Excessively large breasts can produce several functional problems. Many patients complain of neck and back discomfort and deep grooving of their shoulders from bra straps. Also, a heavy “pulling” discomfort on the chest may exist. Many patients are unable to wear many types of “normal” clothing (especially without a bra). Occasionally, a rash or skin problems beneath the breasts can cause significant irritation.
Large breasts prevent many patients from participating in exercise or other athletic activities. Breast self-examination and mammography are more difficult.
Breast reduction improves the functional problems of excess breast size by:
- Reducing the excess size and weight of the breast
- Tailoring the lower skin envelope to reposition the breast mound upward
- Repositioning the nipple and areola upward on the newly shaped breast mound.
Most patients experience a dramatic improvement in their symptoms immediately after reduction mammaplasty, and are able to wear many types of clothing styles for the first time. In addition, they can often participate in many activities that were impossible before surgery.
In order to remove excess tissue from the breasts and reposition the nipple and areola, 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. The scars are usually located around the nipple, from the lower center of the areola to the fold beneath the breast, and in the fold beneath the breast. The extent and location of the scars depends to some degree on the size and shape of your breasts, and the procedure necessary to correct them.
Before the Surgery
Prior to your breast reduction, Dr. Morris will make several measurements and mark specific areas of your breasts with you sitting. These markings are precise guidelines, which are used when your breasts shift and change shape when you lie down. Dr. Morris will also refer to your pre-operative pictures during surgery to assure the best possible result he can achieve in your situation.
During the Surgery
During the reduction procedure, the stalk of tissue carrying the nipple is designed and prepared, and the excess loose skin (mostly in the lower portions of the breast) is then removed. Excess breast tissue and fat are removed, with the amount and location of removal based on the configuration of your breast.
To reposition the breast mound upward, the skin of the lower portion of the breast is tightened, tailored, and then sutured. The nipple and areola are repositioned upward into the proper position on the new breast and sutured into place. Dr. Morris precisely weighs the amount of tissue removed, sits you up on the operating table, and carefully compares your breasts to assure as much symmetry as possible before closure.
After surgery you will wear a special bra for a few days. You may then wear or not wear a bra as you desire. All of your incisions will be carefully closed with sutures placed beneath the skin, so there is no chance of you having “railroad track” type marks, but we hope for fine line scars. You’ll be able to shower or bathe the next day, unless you have had a nipple grafting procedure.
Following breast reduction procedures, most patients have minimal pain, but rather experience nuisances such as tightness or fullness. Most patients require medication for only 2-3 days, if at all.
Your breasts may feel tight to you for 48-72 hours, and this sensation will gradually resolve over the next several days as the swelling decreases. You may develop slight bruising on the breasts, which will resolve in approximately one to two weeks.
The Stages of Recovery
|Bruising and swelling resolve:||10-14 days|
|Return to work, social activity:||1-3 days|
|Aerobic or strenuous activity:||21 days|
We encourage return to most normal activity except as noted above as soon as possible. Do not do any type of strenuous exercise that would push your pulse over 100 for three weeks. Any aerobic activity that increases your pulse over 100 also increases your blood pressure, and could make you bleed. Also, avoid excessive, exaggerated movements with your arms.
Insurance usually helps to cover some or all of the cost of breast reduction! If necessary, we will obtain pre-approval for this procedure from your insurance company.
Differences always exist between your two breasts – they are different sizes, shapes, and the nipple locations are also different. After breast reduction, these differences will be less, but will always exist to some degree.
In order to reposition the nipple upward onto the new breast mound, some of the surrounding breast tissue must be detached. The nipple is generally left attached to a stalk of tissue within the breast. This is designed to include blood supply and nerve supply, but both may be decreased after reduction. Most patients experience return of sensation over a few months, but some loss of sensation is possible following a breast reduction. For very large breasts, or breasts with certain configurations, the nipple may have to be completely detached and replaced as a graft.
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. However, most patients desiring to breast feed have nursed successfully after reduction.