Breast Reduction

CANDIDATES:
Women who demonstrate physical pain, usually in the back or shoulders, caused by the excessive weight of large breasts. Often this excess volume can also cause skin irritation underneath the breast and leave indentations in the shoulders from the bra straps. Women who have difficulty finding clothes that fit, because their breasts are too large in proportion to their body frame; who have one breast that is much larger than the other, or who have difficulty exercising due to the breasts size and weight and dissatisfaction of their self-image because of large breasts.

OBJECTIVE:
To reduce, raise and reshape big breasts by removing excess tissue and skin and repositioning the nipples.

INCISIONS AND TECHNIQUE
As in the breast lift procedure, breast reduction incisions vary according to three different techniques; the "inverted T," where there is one incision around the nipple, one in the fold below the breast and a third vertical incision joining them. The second is the "vertical" technique with the incision around the nipple and extending vertically to the mammary fold, and the third is the "periareolar" incision only around the nipple. The choice of the appropriate technique varies according to the breast and the desired new shape and size. This should be discussed during the consultation.

OPERATING TIME
1 to 3 hours

ANESTHESIA
Local with sedation, or general.

IN/OUT PATIENT:
Usually performed as an inpatient procedure.

RECOVERY TIME:
It will be more comfortable to sleep on the back for the first 2 weeks; return to work is between 1 to 2 weeks. Strenuous activities may be resumed in 1 month, and it will take from several months to a year for the scars to fade.

SIDE EFFECTS:
There can be temporary bruising, some swelling and discomfort, numbness, and dry breast skin. Possible complications: Serious risks are not common. Delays in healing can be caused by collections of fluid (seroma) that need to be drained; infection, bleeding under the skin flap. Poor healing resulting in visible scarring or skin loss. There is the possibility of wide scars (keloids) in patients with this tendency. Surgically the nipples could be unevenly placed; there could be a temporary or permanent loss of feeling in nipples or breast, or the need for a second operation.

DETAILS:
During the computer consultation, you will decide with the surgeon the desired breast shape and size. The nipples and areolas will be repositioned and you will be informed of the incisions needed for each case. There is no age limit to perform a breast reduction once breast development is completed.

DURATION OF THE RESULTS
Pregnancy and breast-feeding may affect and change the size and shape of the breasts. Some women undergo breast reduction surgery before having children, preferring to address any changes in shape and size at a later date. Gravity, pregnancy, aging, and weight changes may have significant and unpredictable effects on the size and shape of the new breast. Breast lift surgery will not interfere with the ability to breast-feed if the milk ducts are left intact, and if you plan to breast feed in the future you should discuss this with your plastic surgeon.