Breast reduction which is also known as reduction mammoplasty, is a procedure to remove excess breast glandular tissue, fat and skin to make the breasts look more proportionate with the body and to relive the symptoms associated with excessively large breasts (gigantomastia).
The large breasts can cause both physical and emotional distress for patients. Patients with macromastia or gigantomastia may experience physical discomfort due to weight of the breasts. The resulting pain in the shoulders, back, chest can make it troublesome for the patients to perform day to day activities. Apart from the physical ailments of macromastia, few people may suffer from emotional distress or more severe mental health problems due to the large breasts.
Usually the breast reduction procedure is performed to address these medical issues. Few women who do not have any symptoms of macromastia but are still unhappy with the breastsize can pursue breast reduction for aesthetic correction. Such clients may attribute number of factors such as social stigmas and wardrobe concerns.
Who is a good candidate for breast reduction procedure?
Overly large breasts causes health and emotional problems. Addition to self-image issues, few women may also experience physical pain and discomfort. The weight of excess breast tissue impairs the ability to lead a comfortable life. The emotional discomfort and self-consciousness due to the large pendulous breasts might reach to an extent as important as the physical discomfort and pain.
Following criteria indicate that you might be needing a breast reduction surgery
- You are physically healthy
- You have realistic expectations
- You do not smoke
- If You feel that your breasts are too large
- You feel that your day to day physical activity is restricted due to the breasts weight
- You experience back, neck and shoulder pain due to weight of the breasts
- You have marks on the shoulders due to the bra straps
- You have excessive sweating and recurrent infections or skin irritation beneath the breast crease
- You are not finding the adequate wardrobe or inner garments which holds the breasts in proper position
- You find that the breasts are disproportionate to your chest size when you see yourself in the mirror
- You feel the nipple position or direction is altered due to the size of the breasts.
Different types of Breast reduction
“Lollipop” or Vertical Breast Reduction
Patients who are looking for a moderate reduction in the breast size and have more noticeable sagging are good candidates for a vertical breast reduction. This includes two incision sites, one which runs around the areolar edge, and another one vertically from the bottom of the areola to thecrease beneath the breast (called infra-mammary fold). These incisions allowthe plastic surgeon to remove excess fat, skin and breast tissue while reshaping the new smaller breast internally. Thus the breasts are lifted to a more youthful position.
Vertical breast reduction leaves minimal scarring on the breast, which is limited to the area below the nipple. This can be easily hidden beneath a bra or bikini top.
“Anchor” or Inverted-T Breast Reduction
The inverted-T breast reduction involves 3 different incisions, the first two similar to the previous procedure and an additional one made along the crease underneath the breast. This procedure allows for the increased access and hence the maximum degree of tissue removal/reshaping. Plastic surgeons typically use this approach if a patient needs more significant breast reduction and/or has excessive sagging or asymmetry that has to be corrected.
The scars resulting from an inverted-T or anchor breast reduction are same as that from a vertical reduction, with an additional, thin scar along the crease below the breast. With proper care and in expert hands, scars fade considerably over the first year after surgery and so on. They are easily concealed by clothing.
Breast Reduction Surgery Procedure&Post-op Recovery
Breast reduction surgery is generally performed as aday care procedure using intravenous sedation with local anaesthesia or a general anaesthesia. After making the appropriate incisions, excess breast tissue, fat, and skin will be removed.The nipple/areola complex is moved to a higher and more forward position over the chest. The remnant breast tissue and skin will be reshaped, giving an adequate support. Theincisions are closed with absorbable sutures. The areolas can be shaped and reduced to more proportionate size during the procedure.
The chest region will be bandaged and a surgical bra will be put. After a short recovery the client is discharged and is able to go home the same day. There might be considerable soreness the first couple of days and the plastic surgeon will prescribe pain medication during this period. Placing ice packs on top of the bandages can help relieve the pain as well.
The total recovery period post breast reduction procedure will depend on the natural healing rate of the body as well as the extent of surgery. The client will be able to get up and walk around, on the same day of surgery.An adult accompaniment is required during the first 24 hours. The patient can have regular shower a few days after surgery, but may need help in getting dressed, as it takes 2-3 days to have full range of motion in your chest and shoulders.
Manyclients will be ready to drive and return to the desk job within 1 week. However you will have to restrain for a minimum of 3 to 4 weeks before resuming strenuous exercises.This helps to ensure that the incisions heal properly. It is essential to keep in touch with the plastic surgeon continuously regarding activity after breast reduction.
After Breast Reduction
Because it both alleviates physical and emotional discomfort while enhancing the patient’s appearance, breast reduction can be one of the most rewarding procedure. Patients will see an increase in self-confidence as well as a renewed sense of freedom to wear their favourite clothes and participate in physical activities they had previously denied.
Many patients experience an immediate relief from back and shoulder pain after the breast reduction procedure. However it will take some time for the final results to be seen. Swelling, redness, feeling sore and tingling sensation are common after breast reduction. Hence the new smaller breasts might appear a bit larger than the expectation when the swelling is present. Additionally, the bilateral breasts usually heal at a different rate. Because of this some asymmetry during the first few months of the recovery is common.
After about 2-3 months, the final results will be more or less in place and then you can shop for new bras with confidence. However, there might be ongoing subtle changes for the next 6 to 12 months.
How Long the Results of Breast Reduction Last?
After breast reduction, The client can expect to enjoy smaller, lighter, well shaped and sized breasts for a lifetime generally. As long as the weight is stable with a buffer of around 20 pounds and if there is no more pregnancies, the breast will maintain the size forever. However, the skin aging process does continue andthe breasts might sag once again at the later stage of life, although not as severely as they might have been due to the weight, before breast reduction.
The future pregnancies can change the shape, size, and appearance of the breasts, possibly reversing some of the changes made during breast reduction. If you are planning to have more children, better talk to the plastic surgeon beforehand. He will help in deciding on whether to have surgery now or wait until the delivery.
Risks of Breast Reduction Surgery?
The decision to undergo breast reduction surgery is entirely personal. You will have to decide if the benefits will suit your requirements and if the risks of breast reduction surgery and potential complications are within acceptable.
The plastic surgeon and/or plastic surgery staff will explain in detail the risks associated with procedure. Written consents will be taken to ensure that you fully understand the procedure and any risks or potential complications.
Possible breast reduction surgery risks include:
- Bleeding (hematoma)
- Blood clots
- Deep vein thrombosis, cardiac and pulmonary complications
- Changes in nipple or breast skin sensation, which may be temporary or permanent
- Anaesthesia risks
- Damage to deeper structures like nerves, blood vessels, muscles and may be temporary or permanent
- Poor wound healing
- Breast contour and shape irregularities
- Partial loss of skin/tissue of breast where incisions meet each other
- Excessive firmness of the breast
- Pain, which may persist
- Allergies to dressing material and tapes or ointment
- Fat Necrosis and cysts
- Partial or full loss of nipple and areola skin
- Breast asymmetry
- Unfavourable scarring
- Skin discoloration, permanent pigmentation changes, swelling and bruising
- Potential inability to breastfeed
- Fluid accumulation
- Possibility of revision surgery
One should be knowing that:
- Breast reduction surgery can interfere with certain diagnostic procedures like mammography etc
- Breast and nipple piercing can cause an infection post-surgery
- Your ability to breastfeed following reduction mammoplasty may be limited.Do talk to your doctor if you are planning for lactating later
- The breast reduction procedure can be performed at any age, but is best done when the breasts are fully developed, which will be after 16 years
- Changes in the breasts during pregnancy can alter the results of previous breast reduction surgery, as can significant weight fluctuations