Breast Reduction Overview
Procedure – Breast reduction, or reduction mammaplasty, is a surgical procedure for reducing the size of breasts. It not only results in smaller breasts, but also returns the breast to a more youthful projecting shape. Many women with large, heavy breasts have neck pain, back pain and difficulty exercising. Studies have shown that reducing the size of the breasts can help improve these symptoms, however there is no guarantee that this will occur.
Surgery and incisions – The surgery usually takes 2-3 hours to complete. Most surgeries are performed in an outpatient or inpatient operating suite, under twilight or general anesthesia. Other procedures can be performed in the office with local anesthetic. Dr. Brown will discuss all options that are right for you during your consultation.
The type of incisions Dr. Brown will make is determined by how large and how droopy (ptotic) your breasts are. Young women with excellent skin tone and minimal droopiness may be candidates for liposuction-only breast reduction. Moderately ptotic breasts require an incision around the areola plus a vertical incision down the center of the breast (also referred to as the “short scar” incision). Finally, very large and ptotic breasts require an additional horizontal incision along the lower breast crease , resulting in an “anchor pattern/inverted-T” scar. Dr. Brown will make every effort to ensure that the scars are as inconspicuous as possible.
Before Breast Reduction Surgery
Initial consultation– In your initial consultation, Dr. Brown will begin by evaluating your health. Be sure to tell your surgeon if you smoke, and if you’re taking any medications, vitamins, or other drugs. Be sure to tell him how your breasts have changed over time-both in terms of size and shape. Discuss any plans for future pregnancies and any family or personal history of breast cancer. Dr. Brown will then explain which surgical technique is most appropriate for you, based on the size and shape of your breasts. Dr. Brown is skilled at all types of breast reduction, including the liposuction-only breast reduction, vertical scar reduction, and traditional “inverted-T” reduction.
Preparing for surgery – Tell Dr. Brown about any medical problems you have, and any problems you may have had with surgery in the past. A history of bleeding problems, nausea with surgery and high blood pressure are important to disclose to your surgeon, because these are risk factors for post-surgical bleeding. You will be told which medications to stop and which to take before surgery. If you smoke, you will be asked to quit for a minimum of 4 weeks prior to surgery as well as 4 weeks after surgery. If you get sick or have any health issues in the days before surgery, please notify the office at once in case we have to postpone your operation.
Can I go home the day of the surgery? – Yes, breast reduction can be done safely as an outpatient, and most patients will be able to go home the same day. Some patients may prefer to spend a night in the hospital if they have young children at home or live alone and do not have any help at home.
After Breast Reduction Surgery Care
What about swelling and bruising? – Swelling and bruising are normal signs of the healing process. They occur after any surgery to varying degrees. Swelling peaks at about 48 hours, and then rapidly decreases. By the end of the first few weeks, 50% of the swelling is gone. During this early period, your breasts will appear larger than their final size due to the swelling. By 6-8 weeks, a majority of the swelling has diminished. By six months, almost all the swelling is gone. Any remaining swelling is almost not perceptible.
What restrictions are there? – Generally, you can shower in 1-2 days after surgery, but you should not submerge incisions in the bath, hot-tub, or swimming pool for 2-3 weeks. The first day after surgery is usually spent lying in bed or sitting in a chair. Most patients then begin walking around the house the day after surgery. By the end of the first week, you will probably be ready to leave the house for short trips and light walks. Vigorous activities should not be performed until 6 weeks after surgery. Also, you should not do any heavy lifting (over 10 pounds) during these 6 weeks.
These are only general guidelines, and Dr. Brown will give you more specific instructions at your consultation.
When can I travel? – Traveling after surgery (air travel, long distance car trips, train rides, etc) should not be done before you have had your first postoperative visit. Typically, this occurs 5-7 days after surgery for suture removal. Patients who are at high risk for developing a blood clot should not travel until instructed by their surgeon. Short car trips under 60 minutes can be done before the first visit. A good rule of thumb is when you are off the stronger pain medication and can get up without assistance you are ready to go for a short drive. You should not drive the car yourself, until your surgeon gives you clearance for this.
What about mammograms? – Routine screening mammograms should be continued after breast augmentation for women who are 40 years of age and older. If you are under 40 but are receiving annual mammograms because you are at high risk for breast cancer you should also continue to have annual screenings. While there is no evidence that breast implants cause breast cancer, they may change the way mammography is performed. When you request a routine mammogram, be sure to go to a radiology center where technicians are experienced in the special techniques required to obtain a reliable x-ray of the breast tissue. Scientific studies have not shown a higher risk of developing breast cancer or a lower survival rate from breast cancer in women who have breast implants.
What if I have a problem? – When should I call the office? We always welcome calls from patients. If you have any concerns at any time, please feel free to contact our office. If it is an emergency, the answering service is available 24 hours a day, including weekends and holidays.