mammoplasty

Breast Reduction

If you're considering a breast reduction...

Over the years, factors such as pregnancy, nursing, and the force of gravity take their toll on a woman's breasts. As the skin loses its elasticity, large breasts often lose their shape and firmness and begin to sag. Breast reduction, or reduction mammoplasty, is a surgical procedure to reducethe size, raise and reshape large sagging breasts. Breast reduction can also reduce the size of the areola, the darker skin surrounding the nipple.

THE BEST CANDIDATES FOR BREAST REDUCTION

A breast reduction can enhance your appearance and your self-confidence, but it won't necessarily change your looks to match your ideal.

The best candidates for breast reduction are healthy, emotionally-stable women who are realistic about what the surgery can accomplish. Breasts of any size can be lifted, but the results may not last as long in heavy breasts.

ALL SURGERY CARRIES SOME UNCERTAINTY AND RISK

A breast reduction is not a simple operation, but it's normally safe when performed by a qualified plastic surgeon. Nevertheless, as with any surgery, there is always a possibility of complications or a reaction to the anesthesia. Bleeding and infection following a breast lift are uncommon, but they can cause scars to widen. You can reduce your risks by closely following your physician's advice both before and after surgery.

Breast reduction does leave noticeable, permanent scars, although they'll be covered by your bra or bathing suit. (Poor healing and wider scars are more common in smokers.) The procedure can also leave you with unevenly positioned nipples, or a permanent loss of feeling in your nipples or breasts.

PLANNING YOUR SURGERY

In your initial consultation, the surgeon will examine your breasts and measure them while you're sitting or standing. He will discuss the variables that may affect the procedure--such as your age, the size and shape of your breasts, and the condition of your skin. You should also discuss where the nipple and areola will be positioned; they'll be moved higher during the procedure, and should be approximately even with the crease beneath your breast.

PREPARING FOR YOUR SURGERY

Depending on your age and family history, the surgeon may require you to have a mammogram (breast x-ray) before surgery. You'll also get specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications.

WHERE YOUR SURGERY WILL BE PERFORMED

Your breast reduction may be performed in a hospital, an outpatient surgery center, or a surgeon's office-based facility. If you're admitted to the hospital as an inpatient, you can expect to stay one or two days.

TYPES OF ANESTHESIA

Breast lifts are usually performed under general anesthesia, which means you'll sleep through the operation. In selected patients--particularly when a smaller incision is being made--the surgeon may use local anesthesia, combined with a sedative to make you drowsy. You'll be awake but relaxed, and will feel minimal discomfort.

THE SURGERY

Breast reduction usually takes two and a half to four and a half hours. Techniques vary, but the most common procedure involves an anchor-shaped incision following the natural contour of the breast.

The incision outlines the area from which breast skin will be removed and defines the new location for the nipple. When the excess skin and fat has been removed, the nipple and areola are moved to the higher position. The skin surrounding the areola is then brought down and together to reshape the breast. Stitches are usually located around the areola, in a vertical line extending downwards from the nipple area, and along the lower crease of the breast.

AFTER YOUR SURGERY

After surgery, you'll wear an elastic bandage or a surgical bra over gauze dressings. Your breasts will be bruised, swollen, and uncomfortable for a day or two, but the pain shouldn't be severe. Any discomfort you do feel can be relieved with medications prescribed by the surgeon.

Within a few days, the bandages or surgical bra will be replaced by a soft support bra. You'll need to wear this bra around the clock for three to four weeks, over a layer of gauze. The stitches will be removed after a week or two.

If your breast skin is very dry following surgery, you can apply a moisturizer several times a day. Be careful not to tug at your skin in the process, and keep the moisturizer away from the suture areas.

You can expect some loss of feeling in your nipples and breast skin, caused by the swelling after surgery. This numbness usually fades as the swelling subsides over the next six weeks or so. In some patients, however, it may last a year or more, and occasionally it may be permanent.

GETTING BACK TO NORMAL

Healing is a gradual process. Although you may be up and about in a day or two, don't plan on returning to work for a week or more, depending on how you feel. And avoid lifting anything over your head for three to four weeks.

The surgeon will give you detailed instructions for resuming your normal activities. You may be instructed to avoid sex for a week or more, and to avoid strenuous sports for about a month. After that, you can resume these activities slowly. If you become pregnant, the operation should not affect your ability to breast-feed, since your milk ducts and nipples will be left intact.

YOUR NEW LOOK

The surgeon will make every effort to make your scars as inconspicuous as possible. Still, it's important to remember that breast reduction scars are extensive and permanent. They often remain lumpy and red for months, then gradually become less obvious, sometimes eventually fading to thin white lines. Fortunately, the scars can usually be placed so that you can wear even low-cut tops.

Your satisfaction with a breast reduction is likely to be greater if you understand the procedure thoroughly and if your expectations are realistic.