Breast Reduction Surgery: Reduction Mammoplasty
Larger breasts do not always mean beautiful breasts. Shape and proportion are what matters. Women who have large breasts or macromastia and want to achieve the size of breast proportionate to their body can go for breast reduction surgery.
What Is Breast Reduction Surgery
Breast reduction surgery or reduction mammoplasty is the removal of excess tissue, fat and skin from the breast. It makes the breasts firmer, less bulky, reduces the size, improves symmetry, eliminates sagging and makes them aesthetically pleasing.
Breast reduction surgery is performed using any of the two procedures:
1. Liposuction- Liposuction is either done in conjunction with the excision technique or alone. In this procedure, only the excess fat tissue from the breast is removed. It is a less invasive method and leaves undetectable scars. The results are long-lasting. However, just patients who desire slight to moderate reduction in breasts size, have minimal or no sagging and good elasticity of skin can achieve optimal results through liposuction. In short, only those women will be benefited by this technique whose large breast size is because of excessive fat tissue.
2. Excision- Here breast reduction surgery is performed by making an incision on your breast and removing excess of glandular tissue, fat and skin.
Which procedure will be used to reduce the breast size depends on the patient’s condition, amount of the reduction, desired result, surgeons advise and personal preferences.
Causes: Reasons Women Consider Breast Reduction Surgery
Breast reduction surgery is opted by females with disproportionately large breasts to mitigate following issues:
1. Chronic irritation and rash under the breast crease
2. The weight of the breast is causing pain in upper back, neck and shoulders that require painkillers for relief
3. Excess breast tissue limits physical activity
4. Nerve pain
5. Poor self-image, self-conscious, emotional or physical distress and lack of confidence
6. Difficulty in fitting into clothing and bra. Bra-strap causes shoulder indentation
7. Social stigma and unhappy with large breast size
8. Breast Sagging
Who are good candidates for breast reduction surgery?
- Women who do not smoke
- Candidates in good health and is not suffering from heart issues or diabetes
- Women who are not obese
- With fully developed breast ( 18 years and above)
- Females who are not pregnant or breastfeeding
- Women who are not on a wei1ght loss program
- A patient with a realistic expectation
What Are The Risks Related To Breast Reduction Surgery
Breast reduction surgery is your personal choice. The chance of potential danger or complication is scarce if a board certified and an experienced surgeon is chosen. Below is the list of potential risks and complications:
- Bleeding or hematoma
- Poor wound healing
- Permanent pigmentation changes or skin discoloration
- Adverse reaction to anesthesia
- Loss of sensation in the nipple and surrounding skin
- Inability or difficulty in breastfeeding
- Asymmetry or shape irregularities
- Chances of re-correction surgery
Precautions Before Surgery
To prepare you for the surgery following steps are taken:
- Your surgeon will check your medical history and evaluate your present health condition. Also, complete lab test and baseline mammogram takes place
- Stop smoking six weeks before the surgery
- It is better to discuss your expectations and desired breast appearance with your surgeon before the surgery
- Do not take anti-inflammatory medicines and herbal supplements that increase the risk of bleeding
- If the surgery is to be performed on an outpatient basis arrange someone to drive you back and stay with you for the first night after the surgery
- Do not eat anything 8 hours prior to surgery
- Wear loose clothes on the day of surgery
Breast reduction surgery is carried out in a hospital, office-based surgical centre, or ambulatory/outpatient centre. Depending on the extent of breast reduction the whole procedure takes 1-3 hours to complete. Mostly it is recommended to stay in the hospital for 1-2 days post-surgery. Breast reduction surgery includes following steps:
1. Anesthesia- For your comfort during breast reduction surgery, intravenous or general anesthesia is administered. Mostly general anesthesia is administered.
2. Incision- Incision in the breast may be done in any of the following patterns:
A circular pattern around the areola- The incision lines are more visible in this pattern. Scars are permanent. However, swimsuit and bra can very well conceal the incisions.
Racquet or keyhole pattern- Here two incisions are made. One is made circling the areola and the second one runs down to the breast crease vertically from the bottom of an areola. This pattern is for women who need a moderate breast reduction and in whom there is noticeable sagging. This type of incision allows the surgeon to remove excess breast tissue, fat and skin and reshape the newer and smaller breast. Also, this incision pattern enables lifting the breast to give a more youthful look.
Anchor-shaped or inverted T- Here three incisions are made. One around the areola edge, second vertically from areola to breast crease and third underneath the breast along the crease. This incision technique allows maximum tissue removal and shaping. This approach is for patients with big breast size, asymmetry or significant sagging.
3. Removal of tissues and repositioning- The nipple is moved to the new position while it is attached to the blood supply. The required areola is reduced by skin excising. The breast tissue is lifted, removed and re-shaped. If the patient has sizeable pendulous breast, the areola and nipple are removed and then transplanted to a higher position.
4. Closing the incisions- To reshape the smaller breast the incisions are brought together. To create and support the newer breast, sutures are layered deep within the breast tissue. Skin is closed with surgical tapes and skin adhesives.
What To Expect
After the surgery, your breast is covered with bandage or gauze dressing. For how long you will have to keep the dressing depends on recovery time. Excess of fluid or blood is drained by placing a thin tube under the arms.
Results are immediate but take a few months to be completely visible. For a few days, your breast might be bruised, swollen, sensitive to touch and tender. Although the incision lines are permanent, they fade, and appearance significantly improves with time. You might be recommended to wear elastic compression bra to support your breasts during the recovery period. If non-dissolving sutures are applied, then stitches will be removed in 1-2 weeks.
Successful breast reduction gives you a proportionate figure, improves your self-image and increases your ability to take part in physical activity. The results are permanent, however, in the future, pregnancy, weight fluctuations, gravity, hormonal changes and ageing may affect the size and shape of the breast.
Precautions After Surgery
For fast recovery your surgeon will recommend you following precautionary measures:
- A cold compress for 48-72 hours to reduce swelling and bruising.
- For a few months post-surgery avoid wearing an underwire bra.
- Limit your physical activities during the recovery period.
- Make sure that during the healing period the incisions are not subjected to abrasion, excessive force or motion.
- Avoid getting nipples pierced unless your surgeon gives a green signal.
- Do not lift your hands over the head or bend during the recovery period.
- Regularly visit your surgeon to check the recovery.
- Baseline mammography is done after the surgery.
- Take the recommended antibiotics and painkillers to decrease the chances of infection.
- Follow the instructions given by your surgeon regarding bathing and cleaning incisions. Usually, for first three days after surgery, only sponge bath is recommended. After eight days you can change your bra, and after 14 days you can take a regular shower. Some surgeons may suggest you to even wear a bra in the shower for a few weeks.
- Avoid lifting heavyweight
- Avoid smoking until complete healing takes place.
1. How much will breast reduction surgery cost?
The cost of breast reduction surgery includes surgeon’s fee, anesthesia fee, hospital room fee, lab test fee and post-surgery garment price. The total amount varies depending on your location and surgeon’s skill.
2. Who is the best doctor for best reduction surgery?
Meet Mumbai’s most experienced and board-certified cosmetic plastic surgeon Dr Parag Telang.
3. Is breast reduction surgery covered by insurance?
If there are medical causes behind having a breast reduction surgery it may be covered by insurance. However, for reimbursement pre-certification is required.
4. Will I experience pain after breast reduction surgery?
You will experience mild to moderate pain for a few days after breast reduction surgery. The pain can be controlled easily using prescribed painkillers.
5. What is the long-term outcome of breast reduction surgery?
Women with proportionately large breasts after reduction mammoplasty have a youthful appearance, active lifestyle and no discomfort.
6. How many days after reduction mammoplasty can I resume regular work?
You may resume your regular work and exercise after a week or two after breast reduction surgery.
7. After how many days of breast reduction surgery can I drive?
You will be able to drive the very next moment you do not experience the pain of wearing the seatbelt.