Breast Reduction

What is Breast Reduction?

Breast reduction also referred to as reduction mammoplasty, is a surgical procedure in which excess fat, tissue, and skin is removed from the breasts. The surgery is normally sought by women who wish to accomplish an aesthetically pleasing breast contour and size proportionate to their body, and to mitigate the discomfort associated with unusually large breasts (macromastia).

Breast reduction surgery can also be combined with breast cancer removal. It is known as Therapeutic Mammoplasty or Adaptive Mammoplasty.

Unlike standard reduction mammoplasty, tumour factors also should be considered when planning for surgery. Therapeutic mammoplasty offers an alternative management approach to both removal of breast cancer and achieving an excellent cosmetic result

Indications for Breast Reduction

Breast reduction surgery is indicated for women with abnormally large breasts and the issues related to it, such as the following:

• Persistent neck, shoulder, and back pain requiring medication
• Persistent rash or skin irritation below the breasts
• Activity restrictions
• Nerve pain
• Trouble fitting into clothing, swimsuits and bras
• Poor self-esteem due to large breasts
• Breast cancer in large breasted women

Preparation

In general, preparation for breast reduction includes the following:

• A thorough examination by your doctor to check for any medical issues that need to be addressed prior to the procedure.
• You will need to undergo tests such as blood work and a mammogram to help detect any abnormalities that could threaten the safety of the procedure.
• You will be asked if you have allergies to medications, anaesthesia, or latex.
• Inform your doctor of any medications, vitamins, or supplements that you are taking.
• Refrain from taking any anti-inflammatory drugs, aspirin or supplements, as they may increase the chance of bleeding.
• Refrain from smoking pre- and post-procedure for a specific period of time, as this may hamper proper healing and increase your chances of areolar or nipple damage, tissue necrosis, and other complications.
• You will review before and after procedure photos of patients with similar breast size and shape.
• Written consent will be obtained from you after the procedure has been explained in detail.

Procedure

Breast reduction is usually performed under general anaesthesia either in an outpatient or hospital setting. The surgery may take 2 to 3 hours. Based on the size and composition of the breasts, your surgeon may employ various techniques to carry out the procedure: vertical or “lollipop”, wise pattern or inverted-T (“Anchor”) breast reduction. In general, your surgeon will take the following steps:

• Use a marker to draw guidelines on the breasts to carry out the incisions
• Make a surgical cut accordingly around the areola and downward on each breast similar to a keyhole
• Remove extra fat, tissue and skin to decrease the size of each breast
• Reposition the areola and nipple and reshape the breast
• May place a drainage tube under each arm to drain excess fluid or blood
• Close the incisions with sutures and apply waterproof dressing

Post-Procedure Care and Recovery

Most people can go home the next day after surgery if no complications are noted. The drain will be removed before discharge from the hospital. In general, postoperative care instructions and recovery involve the following:

• You may experience sensitive, tender, swollen or bruised breasts. Pain and anti-inflammatory medications are provided as needed.
• An elastic compression bra or a surgical bra is advised to protect the breasts. You will be asked to bring the bra to the theatre as it will be used at the end of the procedure.
• Refrain from any physical activity of upper body for at least 2 to 4 weeks to promote healing.
• You will be able to take a shower from the first day after surgery. A waterproof dressing will protect your surgical scar.
• Avoid heavy lifting or any strenuous activities as you recover.
• Refrain from using any underwire bras for a few months.
• Your doctor will provide you with instructions on diet, and wound care.
• You may need to take off from work or studies at least a week to facilitate recovery.
• You will be able to resume normal activities within 1 to 2 weeks but may have certain activity restrictions.
• A periodic follow-up will be scheduled to monitor your overall progress.

Benefits

Some of the benefits of breast reduction include:

• Improvement of self-image and confidence
• Helps you appear more youthful with a firm and well-positioned breast
• Form-fitting clothing, sports bras, and swimsuits will feel and look better

Risks and Complications

Breast reduction is a relatively safe procedure; however, as with any surgery, the following risks and complications are possible:

• Breast scarring
• Temporary pain in the breasts
• Temporary bruising
• Infection
• Bleeding under the skin (hematoma)
• Accumulation of fluids in breast tissue
• Reaction to stitches
• Possibility of revision surgery

Is Breast reduction Surgery supported by Private insurance and Medicare?

Yes, but only in medically indicated cases.