What is Breast Reduction?
Breast reduction, also known as reduction mammaplasty, is a procedure to remove excess breast fat, glandular tissue, and skin to achieve a breast size in proportion with your body and to alleviate the discomfort associated with overly large breasts.
Who is it for?
You may be a candidate for breast reduction surgery:
- If your breasts are too large for your body frame and create neck, back, or shoulder pain
- If you have heavy breasts with nipples and areolas (pigmented skin surrounding the nipples) that point downward
- If one breast is much larger than the other
- If you are unhappy and self-conscious about the large appearance of your breasts
- Your skin has adequate elasticity, so it can resume its former tightness following surgery.
- You are mentally and emotionally stable. Breast reduction requires patience and stability to deal with the healing period.
- You are old enough so that your breast development has stopped.
- You have finished having children and breast-feeding, because this can have significant and unpredictable effects on the size and shape of your breasts.
Prior to breast reduction surgery, you may be asked to:
- Have a mammogram (if you’re over forty years of age), electrocardiogram (ECG) or chest x-ray. If your surgeon recommends weight benchmarks or lifestyle changes, do your best to achieve them to ensure the best results and minimize the chance of complications.
- Take certain medications or adjust your current medications.
- Stop smoking.
- Avoid taking aspirin and certain anti-inflammatory drugs as they can increase bleeding.
What to expect during surgery
Breast reduction surgery, which usually takes from three to five hours, is performed in a hospital or surgical center. An overnight stay is not usually required. The surgery commonly involves three incisions. After the surgeon removes excess breast tissue, fat and skin, the nipple and areola are shifted to a higher position. The areolas may be reduced in size. Skin that was located above the nipple is brought down and together to reshape the breast. Liposuction may be used to improve the contour under the arm.
- Your surgeon will use a surgical marker on your skin to indicate where the incisions will be. These markings are especially important, because your breasts change shape once you are lying on your back on the operating table.
- Most surgeons prefer general anesthesia for this procedure. A few may perform breast reduction with intravenous sedation, also known as “twilight sedation.”
- Your incision pattern will depend on the size of your breasts, how much your breasts sag and where your nipple-areola complex is positioned. With each technique the areolas can be made smaller if they’re too large. An areolatome, more commonly known as a “cookie cutter,” is used as a circular template to make the new areola size. The cookie cutter diameter ranges from thirty-eight to forty-five millimeters. Here are some commonly used incision patterns:
- Microincisions are used for breasts that are fatty (not fibrous) and not sagging. Liposuction is used to decrease breast size. Small incisions allow the liposuction cannula (tube) to enter the breast.
- A donut incision, or periareolar incision, is made solely around the border of the areolas.
- A keyhole incision, also known as a lollipop incision, is made around the border of the areolas and vertically down from the areolas to the breast crease.
- An anchor incision, the most common technique used by plastic surgeons, involves three distinct cuts. One incision is made around the border of the areolas; the second extends down vertically from the areolas to the breast crease and merges with a third incision along the breast crease.
- Your surgeon will remove excess breast skin and fat with a scalpel and/or cautery instrument based on the size breast you desire. If your breasts are asymmetrical (or uneven), the surgeon may remove more tissue from one breast than the other. He or she will then reshape the remaining skin and fat to create a more youthful breast shape and move the nipple-areola complex to a higher position.
- In most cases, drains will be placed in the breasts to collect excess fluid.
- Breast incisions are then closed with sutures that go from the deep tissue layers to the more superficial layers (the skin).
Our goal is to help you achieve the most beautiful and natural-looking results, as well as to make your surgical experience as easy and comfortable as possible.
After your procedure is completed, you will be taken into a recovery area where you will continue to be closely monitored.
A bulky gauze dressing (bandage) will be wrapped around your breasts and chest or you might wear a surgical bra. Drainage tubes may be attached to your breasts.
Before leaving for home, you (or someone looking after you) should feel capable of emptying and resetting the drains.
It is important that you follow all patient care instructions provided by your surgeon. This will include information about wearing compression garments, care of your drains, taking an antibiotic if prescribed and the level and type of activity that is safe.
Your surgeon will also provide detailed instructions about the normal symptoms you will experience and any potential signs of complications. It is important to realize that the amount of time it takes for recovery varies greatly among individuals.
Risks of Breast Reduction Surgery
Fortunately, serious risks of breast reduction surgeries are rare and the satisfaction rate with these procedures is high. The overall complication rate is small if the operation is done by an experienced plastic surgeon operating in an accredited facility.
All surgical procedures have some degree of risk. Some of the potential complications of all surgeries are:
- Adverse reaction to anesthesia
- Hematoma or seroma (an accumulation of blood or fluid under the skin that may require removal)
- Infection and bleeding
- Changes in skin sensation
- Allergic reactions
- Damage to underlying structures
- Unsatisfactory results that may necessitate additional procedures
- Blood clots in the legs or lungs