Breast reduction surgery reduces the size of the breasts by removing breast tissue, fat and skin, often lifting the breast and optimizing its shape in the process. The pigmented skin around the nipples can also be reduced as part of the procedure.
Who is a candidate for breast reduction?
Candidates for breast reduction include healthy patients who have disproportionately larger breasts compared to body frame. This may be associated with poor posture, backache or neck ache and skin irritation under the breasts. Patients should not be smokers or significantly overweight. A mammogram may be required prior to surgery.
How is a breast reduction performed?
Before the procedure begins, your breasts are extensively marked. Dr. Farris is well versed at all the different techniques utilized for a breast reduction. The technique chosen will be customized to suit your specific anatomic needs. In terms of skin incision patterns, there is the anchor shaped incision, which goes around the perimeter of the areola, extends down to the breast crease and continues horizontally along the breast crease. Alternatively, the “lollipop” shaped incision is made around the perimeter of the areola and extends down to the breast crease only. Choice of incision pattern depends on several anatomic factors. The other variable in breast reduction surgery is the choice of breast pedicle. The breast pedicle is the dissected portion of tissue that provides the blood supply to your nipple and areola. It may be based inferiorly, superiorly, medially, centrally or any combination thereof. The type of pedicle chosen is also dependent on several anatomic factors. Dr. Farris will select the optimal combination of techniques and methods described above, in order to address your specific anatomic issues. This serves as an outline for your procedure. After the excess breast tissue, fat and skin is removed, the pedicle is properly positioned and the skin is brought together to recreate your breasts. Dr. Farris also dedicates time to making final adjustments in order to optimize your breast shape and symmetry. These final changes often mean the difference between a good result and an excellent result. The average length of the surgery is about 3 hours, under general anesthesia.
What to expect after surgery?
Dr. Farris and his staff will provide specific instructions regarding your surgery.
Patients typically go home the same day after surgery. Postoperative pain is limited. A surgical bra will be worn until the first postop visit and a snug sports bra may be used after that. Drain care will be required if drains are used. Drains are commonly removed within a few days after surgery. Stitches are placed underneath the skin during surgery so there is nothing to remove in the office. An underwire bra may be used beginning at 4-6 weeks after surgery. Avoid strenuous activity or heavy lifting for 4 weeks. You may use vitamin E cream and scar products beginning 3 weeks after surgery to optimize healing of your scars. Scars change in appearance and improve over time up to 12 months.
- Where are the scars located in a breast reduction?
Depending on the technique used, the scar can be anchor shaped or lollipop shaped.
The anchor shaped scar goes around the perimeter of the areola, extends down to the breast crease and continues horizontally along the breast crease. Alternatively, the lollipop shaped scar goes around the perimeter of the areola and extends down to the breast crease only.
- How long will the results last after a breast reduction?
The results can last a very long time. However, keep in mind that weight change, pregnancy, gravity’s pull on your breasts and aging all have an effect on your breast appearance as you get older.
- Are there different types of breast reduction?
Yes, there are different incision patterns and different pedicle patterns used for breast reduction. The best method for you will depend on the shape of your breasts and anatomy.
- Is the breast also lifted with a breast reduction?
In addition to reducing the volume of the breasts, a breast reduction typically lifts the breasts and improves its shape and position on the chest.
- Can a breast reduction also make my breasts more symmetrical?
Yes. By removing different amounts of tissue from each side, we can achieve better symmetry of the breasts.
- Does a breast reduction also reduce the size of the pigmented skin around the nipple?
Yes. A breast reduction reduces the size of the pigmented skin around your nipple (areola) if it is large.
- When can I go to work after a breast reduction?
Most people are able to return to work after 1 week as long as they’re not engaged in strenuous activity or heavy lifting.
- Will I be able to breastfeed after breast reduction?
Depending on the extent of your breast reduction, your future ability to breastfeed may be affected. The milk ducts can get transected if an extensive reduction is performed.
- When can I wear an underwire bra?
Typically, you may begin to wear an underwire bra 4-6 weeks after surgery. Until then, you may wear a sports bra.
- What are the risks of breast reduction surgery?
Breast reduction offers tremendous benefits but also has risks like any other surgery. The risks for complications are low but include infection, bleeding, fluid collection, asymmetry, wound breakdown, fat or skin necrosis, decreased sensation, poor scarring and reoperation.
- Do I have to stop smoking before a breast reduction?
Yes, this is a must. Smoking contains nicotine, which constricts small blood vessels, diminishing the blood supply to tissue. In the setting of flap-like surgery such as breast reduction, this can increase the risk of wound breakdown, tissue death and infection. You must stop smoking at least 2 weeks, preferably 2-3 months, prior to breast reduction.