What is Breast Reduction?
Breast Reduction surgery or Reduction mammaplasty is a reduction of the breast tissue to make the breasts smaller and lighter. This commonly requested procedure helps in getting more proportionate breasts to one’s frame. It alleviates the immense physical (Back pain, neck pain, bad posture, fungal infection in the lower breast fold) and social discomfort that a woman may be feeling due to the large breasts. It corrects the asymmetry in the nipple-areola area and also in the breast sizes.
When does one need Breast Reduction?
You may need breast reduction if you have
- Large breasts disproportionate to your body frame that make you conscious in everyday life.
- Large breasts which have the nipples and areola that are pointed downwards
- Unhappy about breasts being too large.
- If one breast is larger than the other.
- Shoulder pain, neck pain and back pain due to the heavy breasts.
- Difficulty in breathing when you lie down due to the breasts pressing the neck region in lying down position.
- Shoulder grooving due to bra straps
- Excess sweat or repetitive fungal infections due to the breast folds
- For the better fitting of clothes
- Betterment of poor posture.
What are the Pros and Cons of Breast Reduction?
- Smaller breasts and regained confidence.
- Lifted firmer breasts
- Smaller nipple and areola size
- Relief from the neck, shoulder, upper back pain.
- Better breathing and exercising capability
- Decrease sensations in certain areas which may include nipples and areola.
- Difficulty in breastfeeding.
What are the types of Breast reductions one can have?
The procedures of breast reduction are varied: Liposuction: Although liposuction is performed in almost all breast reduction, it is used as an adjunctive procedure rather than the mainstay of treatment. It is usually used to reduce the fat component of the breasts and the sides. Alone liposuction will only benefit females where they have a substantial fat component in the breasts. This usually happens with post-menopausal women.
If one does liposuction alone the breasts can be reduced only to a moderate degree with some amount of sagging from the procedure.
Doughnut Incision: This is also called the peri-areolar approach. Again this is of limited use and pertains to only certain types of breasts.
Lollipop incision: The lollipop incision is the most common method now used in breasts reduction worldwide. It has an incision around the areola and a line running vertically downwards from the areola to the breast crease.
Anchor incision: In very large breast often anchor incision is utilized to give a pleasing shape to the breasts. This has an incision around the areola, vertically downwards to the crease and along the breasts crease.
The surgeon will make elaborate markings on your breasts before the procedure because once you lie down the breasts change shape and it becomes the surgeon guide as to what tissue is to be removed and what to preserve.The procedure is carried out under General anesthesia and may require you to stay one night in the hospital. Usually drains are put during the surgery to drain out the collections that may happen in the post-operative periods. The drains are usually removed after a day. The procedure may last 3-5 hours or longer if associated procedures are to be performed. The skin that one sees on the upper part of the areola comes down and the remaining breast tissue is draped to give a lifted areola, firmer and rounder breasts. The nipple areola is shifted up and can be made smaller.
Precautions before surgery?
One should be in a stable healthy condition before one opts for this surgery. You should have realistic expectations from the surgery. One must disclose the full medical history to the surgeon including what medications one is taking on a regular basis. If you have a fungal infection around the breast or anywhere else, that will need to be cured before you opt for this surgery.
One can expect a pleasing rounder shape of the breasts which are lifted, firmer and younger looking than the previously large, disproportionate breasts.
Selecting a surgeon
One should select a surgeon based on qualifications, experience with breast reduction and one’s comfort level with the surgeon.
Making the most of one’s consultation
It is advisable that one should have two consultations before the surgery to gain comfort with the surgeon and have all the questions answered. After the first consultation, you should read about the procedure and note down questions that come to your mind and have them answered in your next consultation.
The cost of the surgery varies from surgeon to surgeon and between geographical locations. In India, breast reduction is a very common procedure and medical tourism also attracts international patients to have their procedure done here. Depending on the symptoms that one may face due to the heavy breasts insurance companies may cover the surgery. All companies, however, have their criteria whether they would cover the costs or not. Please get in touch with your surgeon to know more details about this.
Are the results permanent?
Unless one gains massive weight you are likely to have the advantage of lifted firmer breasts all your life. The usual sagging that happens with aging happens in the reduced breasts too but the condition is of a much lesser severity.
What about breastfeeding?
Usually, breast reduction is sought by females who have already had children. Although unmarried females or women who have not had children yet also go through the procedure. Breastfeeding after breast reduction can be unpredictable. You should discuss with your plastic surgeon if you wish to breastfeed in the future.
I am really concerned about the scars.
Aesthetic surgeons make all possible efforts to minimize and hide the scars of any procedures by their special suturing techniques and placing the scars in folds of skin. Although initially the scars do look prominent but it fades away gradually. Breast is one of the tissues where the scars really fade away over time and discernible on very very close observation. The advantages that are got with the procedure outweigh the presence of scars by multiple times. Although if one has a tendency of keloids and pigmented scars then one must bring it to the notice of the Plastic Surgeon.
Your scar can look like one of the following diagrams depending on the method that is adopted that suits your condition the best.
Post-operative recovery at home
You should wear a supportive garment for your breasts so that the breasts heal properly.
You must have the medications as prescribed by your surgeon and visit as called.
In case you find any changes that are not usual please get in touch with your surgeon as soon as possible. If you are sent home with the drains then you should take care of the drains until they are removed.
- Stitch line care: You should keep your stitch line as dry as possible and only apply ointments prescribed. You may have dressings in place with specific instructions on how to take care. Normally dressings come off in a week and if the suture line is dry you may not need any dressings at all or minimal after that.
- Removal of stitches: usually absorbable sutures are placed but if they need to be removed then they will be removed in 8-10 days.
- Fever: It is important to be mindful of your temperature in the post operative period. If you find that temperatures are running high then you must get in touch with your surgeon immediately.
- Soreness and pain: The breast settles down well after about a week of surgery. The areas of liposuction may remain stiff for some time. You should start feeling almost like normal again in 3 weeks times although one can start one’s routine work even after a couple of days of the procedure with some precautions as advised by the surgeon.
- Bruising: may or may not occur. Usually subsides in about 10 days.
- Swelling: Edema is present in tissues after any surgery. You can expect a good amount of settlement after two weeks and things continue to get better. To achieve the final shape one may require about 6 months when all the swelling has subsided.
- Bathing: You may need to sponge yourself till your stitches are dry or one must bathe with waterproof dressings.
- Sleeping: You should sleep with your head up and even advised to put a pillow on the back. Some people prefer to keep a pillow beneath the knees to avoid rolling over during sleep.
- Activity: you can return to your routine activities gradually. Normal non-strenuous activity can be started a couple of days after but more strenuous activity will have to wait for 6-12 weeks depending on your healing and the method of reduction that was done depending on your breast size.
Complications and Risk
The serious side effects of breast reduction are very uncommon if done by an experienced Plastic Surgeon in an accredited facility.
However, all surgical interventions come with certain risks which are usually very low
- Anesthetic complications
- Collection of blood or body fluid which may need to be removed by a needle and syringe.
- Sensation changes including loss of sensation of nipple areola.
- Allergic reactions
- Blood clots in the lungs or legs (mainly due to prolonged immobility.)
- Unsatisfactory results
- If the instructions of the surgeon are followed diligently the risk of complications is very low in experienced hands.
When should one not do Breast reduction or who is not a candidate? Contradictions
- Abnormal mammograms
- Undiagnosed mass in the breasts
- Morbid obesity (One must first get the obesity corrected and subsequently get the breast surgery done)
- Currently breastfeeding
- Coagulation disorders.
Heart diseases that have contradictions for surgical intervention.
If you are in good health and have realistic expectation out of the procedure you will most likely benefit out of this procedure. The goal of every Plastic surgeon is to make you achieve your goal in the smoothest way possible. The support of the staff and the Surgeon go a long way in ensuring the same.
In combination with Other procedures:
Many a time breast reduction is opted for by the patients if one is undergoing another procedure like a liposuction or a tummy tuck or a thigh liposuction.
Many women also club other procedures like the above along with the breast reduction. You can get in touch with us to understand and customize your treatment.