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Breast reduction, technically known as reduction mammoplasty, is a surgical procedure to reduce the size of the breast. This procedure reduces the fat, breast tissue and skin, making the breast smaller, lighter and firmer. The areola can also be reduced, this is the dark tissue that surrounds the nipple. The aim is to give the patient a smaller breast more in proportion to the rest of her body. The information on this page will inform you about the procedure but evey case is different and the specifics of your case will be given to you by your surgeon.
More than an aesthetic problem, it´s a physical problem. Overly large breasts can cause health and emotional problems. In addition to self image issues, you may also experience physical pain and discomfort. In most cases , this procedure is not done until the breasts are totally developed but in certain cases, if the breasts are causing serious problems, it can be done before. The best candidates are those who are sufficiently mature to understand the procedure and have realistic expectations for the results. This procedure is not recommended for women who are breastfeeding.
Breast reduction is not a simple operation but it is very safe if performed by a qualified surgeon. However, as in all surgery there is always the possibility of complications such as infection, haemorrhage or reaction to the anaesthetic. Occasionaly the nipples may hurt after the operation but this will fade with time. If you follow your surgeon´s advice the risks will be minimal. The procedure will leave visible scars although these can be hidden with a bra or swimwear. (Healing is slower and scars are more visible if the patient smokes ). Some patients may lose sensibility in the nipples and breasts.
At the first appointment it´s important to explain your expectations to the surgeon and listen to his or her opinion.The surgeon will examine your breasts, measure them and explain all the options depending on size, age, shape and skin type. The surgeon will explain in detail the procedure informing about all risks and making sure that you fully understand what is involved. He or she will also talk about the type of anaesthetic, where the procedure will be done and the cost.
You will be given all the instructions necessary for the procedure including details about diet, smoking and the taking of or avoiding certain medications or vitamins before the procedure. Be sure that there will be someone to take you home after the operation and give you assistance at home in the first few days after surgery.
Normally the operation is done in the hospital. The procedure will last 2 to 4 hours but in some cases may last longer. The patient will be in hospital for 1 or 2 days.
Although the capacity to produce milk is not affected, it´s true that a part of the connection with the milk ducts is lost which makes the release of milk difficult.
The breast is made up of glandular breast tissue and fatty tissue and it´s the fatty tissue volume that may change with weight changes.
General anaesthetic is used in nearly all of these types of surgery, you will be asleep throughout the operation.
There are different techniques used for breast reduction surgery but the most common consists in making the incision in the shape of an anchor, from the areola downwards and following the curve of the breast. The excess tissue, fat and skin is removed and the areola and nipple are placed in their new position. The skin from around the breast is placed around the areola, creating the new contours of the breast. In the majority of cases the nipple remains connected to the blood supply and nerves.If the breasts are very large and hang low, the areola and nipple must be diconnected and replaced in a higher position. The scars will always be situated around the areola and depending on breast size and the choice of surgical technique, may also be vertical with or without short horizontal incisions looking like an inverted T. Occasionaly liposuction may be used to remodel areas of the breast.
An elastic bandage or sugical bra will be worn on top of the gauze. Small drainage tubes will be inserted to drain blood and fluid and these will be removed after 1 or 2 days. Pain can be felt during the first 2 days particularly when coughing. The discomfort may last a week and your doctor will prescribe medication for the pain. The adhesive drapes placed after surgery will be removed after a few days but the surgical bra must be worn for a few weeks until the inflammation and bruising disappear. The breasts may be painful during the first menstruation after surgery and a bit of sensitivity may be lost in the nipples and the skin of the breasts due to the swelling after the surgery. This will disappear after 4 to 6 weeks. In some cases it may last longer and very ocassionaly it may be permanent.
Although you will leave hospital the day after the procedure, for about two weeks you may feel some discomfort. You should avoid lifting or pushing heavy weights for 3 to 4 weeks. Your surgeon will give you instructions to follow until you can return to your normal daily life (after 2 weeks ) although any strenuous activity must be avoided for up to 6 weeks. It´s normal that a small quantity of fluid will seep from your wounds. Do not hesitate to call your doctor if you show any strange symptoms.
It could take between 6 months and a year for your breasts to complete the process of assimilating their new shape. Even after this period hormones, weight changes and pregnancy will change their shape for a time. Don´t forget that the scars will fade but they will always be there. At first they will be a red colour but slowly they will turn white. You will notice that your shape has changed, it will be more proportioned and clothes will look better on you. Be patient and think of the reason you decided to undergo the operation.
CANDIDATES: Women who wish to reduce the size of their breasts
RADIOLOGICAL STUDIES: Mammogram and/or breast scan
TYPE OF PAIN: Stinging and some tightness in breast. Less than breast enlargement procedure
SCARS: Periareolar, vertical and horizontal from 4 cm or more depending on amount of skin and tissue removed.
CONSEQUENCES: Loss of sensibility of the nipple, difficulty breastfeeding
This procedure is for women with large and sagging breasts who may have physical problems caused by this condition. These include neck or back pain, skin problems, respiratory problems and bone deformity. An overly large breast size can cause psychological problems.
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© Dra. Emma Torres 2017