmetry—may be due to previous surgery to one breast (eg mastectomy or lumpectomy)
- Large male breasts, known as gynecomastia—can be related to hormonal changes, medicines, or other health conditions
After the surgery, your breasts will be smaller and more symmetrical in appearance. They should reflect the size, shape, and symmetry you desired.
Possible Complications
Complications are rare, but no procedure is completely free of risk. If you are planning to have a breast reduction, your doctor will review a list of possible complications, which may include:
- Infection
- Bleeding and bruising
- Possible loss of sensation to the breast, nipple, and/or areola
- Possible loss of ability to breast feed
- Asymmetry between breasts
- Limited arm and/or shoulder movement
- Delayed wound healing
- Scarring
- Fluid or blood-filled cysts in the healing breast tissue
- Loss of nipple, areola, skin, or breast tissue due to change in blood supply
Some factors that may increase the risk of complications include:
- Obesity
- Smoking, alcohol abuse, or drug use
- Diabetes
- Prior radiation to the breast area
- Poor nutrition
What to Expect
Prior to Procedure
You may be asked to look through an album of breast sizes and shapes. This will help the doctor understand the outcome you desire.
Your doctor will likely do the following:
- Physical exam, including a breast exam
- Blood tests
- Mammogram
- Take photos for comparison after surgery
In the days leading up to your procedure:
- Arrange for a ride to and from the procedure. Also arrange for help at home after the procedure.
- The night before, eat a light meal. Do not eat or drink anything after midnight.
- You may be asked to shower before your procedure. You may be given special antibacterial soap to use.
Talk to your doctor about your medicines. You may be asked to stop taking some medicines or herbal supplements up to one week before the procedure, like:
- Anti-inflammatory drugs
- Blood thinners
- Gingko biloba or other supplements
Anesthesia
You may be given:
- General anesthesia—You will be asleep.
- Local anesthesia—The area will be numbed.
Description of the Procedure
The doctor will cut around the nipple and areola. Skin, fat, and breast tissue will be removed in a specific pattern. Depending on how much breast tissue is removed, the doctor may need to reposition the nipple and areola higher up on the breast tissue.
Liposuction, a vacuum procedure used to remove excess fat, may also be used.
The amount of scarring will depend on the amount that the breast is reduced and the amount of repositioning needed to the nipple and areola. The scarring can occur around the areola, around the areola and down to the breast crease, or around the areola, down to the breast crease, and along the breast crease.
Depending on the extent of operating required, the doctor may place a small flexible tube in one or both breasts to drain any fluid from the early phases of healing. These drains may need to stay in place for several days. They can be removed in the doctor's office. You will not need a second surgery to remove them.
The cuts in the breast skin will be closed with tiny stitches.
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Immediately After Procedure
You will be tightly bandaged around your chest, or you will have a special surgical bra. These will provide pressure and support.
How Long Will It Take?
2-4 hours
How Much Will It Hurt?
Anesthesia prevents pain during the surgery. You will have tenderness, swelling, and bruising of the breasts for several weeks after surgery. The pain can be controlled with pain medicines.
Average Hospital Stay
The hospital stay may be up to four days. It may be possible to leave the hospital or surgery center on the same day of the procedure. Speak to your doctor to see if this is an option in your case.
Post-procedure Care
- Wear a special surgical bra that applies pressure. This will properly shape your breast(s) after the operation.
- If drains have been placed in either breast, they will be removed 2-4 days after surgery.
- Stitches are usually removed about 7-10 days after surgery.
- Absorbable sutures may also be used by your doctor; they do not need to be removed.
- Your doctor may advise you to avoid heavy lifting, straining, or difficult exercise for the first week or two after surgery.
- Ask your doctor about when it is safe to shower, bathe, or soak in water.
- Be sure to follow your doctor’s instructions.
Call Your Doctor
After you leave the hospital, contact your doctor if any of the following occur:
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
- Nausea and/or vomiting that you cannot control with the medicines you were given after surgery, or which last for more than two days after you leave the hospital
- Pain that you cannot control with the medicines you have been given
- Cough, shortness of breath, or chest pain
- Pain or swelling in your calves, legs, or feet
- You have concerns about the size and/or shape of your breasts
- Fluid or blood collecting in either breast
- Any pain or stiffness when moving your arm
In case of an emergency, call for medical help right away.
RESOURCES
American Society for Aesthetic Plastic Surgery http://surgery.org
American Society of Plastic Surgeons http://www.plasticsurgery.org
CANADIAN RESOURCES
Canadian Society of Plastic Surgery http://www.plasticsurgery.ca
Guide to Breast Augmentation in Canada http://www.canadaba.ca
References
Breast reduction. American Society of Plastic Surgeons website. Available at: http://www.plasticsurgery.org/Reconstructive-Procedures/Breast-Reduction.html. Accessed January 22, 2013.
Sabiston DC. Textbook of Surgery. 17th ed. Philadelphia, PA: WB Saunders Co.; 2003.
Spear SL. Surgery of the breast. Principles and art. 2nd ed. Lippincott Williams and Wilkins 2005.
