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BREAST REDUCTION

What is a Breast Reduction?

Overly large breasts can cause 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 can be as important an issue as the physical discomfort and pain.

Breast reduction, also known as reduction mammaplasty, is a procedure to remove 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.

Breast reduction is a good option for you if you:

  • Are physically healthy

  • Have realistic expectations

  • Don't smoke

  • Are bothered by feeling that your breasts are too large

  • Have breasts that limit your physical activity

  • Experience back, neck, and shoulder pain caused by the weight of your breasts

  • Have shoulder indentations from bra straps

  • Have skin irritation beneath the breast crease

Consultation and Preparing for Surgery

During your consultation be prepared to discuss:

  • Your surgical goals

  • Medical conditions, drug allergies, and medical treatments

  • Current medications, vitamins, herbal supplements, alcohol, tobacco, and drug use

  • Previous surgeries

  • If you have a family history of breast cancer

  • The results of any mammograms or previous biopsies

Your surgeon may also:

  • Evaluate your general health status and any pre-existing health conditions or risk factors

  • Examine your breasts and may take detailed measurements of their size and shape, skin quality, and placement of your nipples and areolas

  • Take photographs

  • Discuss your options

  • Recommend a course of treatment

  • Discuss likely outcomes of breast lift surgery and any risks or potential complications

  • Discuss the use of anesthesia during your breast lift

Prior to surgery, you may be asked to:

  • Get lab testing or a medical evaluation

  • Take certain medications or adjust your current medications

  • Get a baseline mammogram before surgery

  • Stop smoking

  • Avoid taking aspirin, anti-inflammatory drugs, and herbal supplements as they can increase bleeding

Breast reduction surgery may be performed in an accredited office-based surgical center, outpatient or ambulatory surgical facility, or a hospital. Be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery.

Be sure to ask Dr. Smith questions. It's very important to understand all aspects of your breast reduction procedure. It's natural to feel some anxiety, whether it's excitement or a bit of preoperative stress. Don't be shy about discussing these feelings with Dr. Smith.

 

The Procedure

Breast reduction involves making incisions on the breast skin to remove the excess breast tissue and skin.

In some cases, excess fat may be removed through liposuction in conjunction with the excision techniques described below. 

The technique used to reduce the size of your breasts will be determined by your individual anatomy, breast composition, amount of reduction desired, your personal preferences and the surgeon's advice.

Your breast reduction surgery can be achieved through a variety of incision patterns and techniques. The appropriate technique for you will be determined based on:

  • Breast size and shape

  • The size and position of your areolas

  • The degree of breast sagging

  • Skin quality and elasticity as well as the amount of extra skin

Step 1 - Anesthesia
Medications are administered for your comfort during the surgical procedure. Breast reduction is usually performed under a general anesthesia.

Step 2 - The incision 
There are two common incision patterns:

  • Around the areola and vertically down from the areola to the breast crease

  • Around the areola, vertically down from the breast crease and horizontally along the breast crease

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 diameter is reduced by excising skin at the perimeter, if necessary. Underlying breast tissue is reduced, and the remaining breast tissue is lifted and shaped. Rarely, in extremely large breasted women, the nipple and areola may need to be removed and repositioned 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.

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

Step 5 - See the results
The results of your breast reduction surgery are immediately visible. Satisfaction with your new breast size should continue to grow as you recover. Over time, post-surgical swelling will resolve and incision lines will fade.

Risks and Safety

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. You will be asked to sign consent forms to ensure that you fully understand the procedure and any risks and potential complications.

The risks include:

  • Anesthesia risks

  • Bleeding or hematoma formation

  • Infection

  • Poor healing of incisions

  • Changes in nipple or breast sensation, which may be temporary or permanent

  • Breast contour and shape irregularities

  • Breast asymmetry

  • Fatty tissue found deep in the breast might die (fat necrosis)

  • Fluid accumulation

  • Potential partial or total loss of nipple and areola

  • Deep vein thrombosis, cardiac and pulmonary complications

  • Possibility of revisional surgery

These risks and others will be fully discussed prior to your consent. It is important that you address all of your questions directly with Dr. Smith.

Recovery After Surgery

After your breast reduction procedure is completed, dressings or bandages will be applied to the incisions. You'll need to wear an elastic bandage or support bra to minimize swelling and support your breasts as they heal.

You will be given specific instructions that may include how to care for your breasts following surgery, medications to apply or take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in your general health, and when to follow up with Dr. Smith.

Be sure to ask Dr. Smith specific questions about what you can expect during your individual recovery period.

  • Where will I be taken after my surgery is complete?

  • What medication will I be given or prescribed after surgery?

  • Will I have dressings/bandages after surgery?

  • When will they be removed?

  • Are stitches removed? When?

  • When can I resume normal activity and exercise?

  • When do I return for follow-up care?

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 from surgery. The final results of your breast reduction will appear over the next few months as breast shape and position continue to settle. Incision lines are permanent but will continue to fade over time.

The results of your breast reduction surgery will be long lasting. Over time, your breasts can continue to change due to aging and gravity. You'll be able to retain your new look longer if you:

  • Maintain your weight

  • Keep a healthy lifestyle


Breast surgery is often best entertained after child bearing is completed. Changes that occur in the breasts during pregnancy can minimize or reverse the improvement a breast reduction provides. Likewise, significant weight loss after breast surgery can negatively impact breast appearance.

Following your physician's instructions is essential to the success of your surgery. It's important that the surgical incisions are not subjected to excessive force, swelling, abrasion, or motion during the time of healing. Dr. Smith will give you specific instructions on how to care for yourself.

Cost

Prices for breast reduction procedures can vary. The cost will be based on the type of procedure required to address your specific needs.  Dr. Smith does offer patient financing plans, so be sure to ask.

You will be charged one fee and this will include:

  • Anesthesia fees

  • Hospital or surgical facility costs

  • Medical tests (if required)

  • Post-surgery garments (if required)

  • Surgeon's fee

Dr. Smith

Your satisfaction involves more than a fee.  When choosing a plastic surgeon for breast reduction, remember that the surgeon's experience and your comfort with him or her is just as important as the final cost of the surgery.

Plastic surgery involves many choices. The first and most important is selecting a Plastic Surgeon you can trust. Plastic Surgeons such as Dr. Smith, certified by the Royal College of Physicians and Surgeons of Canada meet rigorous standards:

  • Board certification by Royal College of Physicians and Surgeons of Canada®

  • Completed five years of surgical training following medical school

  • Pass comprehensive oral and written exams

  • Complete continuing medical education, including patient safety

  • Perform surgery in accredited hospitals and surgical facilities

Following Dr. Smith’s Plastic Surgery residency, he completed an extra year of training, completing two additional clinical Fellowships to further his expertise in the field of Plastic Surgery. Please see his biography for more details.

Do not be confused by other official sounding boards and certifications.  Be sure to choose a highly trained plastic surgeon who is board-certified by the American Board of Plastic Surgeons or The Royal College of Physicians and Surgeons of Canada.

 

This procedural information is intended strictly for educational purposes. Only models are depicted in these procedural information pages. It is not intended to make any representations or warranties about the outcome of any procedure. It is not a substitute for a thorough, in-person consultation with Dr. Smith.