Breast Reduction Surgery
Dr. Hootan Daneshmand
Women with very large, pendulous breasts may experience a variety of medical problems caused by the excessive breast weight. Back and neck pain, skin irritation, skeletal deformities, and breathing problems are some of the typical problems associated with macromastia (large breasts). Bra straps may leave indentations in their shoulders. Unusually large breasts can make a woman or a teenage girl feel extremely self-conscious.
Orange County breast reduction, technically known as reduction mammaplasty, is designed for such women. The procedure removes fat, glandular tissue, and skin from the breasts, making them smaller, lighter, and firmer. It also reduces the size of the areola (the darker skin surrounding the nipple). The goal of this type of breast surgery is to give the woman smaller, better-shaped breasts in proportion with the rest of her body.
If you’re considering breast reduction plastic surgery in Orange County, this will give you a basic understanding of the procedure, when it can help, how it’s performed, and what results you can expect. It can’t answer all of your questions, since a lot depends on your individual circumstances. Please be sure to ask your doctor if there is anything about the procedure you don’t understand.
Am I a good candidate for breast reduction?
Breast reduction must be carefully individualized to each patients needs. A consultation to evaluate your breast exam and discuss your goals can best determine how well the procedure will work for you. Usually, women with large, heavy, pendulous breasts will benefit from a reduction procedure.
How much scarring will I have?
There are several types of breast reduction procedures. The surgical option that is best for you depends upon your breast exam and goals. There is no way to reduce a breast without scarring. However, usually the scars are very well tolerated as a trade-off for smaller, more aesthetic breasts. The scarring will be around the areola with a vertical component that extends down from the areola to the crease below the breast. An additional scar is often necessary in the crease below the breast in order to give you the best contour possible.
Will smoking affect my recovery?
Smoking adversely affects wound healing. Smoking causes constriction of blood vessels which impairs wound healing. The incidence of having a wound complication such as an open wound or skin death is much higher in smokers. Furthermore, the rate of wound infection is also significantly increased in smokers for the same reason of limited blood flow. Because of this, a patient must stop smoking for a minimum of four weeks prior to surgery to decrease the risk of these complications. In addition, smoking is prohibited for one month after surgery as poor wound healing may result if smoking is resumed during this time.
Am I a candidate for a minimal-scar breast reduction?
That depends upon your breast exam and measurements. Every attempt is made to limit scarring without compromising the ultimate shape and size of your breasts. A consultation with Southern California board certified plastic surgeon Dr. Daneshmand can help you better understand if this is a good procedure for you.
What size will I be after the procedure?
It is imperative that you and your plastic surgeon understand one another regarding the size you wish to be. The patientís body type, size, and chest circumference all influence the final size that will result in the best appearance. This must be combined with the patientís individual goals to achieve a successful outcome.
Does a breast reduction include a breast lift?
Yes. Lifting the breast is an integral component of the breast reduction procedure and is included in the operative planning. The overwhelming majority of women who wish to have their breasts reduced also require a lifting of the breast tissue and nipples to achieve an attractive result.
What about nipple sensation?
Typically, permanent nipple sensation is not altered with breast reduction surgery. Occasionally, a patient may have reduced sensation after the procedure. Smaller reductions decrease the chance of having some sensory loss. Most often sensory changes are temporary after breast reduction and improve with time. Most women have no change from the procedure and their nipple sensation is kept intact. Some women actually have improved nipple sensation after a reduction, presumably due to reducing the stretch on the nerves that innervate the nipple.
Will a breast reduction affect my ability to breast feed?
Every attempt is made to preserve as many milk ducts as possible to ensure the best chance of being able to nurse after a reduction. Despite this, a percentage of women will have some difficulty with breast feeding. The amount of tissue that is removed may impact the ability to breast feed after surgery.
What are the complications of breast reduction surgery?
As with any surgery, there is always a possibility of complications including bleeding, infection, or wound healing problems. These occur in a small percentage of patients. You can reduce your risks by closely following your physician’s advice both before and after surgery.
The procedure 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 slightly mismatched breasts or unevenly positioned nipples. Future breast-feeding may not be possible, since the surgery removes many of the milk ducts leading to the nipples.
Some patients may experience a permanent loss of feeling in their nipples or breasts. Rarely, the nipple and areola may lose their blood supply and the tissue will die. (The nipple and areola can usually be rebuilt, however, using skin grafts from elsewhere on the body.)
Will my nipple have to be removed and replaced as a free nipple graft?
There is rarely a case that requires a free nipple graft. The nipple stays on the breast tissue and is moved up along with the breast mound and its blood supply. This gives you the best chance of preserving your sensation and contractility.
Where is the surgery performed?
Breast reduction is performed at accredited outpatient surgical facilities. Anesthesia is performed by board-certified anesthesiologists and your recovery is supervised by highly trained nurses. This ensures the highest degree of safety and the lowest infection rates.
What kind of anesthesia is used for the procedure?
General anesthesia is the preferred method of achieving adequate sedation and pain control. You will be entirely asleep for the duration of the procedure and awake in recovery before you know it. Board-certified anesthesiologists deliver the anesthesia and care for you before, during, and after surgery so that you have a comfortable and safe experience.
What is the recovery period?
After a breast reduction, you may either recover at home, in an after-care facility with nurses, or in the hospital depending upon your needs. You will be walking the day of surgery with some discomfort and tightness in your chest. The first evening a large ace wrap will be applied to compress the tissue. A sports bra that buttons or zipps in the front are generally the best dressing for the next few weeks as the tissue heals. Generally patients are off of pain medication after a few days and back to work within a week or two. At 4 weeks, low-impact exercise is permissible followed by unrestricted activity after 6-8 weeks.
When will the healing be complete?
Although much of the swelling and bruising will disappear in the first few weeks, it may be six months to a year before your breasts settle into their new shape. Even then, their shape may fluctuate in response to your hormonal shifts, weight changes, and pregnancy. Your 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.
Of all plastic surgery procedures, breast reduction results in the quickest body-image changes. You’ll be rid of the physical discomfort of large breasts, your body will look better proportioned, and clothes will fit you better.
However, as much as you may have desired these changes, you’ll need time to adjust to your new image-as will your family and friends. Be patient with yourself, and with them. Keep in mind why you had this surgery, and chances are that, like most women, you’ll be pleased with the results.
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