Cosmetic Breast Reduction
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Candidates for breast reduction include patients whose breast size is too large for their body and frame that often leads to back, neck, and shoulder pain. The women’s bra straps often leave deep grooves in their shoulders and they may even experience a rash underneath their breasts. Their large breasts often sag and result in nipples that point downward. Breast reduction surgery can address both reducing and lifting a patient’s breasts to improve the appearance of her breasts and to help alleviate her associated symptoms.
During the initial consultation, Dr. Casas will assess the development of your breasts, and she will ask about your desired breast size as well as anything else about your breasts that you would like to see improved. This will help Dr. Casas understand your expectations and determine whether they realistically can be achieved. Timing is very important, and Dr. Casas will explain that breast size and shape are altered with weight gain and hormonal influences. Together, you will decide when these factors are stable to provide the proper conditions for breast reduction surgery. If you plan to breast-feed in the future, you should discuss this with Dr. Casas.
Breast reduction procedures vary depending on the size and shape of the breast and the quality of the skin. Patients typically undergo general anesthesia for breast reduction surgery. Rarely, breast reduction with liposuction alone can achieve the desired result. Most commonly, two incisions are needed: one around the areola to make it smaller and one vertically directed from the areola to the base of the breast. Occasionally with extremely large breasts, a free nipple graft reduction is needed. Liposuction around the breast at the upper abdomen and underneath the arm is used to improve the contour of the breast. Usually, the nipples and areolas remain attached to underlying mounds of tissue, and this allows for the preservation of sensation. The ability to breast-feed may also be preserved by this method, although this cannot be guaranteed.
The day after surgery, you will be encouraged to get out of bed for short periods of time. After several days, you will be able to move about more comfortably. However, Dr. Casas will emphasize that straining, bending, and lifting must be avoided since these activities might cause increased swelling or even bleeding. You may be instructed to sleep on your back to avoid pressure on your breasts. Any surgical drains will be removed a day or two after surgery, at which time your dressings may also be changed or removed. Dr. Casas will instruct you to wear a support bra until the swelling and discoloration of your breasts diminishes and the breast acquires its new shape. Generally, stitches will be removed in four weeks.
Within just a couple of weeks, it is often possible to return to work, depending on your job, and you can resume most of your normal activities including some form of mild exercise. You may continue to experience some mild, periodic discomfort during this time, but such feelings are normal and Dr. Casas will advise you regarding the most appropriate management to keep you as comfortable as possible.
Any sexual activity should be avoided for a minimum of two weeks, and Dr. Casas may advise you to wait longer. After that, care must be taken to be extremely gentle with your breasts for at least the next six weeks.
Manual Lymphatic Drainage, administered by massage, is used after each procedure to reduce swelling. The number of sessions is individualized. It is important that patients follow a healthy lifestyle leading up to and following procedures, including non-smoking, a healthy diet and daily vitamins. Click here to learn more.
One common breast reduction technique removes excess breast tissue, fat and skin through the incisions shown. The nipple and areola remain attached to the underlying tissue but are shifted to a higher position. The size of the areola is often reduced at the same time.
Skin that formerly was located above the nipple is brought down and together to reshape the breast.