Breast Surgery

Breast Reduction and Lift

Breast Reduction in Seattle

Breast reduction is surgery to remove excess fat, breast tissue, and skin to achieve a breast size proportional to a woman’s body.  It not only improves an individual’s appearance and relieves social discomfort, but also corrects the functional symptoms of physical discomfort and pain that are associated with large breasts. This article explains what it takes to achieve good results, describes the techniques available, lists the possible complications, and suggests the steps someone considering this surgery should take.

Breast reduction, also called reduction mammaplasty decreases the size of the breasts, but also lifts and reshapes the breasts in order to correct the drooping and to increase projection of the breast at the correct level on the chest wall.  It is the fifth most common reconstructive surgical procedure performed by Board-certified plastic surgeons.

Before Breast Reduction Surgery

Prior to breast reduction surgery, a complete medical history is taken in order to evaluate the general health of the patient. The breasts themselves are then examined thoroughly to determine the most effective surgical approach. The cosmetic surgeon describes the type of anesthesia to be used, the procedure, what results might realistically be expected and possible risks and complications.

Mammograms or x-rays may be taken as well as photographs. Preoperative instructions often include the elimination of certain drugs containing aspirin for several weeks before surgery in order to minimize the possibility of excess bleeding. Birth control and other estrogen containing hormones may also be discontinued temporarily. Antibiotics may be prescribed for a few days prior to breast surgery to prevent infection.

After Breast Reduction Surgery

Ideally, there are three consequences of breast reduction that one would like to avoid if the “ideal” surgical technique could be developed.  These include:

  • Visible scars and these vary depending on myriad factors including how different persons form scars when wounds are healing
  • Possible loss of the ability to breast feed children after the surgery (see comments above)
  • A change in the sensibility of the nipple and areola in about 20 – 25% of cases and this can be either an increase or a decrease in sensation

Plastic surgeons encourage patients to consider these three important consequences carefully before making a decision about going forward with this surgery.

The Breast Reduction Procedure

Prior to breast reduction surgery, a complete medical history is taken in order to evaluate the general health of the patient. The breasts themselves are then examined thoroughly to determine the most effective surgical approach. The cosmetic surgeon describes the type of anesthesia to be used, the procedure, what results might realistically be expected and possible risks and complications.

Mammograms or x-rays may be taken as well as photographs. Preoperative instructions often include the elimination of certain drugs containing aspirin for several weeks before surgery in order to minimize the possibility of excess bleeding. Birth control and other estrogen containing hormones may also be discontinued temporarily. Antibiotics may be prescribed for a few days prior to breast surgery to prevent infection.

One of the techniques most frequently used is called a brassiere pattern skin reduction. This technique involves both vertical and horizontal incisions made around the nipple area after which excess fat, tissue and skin are removed from the sides of the breast. Following the excision, the nipple, areola (dark, pink area circling the nipple) and tissue below are relocated but not detached. Small sutures are used to close the incisions.

A second procedure, used on patients with extremely large breasts, includes complete detachment and relocation of the nipple. After fat and tissue are removed, skin on the sides of the breast is brought down and around the areola to reshape the breast. The incision is then sutured. A breast reduction can take three to five hours or more, depending upon the extent of the surgery.

Following Breast Reduction Surgery

Following surgery, the patient wears either bandages or a special garment. These are usually replaced in a few days with a surgical bra which is worn for several weeks. Patients who are operated on in a hospital are released in a day or two.

Sutures are removed in about seven days. Numbness around the treated area may occur, but this condition is usually temporary. Swelling and discoloration disappear in a few days, and scars from incisions, although permanent, fade significantly with time.

Complications of infection and slow healing are rare: however, there are certain inherent risks connected with every surgical procedure which should be thoroughly discussed with the cosmetic surgeon. Patients can minimize complications by carefully following directions given by the cosmetic surgeon. Some patients who experience poor healing may require additional treatment.

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