Many women develop large breasts that are out of proportion to their body size after puberty or pregnancy. These women can have symptoms that include neck and back pain, rash, painful bra strap marks, difficulty fitting into clothes, tingling in the hands, and, in younger girls, difficulty adjusting socially. In these women, the breast can be reduced to a more normal size with complete relief of these symptoms.
Breast reduction is one of the most common procedures performed on the breast. Many women have a breast size which is out of proportion to the remainder of their body. Due to the weight that their breasts exert on the shoulders and neck, many women experience neck and shoulder pain related to their large breast size. Other symptoms include rashes, which develop on the underside of the breast in warm summer months and headaches associated with weight on the neck. Large breasts also prevent some patients from participating in athletic activities and can make breast mammograms more difficult.
These symptoms are nearly completely eliminated with a standard breast reduction. In most instances, the procedure is covered by insurance. As a whole, patients who undergo breast reduction are the happiest patients we see in plastic surgery. Their symptoms of neck pain, back and shoulder pain are nearly completely relieved. The patients have a much better body image, are able to wear clothing with much less difficulty, and have a much more positive outlook on life.
Breast reduction procedures improve functional problems of excess breast size by:
- Reducing the excess size and weight of the breast.
- Removing excess breast tissue from within the breast.
- Tailoring the lower skin envelope of the breast to reposition the breast mound upward to a more normal position, and
- Repositioning the nipple-areola complex upward onto the newly shaped and positioned breast mound.
Most patients experience a dramatic improvement in their symptoms soon after reduction mammaplasty. They’re able to wear many types of clothing for the first time and they can participate in many activities that they were unable or unwilling to before.
In order to remove excess tissue from the breasts and reposition the breast mound, incisions must be made in the lower part of the breast. These incisions produce scars which are visible, but improve significantly over 6-12 months. These scars are usually located around the nipple, from the lower center of the areola to the fold beneath the breast, and in larger breasts, extend out laterally underneath the breast.
Differences always exist between your two breasts – they are different sizes and the nipple locations are also different. After breast reduction, these differences will be less visible, but will always exist to some degree.
In order to reposition the nipple upward onto the new breast mound, some of its attachments must be detached. However, the nipple is left attached to a stalk of tissue, from within the breast, that is designed to include blood supply and nerve supply. Both the nerve and blood supply may be decreased after reduction. Most patients experience a return of sensation over a few months, but some loss of sensation is possible following breast reduction.
When reducing the amount of milk-producing tissue within the breast, it is necessary to divide some of the milk ducts that converge at the nipple. For this reason, the ability to nurse may also be decreased following breast reduction. Some patients, however, have nursed successfully after reduction.
Risks common to all surgical procedures such as bleeding, infection, and scar tissue formation occur in a very small percentage of cases. We’ll give you more detailed information about these and other inherent risks during your constultation and encourage you to discuss any concerns during that time.
Prior to your breast reduction, Dr. Sonderman will make several measurements and mark specific areas of your breast when you’re sitting or standing. These markings are precise guidelines which are used when your breast is distorted or shifted when you are lying down. Dr. Sonderman will also refer to your pre-operative pictures during surgery to assure the best possible results.
During the reduction procedure, the stalk of tissue carrying the nipple is designed and prepared. The excess loose skin (mostly in the lower portions of the breast) is then removed. Excess glandular or milk producing breast tissue is removed depending on your desired breast size and shape.
To reposition the breast mound upward, the skin of the lower portion of the breast is tightened, tailored, and then sutured closed. The nipple-areola complex is repositioned upward into the proper position on the new mound and sutured in place. Dr. Sonderman precisely weighs the amounts of tissue removed, sits you up on the operating table, places temporary stitches and carefully compares your breasts to assure as much symmetry as possible before closure.
You will wake up with a surgical bra in place which you will wear for one week. Then you’ll be able to switch to a softer, but supportive bra of your own choosing.
All your incisions will be carefully closed with stitches placed beneath the skin which will leave very fine line scars instead of “railroad track” type marks. You will be able to shower or bathe two days after surgery. Suture removal consists of clipping a few ends of the sutures that are left outside the skin. The remainder of the sutures simply dissolve.
Following breast reduction procedures, most patients experience nuisances such as tightness or fullness,but have very little pain.
We’ll prescribe medication if you have moderate feelings of soreness. Most patients require medication for only 2-3 days.
Your breast may feel tight to you for 48-72 hours. The tightness will gradually diminish over the next several days as the swelling decreases. You may develop slight bruising on the breasts which will resolve in about a week.
Usually, our patients want to know about four stages of recovery: (1) hospitalization time, (2) when swelling and bruising will diminish, (3) when they’ll be able to return to work or social activity, and (4) when they can return to full aerobic or strenuous activity. Typically, breast reduction procedures require the following:
- Breast reduction is performed as an outpatient procedure. It is done under a general anesthetic and takes about three hours to do.
- Bruising will resolve in 10-14 days.
- Patients often return to work or social activity after approximately 1-2 weeks. It may take up to six weeks before a return to extremely heavy work.
- We want you to wait 3-4 weeks after surgery before doing aerobic and strenuous activity.