Breast reduction is a procedure that reduces the size of the patient’s breasts. Large, pendulous breasts can create problems such as back pain, poor posture, neck pain, shoulder pain, grooves underneath the breasts, difficulty with exercise or movement, and occasional numbness of the fingers due to a heavy brassiere strap pulling down on the clavicle. Breast reduction can eliminate or improve these problems, and give a nicer aesthetic look and better fit in clothing.
PRE-OPERATIVE – SURGICAL PREPARATION
Preoperatively the patient may be requested to have blood testing such as CBC and serum electrolytes or electrocardiogram to obtain clearance, depending on existing medical conditions. If the patient is over the age of 33, they will also be required to have a preoperative mammogram. The patient will be advised to abstain from certain foods and medication, such as Aspirin, Ibuprofen, Vitamin E, garlic and broccoli, as well as to abstain from smoking or alcohol use, for several days prior to surgery. These precautions decrease the risk of bleeding and circulation complications. Photos of the existing area will be taken in order to assess the improvement obtained by the procedure.
The procedure takes approximately 1 ½ to 3 hours. It is performed under general anesthesia in an accredited surgical facility in an office, or in the hospital operating room. In most cases, an incision is made around the areola, down to the crease beneath the breast (lollipop technique), and then often in the width of the crease, depending on the patient and desired result. Excess skin and breast tissue is removed, and the skin is stitched back together with dissolvable sutures. In some cases, concomitant liposuction is performed. The area is then bandaged tightly. As a result, the breast is lifted and the areola is raised.
POST-OPERATIVE – RECOVERY
Postoperatively the patient will be seen in the office several times for follow-up examination and evaluation. Patients can expect minimal discomfort for the first 24-48 hours. Swelling and ecchymoses (black and blue) can be expected and will subside in time. If necessary, pain medication will be prescribed. The patient will be given prophylactic antibiotics on the day of surgery and for some days after surgery. If a breast reduction is performed on a Thursday, by Monday the patient may return to work as long as there is no heavy lifting. While full recovery takes about 3-4 weeks, most daily activities can be resumed within a few days. The patient will be advised to abstain from salty food which can increase the swelling in the operative site. Scars are permanent but will fade with time.
Some possible risks and complications can occur with this procedure, including those that could occur with any type of surgery, such as bleeding, infection and, most uncommonly, anesthesia complications. Other possible risks and complications include lack of circulation to the skin or the nipple areola complex, which will delay the healing, or lack of nipple sensation. Breast asymmetry is also possible, although the surgeon will try to create symmetry between the two breasts to the best of his ability.
It is important that the patient discusses future pregnancy plans with the surgeon prior to having this procedure. The patient should expect the breasts to engorge if she becomes pregnant again, and if she gains a lot of weight after surgery the breasts might regrow to an extent. The patient may be unable to lactate after future pregnancies. These and any other less common risks and complications will be discussed at the time of surgical consent. It is necessary for the patient to comply with our pre- and post-operative instructions in order to decrease the likelihood of complications.
The fee for this procedure varies depending on the geographic location of your surgeon, the reputation of the surgeon, and the complexity of the individual surgical procedure. Our fees for the procedure range from $15,000-$25,000. You may incur other fees such as anesthesia or operating room fees. In many cases, because of the physical duress large breasts can cause on a body, breast reduction may be covered by your insurance. You should check with your insurance company to determine if you are a covered candidate. Breast reductions covered by insurance are performed in a hospital operating room.