Breast Reduction Surgery

Overly large breasts can cause some women to have both health and emotional problems. In addition to self image issues, you may also experience physical pain and discomfort.

The weight of excess breast tissue can impair your ability to lead an active life. The emotional discomfort and self-consciousness often associated with having large pendulous breasts is as important an issue to many women as the physical discomfort and pain.

Also known as reduction mammaplasty, this procedure removes excess breast fat, glandular tissue and skin to achieve a breast size in proportion with your body and to alleviate the discomfort associated with overly large breasts.

Is it right for me?
Breast reduction is a highly individualized procedure and you should do it for yourself, not to fulfill someone else’s desires or to try to fit any sort of ideal image.

Breast reduction is a good option for you if:

  • You are physically healthy
  • You have realistic expectations
  • You don’t smoke
  • You are bothered by the feeling that your breasts are too large
  • Your breasts limit your physical activity
  • You experience back, neck and shoulder pain caused by the weight of your breasts
  • You have regular indentations from bra straps that support heavy, pendulous breasts
  • You have skin irritation beneath the breast crease
  • Your breasts hang low and have stretched skin
  • Your nipples rest below the breast crease when your breasts are unsupported
  • You have enlarged areolas caused by stretched skin

What happens during breast reduction surgery?
Breast reduction is usually performed through incisions on your breasts with surgical removal of the excess fat, glandular tissue and skin.

In some cases, excess fat may be removed through liposuction in conjunction with the excision techniques described below. If breast size is largely due to fatty tissue and excess skin is not a factor, liposuction alone may be used for breast reduction.
The technique used to reduce the size of your breasts will be determined by your individual condition, breast composition, amount of reduction desired, your personal preferences and the surgeon’s advice.

Step 1 - Anesthesia
Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.

Step 2 - The Incision
Incision options include:

A circular pattern around the areola
Breast Reduction - Circular Pattern, BeforeBreast Reduction - Circular Pattern, After

The incision lines that remain are visible and permanent scars, although usually well concealed beneath a swimsuit or bra.

A keyhole or racquet-shaped pattern with an incision around the areola and vertically down to the breast crease
Breast Reduction - Vertical Incision, BeforeBreast Reduction - Vertical Incision, After

An inverted T or anchor-shaped incision pattern
Breast Reduction - Anchor Shaped Incision, BeforeBreast Reduction - Anchor Shaped Incision, After

Step 3 - Removing Tissue And Repositioning
After the incision is made, the nipple-which remains tethered to its original blood and nerve supply-is then repositioned. The areola is reduced by excising skin at the perimeter, if necessary.

Underlying breast tissue is reduced, lifted and shaped. Occasionally, for extremely large pendulous breasts, the nipple and areola may need to be removed and transplanted to a higher position on the breast (free nipple graft).

Step 4 - Closing The Incisions
The incisions are brought together to reshape the now smaller breast. Sutures are layered deep within the breast tissue to create and support the newly shaped breasts; sutures, skin adhesives and/or surgical tape close the skin. Incision lines are permanent, but in most cases will fade and significantly improve over time.

Step 5 - See The Results
The results of your breast reduction surgery are immediately visible. Over time, post-surgical swelling will resolve and incision lines will fade. Satisfaction with your new image should continue to grow as you recover.
Important facts about the safety and risks of breast reduction
The decision to have breast reduction surgery is extremely personal and you’ll have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable.
Your plastic surgeon and/or staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks or potential complications.

The risks include:

  • Unfavorable scarring
  • Infection
  • Changes in nipple or breast sensation, which may be temporary or permanent
  • Anesthesia risks
  • Bleeding (hematoma)
  • Blood clots
  • Poor wound healing
  • Breast contour and shape irregularities
  • Skin discoloration, permanent pigmentation changes, swelling and bruising
  • Damage to deeper structures - such as nerves, blood vessels, muscles, and lungs - can occur and may be temporary or permanent
  • Breast asymmetry
  • Fluid accumulation
  • Excessive firmness of the breast
  • 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
  • Deep vein thrombosis, cardiac and pulmonary complications
  • Pain, which may persist
  • Allergies to tape, suture materials and glues, blood products, topical preparations or injectable agents.
  • Fatty tissue deep in the skin could die (fat necrosis)
  • Possibility of revisional surgery

You should know that:

  • Breast reduction surgery can interfere with certain diagnostic procedures
  • Breast and nipple piercing can cause an infection
  • Your ability to breastfeed following reduction mammaplasty may be limited; talk to your doctor if you are planning to nurse a baby
  • The procedure can be performed at any age, but is best done when your breasts are fully developed
  • Changes in the breasts during pregnancy can alter the outcomes of previous breast reduction surgery, as can significant weight fluctuations

When You Go Home
If you experience shortness of breath, chest pains, or unusual heart beats, seek medical attention immediately. Should any of these complications occur, you may require hospitalization and additional treatment.
The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedures and another surgery may be necessary.

Be Careful
Following your physician’s instructions is key to the success of your surgery. It is important that the surgical incisions are not subjected to excessive force, abrasion, or motion during the time of healing. Your doctor will give you specific instructions on how to care for yourself.

Be sure to ask questions: It’s very important to address all your questions directly with your plastic surgeon. It is natural to feel some anxiety, whether excitement for the anticipated outcome or preoperative stress. Discuss these feelings with Dr. Soto

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