Breast reduction, also known as reduction mammaplasty, is a procedure used to reduce the size of large, pendulous breasts. Significant amounts of excess weight can be removed and the breasts can be lifted, firmed up and tightened at the same time.
Excess weight and sagging of breasts have been shown to cause numerous medical problems, including significant neck and back pain, skin irritation and even skeletal deformities and breathing problems. Significant complaints of bra strap irritation and grooving, or digging into the shoulders, are also quite common and can be significantly improved with breast reduction surgery. Physical activity, including such common exercises as jogging, can become quite challenging, and women or teenage girls with unusually large breasts may become extremely self-conscious.
What is a Breast Reduction?
Breast reduction is a surgery that removes excess skin and fat from the breast and under the armpit area. In addition, it allows shaping and contouring of the breast and overlying skin, which can significantly improve the shape, appearance and weight of the breast. Improvements can be significant, and the vast majority of breast reduction patients are extremely happy with their result. During the procedure, skin, fat and breast glandular tissue are removed. The size of the nipple and areola may also be improved and made smaller.
It should be noted, however, that removal of these significant amounts of skin, fat and breast glandular tissue must be performed through incisions that may leave long scars. These scars usually heal well with time, but can be unsightly and wide in a small number of cases. The overall benefits of the procedure must be weighed carefully by the patient and her physician in each individual case.
The best candidates for breast reduction are women who seek significant functional and aesthetic improvement from a reduction of weight in the breasts.
Good candidates for breast reduction:
- Have disproportionately large, sagging breasts
- Have significant physical activity restrictions due to the size of their breasts
- Have significant symptoms, including back pain, bra strap grooving and skin rashes from their breasts
- Maintain a stable weight
- Are mature enough to fully understand the risks and benefits of their procedure
Women who are poor candidates for breast reduction:
- Are excessively obese or overweight
- Have weight swings with a significant amount of weight gain and weight loss
- Have no functional impairment from their breasts (these women should consider a mastopexy or breast lift instead)
- Are women who are intent on breast-feeding after their procedure
- Are disturbed by long scars or the possibility of long scars.
Breast reduction typically takes between three and six hours depending upon the size of the patient and the size of the breasts that need to be reduced. A surgeon may work alone or have an assistant during the procedure.
General anesthesia is used and the patient is asleep and comfortable during the entire operation.
Marks are placed by the surgeon, prior to the procedure, with the patient in a standing or sitting position. The procedure is then reviewed and the marks are carefully checked and discussed with the patient one more time prior to the procedure.
In the operating room, incisions are carefully made and excess skin, fat and breast tissue are removed as required. The remaining tissue is shaped and is often folded upwards and inwards to provide increased lift, improved shape and better final overall appearance of the breast. The size of the areola around the nipple may be reduced as well. The skin is then carefully brought together over the breast and sutured meticulously in multiple layers to provide for an overall improved size and shape of the breast.
Patients may go home the day of the breast operation, although sometimes they elect to stay overnight in an after-care facility or hospital.
After the Surgery
Breast reduction is usually not painful. A simple wrap placed around the chest in the operating room at the conclusion of the procedure is used to reduce swelling and the possibility of collections of fluid or blood underneath the breast tissue. Drains may or may not be required, depending on the size of the breast and the complexity of the operation. If they are required, they are usually removed 1-2 days after surgery. Some soreness may be present for several days after the procedure.
Dr. Granzow typically does not require significant limitations in the range of movement in the arms after surgery, although heavy activity and lifting is not allowed at first.
Dr. Granzow uses carefully-placed absorbable sutures in almost all cases with special skin sealant for the scars. This allows the patient to shower the day following her surgery and for healing to progress rapidly. Patients may return to a desk job approximately one week after surgery and increase their physical activity proportionally for the first several weeks after surgery. Full physical activity, including strenuous activities such as golf, tennis or yoga, is allowed approximately six weeks after surgery.
Risks of Breast Reduction
Breast reduction is not a simple operation, but it is typically a safe operation. Risks are low and are common for all doctors and centers. These include bleeding, infection, pain, and damage to nerves and vessels. Long scars will be present and typically heal well. However, scars may widen, thicken and be painful. There is always a risk of loss of sensation or tissue around the nipple or the breast itself as well as risks of fluid or blood collection, pain, asymmetry and an unsightly appearance. Anesthesia risks are also low but are typically present and include risks of blood clots in the legs and lung. Future breast-feeding may not be possible after the procedure.
The Final Appearance
Some bruising and swelling is normal and expected immediately and in the first 1-2 weeks after surgery. These will subside with time, although small amounts of swelling may be present for several weeks or even months after the procedure. Scars may be long and permanent, although they usually fade significantly over time.
The weight reduction will be noticed immediately, and the final shape will tend to maintain a “lifted” appearance for many years longer than a breast of similar size which has not had the procedure.