What is the Breast Reduction Surgery?
Breast reduction, also known as reduction mammoplasty, is a procedure to remove excess breast fat, glandular tissue and skin to achieve a breast size more in proportion with your body and to alleviate the discomfort associated with excessively large breasts (macromastia).
Disproportionately large breasts can cause both physical and emotional distress for patients. Patients with macromastia may experience physical discomfort resulting from the weight of their breasts. The resulting pain can make it challenging for some patients to perform common physical activities. Along with the physical ailments of macromastia, some patients may suffer from emotional distress or more significant mental health problems as a result of their large breasts.
When is Breast Reduction Surgery needed?
Breast reduction surgery is meant for women who have large breasts and want to resolve issues such as:
- Chronic back, neck and shoulder pain that requires pain medications
- Chronic rash or skin irritation under the breasts
- Nerve pain
- Restricted activity
- Poor self-image related to large breasts
- Difficulty fitting into bras and clothing
What should expect from Breast Reduction Surgery ?
- Your breast will be lifted and firmer, helping you look more youthful
- Bras will fit more comfortably and attractively
- With better proportioned breasts, your overall silhouette will be more balanced and attractive
- Stretched areolas and/or large nipples can be reduced during the same procedure, helping you look better in and out of clothing
- Swimsuits, sports bras, and form-fitting clothes will look and feel better, helping boost your confidence during activity
How is Breast Reduction Surgery performed?
The specific technique used to reduce the size of your breasts can vary. The procedure might include:
- Surgery through incisions
- Liposuction to remove the excess fat in your breasts
The surgeon usually:
- Makes an incision around the areola and down each breast
- Removes excess breast tissue, fat and skin to reduce the size of each breast
- Reshapes the breast and repositions the nipple and areola
The nipple and areola:
- Usually remain attached to the breast
- Might need to be removed and then reattached at a higher position as a skin graft if your breasts are very large
Your surgeon will try to achieve symmetry between your breasts, but some variation in breast size and shape might occur. The size of the areola also might be reduced. Your incision scars might fade over time but will never completely disappear.
Main Breast Reduction surgery techniques -
Liposuction for Breast Reduction
In certain cases, breast reduction can be performed using liposuction alone.
The advantages of liposuction for breast reduction are a shorter, less invasive procedure, virtually undetectable scars on the breast, and lasting results. However, this technique will only achieve optimal results in certain patients. The best candidates are those who need or desire a slight to moderate reduction in breast size, have good skin elasticity and little to no sagging to correct, and whose excess breast size is largely due to excess fatty tissue.
If you have sagging, asymmetrical breasts, stretched skin, or a more significant amount of tissue to remove, one of the next breast reduction techniques will probably benefit you the most.
Vertical or “Lollipop” Breast Reduction
Patients who need a moderate reduction in breast size and have more noticeable sagging are often good candidates for a vertical breast reduction. This involves two incision sites: one is around the edge of the areola, and a second incision running vertically from the bottom of the areola to the inframammary fold, or the crease beneath the breast. This incision pattern allows a cosmetic surgeon to remove excess fat, skin and breast tissue, reshape the new smaller breast internally, and lift the breast into a more youthful position.
While a vertical breast reduction leaves some scarring on the breast, it is limited to the area below the nipple and therefore can be easily hidden beneath a bra or bikini top.
Inverted-T or “Anchor” Breast Reduction
The inverted-T breast reduction involves 3 incisions: one around the edge of the areola, one vertically from the areola to the breast crease, and one made along the crease underneath the breast. Because this technique allows for the maximum degree of tissue removal and reshaping, cosmetic surgeons will typically use this approach if a patient needs a more significant breast size reduction and/or has considerable sagging or asymmetry to correct.
The scars resulting from an inverted-T or anchor breast reduction are similar to those from a vertical reduction, with one additional, thin scar running along the crease beneath the breast. With proper care, scars typically fade considerably over the first year or so after surgery and are easily concealed by clothing, even a bikini top.
Gynecomastia Surgery: Breast Reduction
Breast reduction can also address gynecomastia, which is excess breast tissue or fatty tissue in one or both breasts of a person designated male at birth. Your cosmetic surgeon can offer recommendations as to what type of procedure will work best for you.
One option for this surgery that can minimize scarring involves removing tissue without lifting and revising the skin of the breast. In these cases, breast reduction for men may take 2 to 3 hours. In other patients, excess skin and nipple and areola relocation are necessary. This may lead to additional scarring and additional operating time.
Patients undergoing surgery for gynecomastia should know that their scars may be visible when they are shirtless.
Also, Breast Reduction (Bilateral mastectomy) can be part of surgery for gender affirmation.
How long does the Breast Reduction Surgery take?
In general, the Breast Reduction Surgery takes about two to four hours. Removing excess breast volume (fat and glandular tissue), creating an aesthetic contour and closing the wound to minimize scarring can take additional time in some patients.
What are the risks and complications involved in Breast Reduction Surgery?
Complications after Breast Reduction are relatively rare. The most common are bleeding, infection, and scarring. Your surgeon will give you instructions that will help lower the risk of complications. Those instructions will include such things as not smoking, making sure you are off medications that may make bleeding more likely, and taking antibiotics if necessary.
Possible breast reduction surgery risks include:
- Allergies to tape, suture materials and glues, blood products, topical preparations or injectable agents
- Anesthesia risks
- Bleeding (hematoma)
- Blood clots
- Breast asymmetry
- Breast contour and shape irregularities
- Changes in nipple or breast sensation, which may be temporary or permanent
- Damage to deeper structures – such as nerves, blood vessels, muscles and lungs – can occur and may be temporary or permanent
- Deep vein thrombosis, cardiac and pulmonary complications
- Excessive firmness of the breast
- Fatty tissue deep in the skin could die (fat necrosis)
- Fluid accumulation
- Pain, which may persist
- Poor wound healing
- Possibility of revisional surgery
- Potential inability to breastfeed
- Potential loss of skin/tissue of breast where incisions meet each other
- Potential, partial or total loss of nipple and areola
- Skin discoloration, permanent pigmentation changes, swelling and bruising
- Unfavorable scarring
What are the features of recovery after Breast Reduction Surgery?
After spending a brief time in supervised recovery, you will be able to go home that same day to continue your recovery. Your chest will be bandaged, and you may be sent home in a surgical bra. You can expect to feel considerable soreness the first couple of days after your procedure, and your cosmetic surgeon will prescribe pain medication to help keep you comfortable during this initial period. Gently placing ice packs on top of the bandages can help alleviate discomfort as well.
The amount of time you need to recover from breast reduction will depend on your natural healing rate as well as the extent of surgery performed. You will be able to get up and walk around the same day of surgery, although you should have a trusted adult with you during the first 24 hours. While you may be permitted to shower a few days after surgery, you will probably need help getting dressed, as you will not have full range of motion in your chest and shoulders at first.
When can I return to work after the Breast Reduction surgery ?
Most patients feel ready to drive and return to a desk job within 1 week, after they are no longer taking prescription pain medication. Your cosmetic surgeon will likely have you wait a minimum of 3 to 4 weeks before resuming exercise other than walking; this helps to ensure your incisions heal properly. It is essential to follow your cosmetic surgeon’s regarding activity after breast reduction.
Results of Breast Reduction Surgery -
After breast reduction, you can expect to enjoy smaller, lighter breasts for a lifetime, so long as you maintain a stable weight and do not have any more children. However, nothing can stop the normal aging process. Eventually your breasts will probably begin to sag once again, although not as severely as they might have before breast reduction.
Also, future pregnancies are likely to change the shape, size, and appearance of your breasts, possibly reversing some of the positive changes made during breast reduction. If you are planning to have more children, talk to your cosmetic surgeon. He or she can help you weigh the pros and cons of having surgery now or waiting until you have finished having children.
How much does a Breast Reduction surgery cost?
It can vary significantly depending on multiple factors, including:
Experience of the surgeon
Location of the procedure (office, surgery center, hospital)
Type of anesthesia used
*A low-cost Breast reduction surgery performed by an inexperienced surgeon who delivers poor results is not a good combination.