Breast reduction (reduction mammaplasty) is designed to reduce the size of excessively large breasts. Women with very large, pendulous breasts may experience a variety of medical problems including back, neck and shoulder pain. Bra straps may leave grooves on the shoulders. Unusually large breasts can also be a source of embarrassment to teenage girls.

The surgical procedure involves the removal of excess glandular tissue, fat and skin from the breasts making them smaller and lighter, in addition to lifting the breasts on the chest wall. It can also reduce the size of the areola, the darker skin surrounding the nipple. The goal is to give the patient smaller, better-shaped breasts in proportion with the rest of her body.

Breast reduction is usually performed for physical relief rather than simple cosmetic improvement. Most women who have the surgery are troubled by very large, sagging breasts that restrict their activities and cause physical discomfort. Breast reduction is not usually recommended for women who intend to breast-feed.

As with any surgery, there are occasional complications following breast reduction. These include bleeding, infection or reaction to the anesthesia. The procedure does leave noticeable, permanent scars although they will be covered by your bra or bathing suit. 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 experience a permanent loss of feeling in their nipples or breasts. Rarely the nipple and areola may loose their blood supply and the tissue will not survive. The nipple and areola can usually be rebuilt, however, using skin grafts from elsewhere in the body.

During your consultation, Dr. Bromley will examine and measure your breasts. Photographs will be taken for pre-operative documentation as well as insurance determination. At that time all questions regarding amount of reduction, final bra size and specific surgical technique will be discussed.

Breast reduction is generally done in as an out-patient procedure. The surgery itself takes three to fours hours. The procedure is done under general anesthesia. Most patients are discharged on the day after surgery.

In most cases the nipples remain attached to their blood vessels and nerves. However, if the breast are very large or pendulous, the nipples and areolas may have to be completely removed and grafted into a higher position. The will result in some loss of sensation in the nipple and areola.

Sutures are usually located around the areola, in a vertical line extending downward and along the lower crease of the breast. These resulting scars are permanent, but can be easily concealed by clothing.

After surgery, you'll be wrapped in a surgical bra over gauze dressings. A small tube may be placed in each breast to drain off blood and fluids. This drain is usually removed on the first post-operative day.

You may feel some discomfort for the first couple of days. This should be easily controlled with oral pain medication. The bandages will be changed approximately one week after surgery. Your sutures will be removed in two weeks. You will be advised to continue wearing a sport-type bra for continued support in the initial post-op period.

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

Most patients resume light daily activities one to three days after the surgery. It will probably take one to two weeks for you to resume all usual daily activities, including return to work. You should avoid lifting or pushing anything heavy for three to four weeks. Additional activities like athletics will be discussed during your post-operative visits.

A small amount of fluid draining from your surgical wound, or some crusting is normal and usually resolves with no permanent effects. It takes approximately three months to a year for your breast to settle into their new shape. Their shape may fluctuate in response to your menstrual cycle shifts, weight change and pregnancy.

Every effort is made to keep your scars as inconspicuous as possible. Still, it's important to remember that breast reduction scars are permanent. They often remain firm and red for months then gradually fade to thin white lines. There are a variety of treatment options available that will help to minimize these scars. These options will be discussed during your post-operative visits.

If you have any questions regarding breast reduction, or any other plastic surgical procedure, please contact our office.  Photo  galleries, in addition to 3D animation of this procedure can be found at the American Society of Plastic Surgeons website.

Excessively large breasts can cause back, neck and shoulder discomfort

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