Breast Reduction - FAQ
Is a breast reduction right for me?
Breast reduction is a highly individualized procedure and you should do it for yourself, not to fullfill someone else's desires or to try to fit any sort of ideal image. Breast reduction is a good option for you if:
- You are physically healthy
- You have realistic expectations
- You don't smoke
- You are bothered by the feeling that your breasts are too large
- Your breasts limit your physical activity
- You experience back, neck and shoulder pain caused by the weight of your breasts
- You have regular indentations from bra straps that support heavy, pendulous breasts
- You have skin irritation beneath the breast crease
- Your breasts hang low and have stretched skin
- Your nipples rest below the breast crease when your breasts are unsupported'You have enlarged areolas caused by stretched skin
The success and safety of your breast reduction procedure depends very much on your complete candidness during your consultation. You'll be asked a number of questions about your health, desires and lifestyle.
Be prepared to discuss:
- Why you want the surgery, your expectations and desired outcome
- Medical conditions, drug allergies and medical treatments
- Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs
- Previous surgeries
- Family history of breast cancer and results of any mammograms of previous biopsies
Your surgeon may also:
- Evaluate your general health status and any pre-existing health conditions or risk factors
- Examine your breasts, and may take detailed measurements of their size and shape, skin quality, placement of your nipples and areolas
- Take photographs for your medical record
- Discuss your options and recommend a course of treatment
- Discuss likely outcomes of breast reduction and any risks or potential complications
- Discuss the use of anesthesia during your breast reduction
Prior to surgery you may be asked to:
- Get lab testing or a medical evaluation
- Take certain medications or adjust your current medications
- Get a baseline mammogram before surgery and another one after surgery to help detect any future changes in your breast tissue
- Stop smoking well in advance of surgery
- Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding
- What to do on the day of surgery
- Post-operative care and follow-up
Your plastic surgeon will also discuss where your procedure will be performed. Breast reduction surgery is performed at the Austin-Weston Center accredited office-based surgical center.
You'll need help:
Be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery.
What happens during breast reduction surgery?
Step 1 - Anesthesia
Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.
Step 2 - The incision
Incision options include:
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
An inverted T or anchor-shaped incision pattern
Step 3 - Removing tissue and repositioning
After the incision is made, the nipple -- which remians tethered to its original blood and nerve supply -- is then repositioned. The areola is reduced by excising skin at the perimeter, if necessary. Underlying breast tissue is reduced, lifted and shaped. Occasionally, for extremely large pendulous breasts, the nipple and areola may need to be removed and transplanted to a higher position on the breast (free niplle graft).
Step 4 - Closing the incisions
The incisions are brought together to reshape the now smaller breast. Sutures are layered deep within the breast tissue to create and support the newly shaped breasts; sutures, skin adhesives and/or surgical tape close the skin. Incision lines are permanent, but in most cases will fade and significantly improve over time.
Step 5 - See the results
The results of your breast reduction surgery are immediately visible. Over time, post-surgical swelling will resolve and incision lines will fade. Satisfaction with you rnew image should continue to grow as you recover.
Important facts about the safety and risks of breast reduction
The decision to have breast reduction surgery is extrmely personal and you'll have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable. Your plastic surgeon and/or staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks or potential complications.
The risks include:
- Unfavorable scarring
- Changes in nipple or breast sensation, which may be temporary or permanent
- Anesthesia risks
- Bleeding (hematoma)
- Blood clots
- Poor wound healing
- Breast contour and shape irregularities
- Skin discoloration, permanent pigmentation changes, swelling and bruising
- Damage to deeper structures -- such as nerves, blood vessels, muscles, and lungs -- can occur and may be temporary or permanent
- Breast asymmetry
- Fluid accumulation
- Excessive firmness of the breast
- Potential inability to breastfeed
- Potential loss of skin/tissue of breast where incisions meet each other
- Potential partial or total loss of nipple or areola
- Deep vein thrombosis, cardiac and pulmonary complications
- Pain, which may persist
- Allergies to tape, suture materials and glues, blood products, topical preparations or injectable agents
- Fatty tissue deep in the skin could die (fat necrosis)
- Possibility of revisional surgery
You should know that:
- Breast reduction surgery can interfere with certain diagnostic procedures
- Breast and nipple piercing can cause an infection
- Your ability to breastfeed following reduction mammaplasty may be limited; talk to you rdoctor if you are planning to nurse a baby
- The procedure can be performed at any age, but is best done when your breasts are fully developed
- Changes in the breasts during pregnancy can alter the outcomes of previous breast reduction surgery, as can significant weight fluctuations
When you go home:
If you experience shortness of breath, chest pains, or unusual heart beats, seek medical attention immediately. Should any of these complications occur, you may require hospitalization and additional treatment.
The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee, In some situations, it may not be possible to achieve optimal results with a single surgical procedure and another surgery may be necessary.
Following your physician's instructions is key to the success of your surgery. It is important that the surgical incisions are not subjected to excessive force, swelling, abrasion, or motion during the time of healing. Your doctor will give you specific instructions on how to care for yourself.
Be sure to ask questions: It's very important to address all your questions directly with your plastic surgeon. It's natural to feel some anxiety, whether it's excitement for your anticipated new look or a bit of preoperative stress. Don't be shy about discussing these feelings with your plastic surgeon.
When your procedure is complete, dressings or bandages will be applied to the incisions. An elastic bandage or support bra may be worn to minimize swelling and support the breasts as they heal. A small, thin tube may be temporarily placed under the skin to drain any excess blood or fluid that may collect.
You will be given specific instructions that may include: How to care for your surgical site(s) following surgery, medications to apply or take orally to aid healing and reduce the risk of infection, specific concerns to look for at the surgical site or in your general health, and when to follow up with your plastic surgeon.
Be sure to ask your plastic surgeon specific questions about what you can expect during your individual recovery period.
- Where will I be taken after my surgery is complete?
- What medication will I be given or prescribed after surgery?
- Will I have dressings/bandages after surgery? When will they be removed?
- Are stitches removed? When?
- When can I resume normal activity and exercise?
- When do I return for follow-up care?
The results will be long-lasting
The results of breast reduction surgery will be long-lasting. Your new breast size should help relieve you from the pain and physical limitations experienced prior to breast reduction. Your better proportioned figure will likely enhance your self image and boost your self confidence. However, over time your breasts can change due to aging, weight fluctuations, hormonal factors and gravity.