Breast Reduction

Breast reduction is a procedure which involves the excision of breast tissue to reduce its size. Otherwise known as reduction mammoplasty, breast reduction is often done in women who have very large breasts and men afflicted with gynecomastia, the abnormal development of very large breasts in males.

Indications

Women who opt for a breast reduction often have very large breasts (gigantomastia) which can cause all sorts of discomfort like neck and back pain, breathing problems and problems with posture. The awkwardness that comes out of having very large breasts may also be one of the reasons why women choose to have the procedure done. Women who have large breasts but prefer smaller, lighter, and firmer breasts are also candidates for this procedure. Men who have very large breasts (gynecomastia) often feel embarrassed and ashamed of their condition and may resort to surgery in order to restore their self-confidence. However, the procedure may not be recommended for women with under-developed breasts and women who are planning to breastfeed in the near future, since it may impair the breasts' ability to produce enough milk.

How is it done?

There are many ways through which your surgeon may choose to perform your operation. The two most popular techniques used by surgeons in the States are the inferior pedicle and vertical scar techniques. Both techniques are least likely to produce disruptions in breast sensitivity and lactation compared to other techniques in the past. In most cases, an anchor-shaped incision is created from the areola, down towards the crease between the breast and abdomen and then on to the crease under the breast itself. The surgeon then removes excess tissue, fat and skin from the breast. In cases where breast ptosis is severe, the nipple and areola may need to be removed and reattached at a higher point in the breast as a graft. Since the procedure causes the areola and nipples to be detached from the blood vessels and nerves, this may result to the woman's inability to breast feed in the future.

A typical breast reduction surgery is often done under general anesthesia and IV sedation and lasts two to three hours.

Patients can expect to wake up hours after the surgery with a drainage tube under each arm to collect the fluid from the incisions. Although the procedure can be done in an outpatient basis some patients may also stay in the hospital overnight, depending on the doctor's orders. During the initial recovery period, the breast tissue may often be sensitive, swollen, and bruised. Pain medications can usually take care of the pain and discomfort the patients feel after surgery. Patients can resume normal activities within two to three weeks, although no strenuous activities are allowed until the wound has fully healed. It may take 6 months for the full shape of the breast to become noticeable. Full adjustment to the new breast size may take patients 6 months to one year.

Possible Complications

As with any other type of surgery, breast reduction carries with it some risks for possible complications. This includes difficulty or inability to breast feed, scarring, changes or loss in sensation around the breasts, and recurrent sagging and drooping of the breasts. A severe complication is nipple loss, where the nipples are cut off from the circulation and die. Women who smoke are more prone to nipple loss as a consequence of breast reduction surgery, which is why they are often advised to quit before the surgery can be performed. In some cases, nipples are recreated using the patient's own skin or tattooed in place.