Breast reduction, or reduction mammaplasty, is designed to relieve the physical pain often associated with very large breasts and enhance the overall appearance of your breasts. The procedure removes excess breast tissue and skin, making your breasts smaller, firmer and up-lifted. The areola (the pigmented skin surrounding the nipple) is usually reduced and repositioned.
If you are considering breast reduction, Dr. Jensen wants you to be thoroughly informed about the procedure. Reading this information is the first step. A personal consultation with Dr. Jensen is the best way to obtain the additional information you need.
Considering breast reduction
Patients undergoing breast reduction surgery often seek relief from physical symptoms caused by the excessive weight of large breasts. Breast reduction usually can solve these problems as well as improve the shape of your breasts. Following breast reduction, your breasts will be more proportional to the rest of your body, and clothes will often fit better.
Are you a good candidate for breast reduction?
You are probably a good candidate for breast reduction if you have one or more of the following conditions:
- Breasts that are too large in proportion to your body frame and weight
- Pendulous breasts with nipples that point downward
- One breast which is much larger than the other
- Back, neck or shoulder pain caused by the weight of your breasts
- Skin rash beneath your breasts
- Shoulder indentations from tight bra straps
- Limitation of physical activity due to the size and weight of your breasts
- Self-consciousness about the size of your breasts
Breast reduction may be performed at any age, but plastic surgeons usually recommend waiting until breast development has stopped. Childbirth and breast-feeding may have unpredictable effects on the size and shape of your breasts. Nevertheless, many women will undergo breast reduction before having children and feel that they can address any subsequent changes later. If you plan to breast-feed in the future, you should discuss this with Dr. Jensen.
Your personal consultation
During the consultation, you will be asked about your desired breast size as well as anything else about your breasts that you would like improved. This will help Dr. Jensen understand your expectations and determine whether they realistically can be achieved.
Dr. Jensen will examine your breasts, taking measurements and perhaps photographs for your medical record. The size and shape of your breasts, the skin tone and placement of the nipples and areolas will be carefully evaluated.
You should come prepared to discuss your medical history. This will include information about any medical problems, drug allergies and medical treatments you have received, previous surgeries including breast biopsies, and medications you take. It is important for you to provide a complete history.
You should tell Dr. Jensen if you plan to lose a significant amount of weight, particularly if your breasts become smaller with weight loss. Dr. Jensen may recommend that you stabilize your weight before having surgery.
Will my insurance help cover the cost of surgery?
Insurance coverage is frequently available for breast reduction surgery. A few factors determine your eligibility, including the terms of your insurance policy and the amount of breast tissue to be removed. A letter of predetermination is often required by your insurance company prior to surgery. Dr. Jensen will discuss these matters with you.
Breast reduction procedure
Individual factors will determine the specific technique selected to reduce the size of your breasts.
Placement of incisions
The most common method of reducing the breasts involves three incisions. One incision is made around the areola. The second runs vertically from the bottom of the areola to the crease beneath the breast. The last incision runs horizontal beneath the breast and follows the natural curve of the breast crease.
After Dr. Jensen has removed the excess breast tissue, the nipple and areola are lifted to a higher position.
The areola, which usually has been stretched, also is reduced in size. Skin that was formerly located above the nipple is brought down beneath the nipple and together to reshape the breast. Liposuction is often used to improve the contour under the arm.
Most frequently, the nipples and areolas remain attached to underlying breast tissue, allowing for the preservation of sensation. The ability to breast-feed may also be preserved by this method, although this cannot be guaranteed.
Variations to the common breast reduction technique
The size and shape of your breasts, as well as the desired amount of reduction, are factors that will help Dr. Jensen determine the best technique for you.
In rare instances, it may be possible to avoid the vertical incision that runs from the bottom edge of the areola to the breast crease or the horizontal incision underneath the breast.
Very rarely, if your breasts are extremely large or pendulous, the nipples and areolas may need to be completely detached before they are shifted to a higher level. In such a case, you will need to have made the decision to sacrifice sensation and the possibility of breast-feeding in order to achieve your desired breast size.
Fortunately, significant complications from breast reduction have been infrequent. Every year, many thousands of women undergo successful breast reduction surgery, experience no major problems and are pleased with the results. Anyone considering surgery, however, should be aware of both the benefits and possible risks. It is important to understand that every surgical procedure has risks, but how will you learn more so that you can make an informed decision.
The subject of risks and potential complications of surgery is best discussed on a personal basis between you and Dr. Jensen.
Some of the potential complications that will be discussed with you include bleeding, infection and reactions to anesthesia.
Following reduction, rarely the breasts may not be perfectly symmetrical or the nipple height may vary slightly. If desired, minor adjustments can be made at a later time. Permanent loss of sensation in the nipples or breasts can occur rarely. In the unlikely event of injury to or loss of the nipple and areola, they usually can be satisfactorily reconstructed using skin grafts.
You can help to decrease certain risks by following the advice and instructions of Dr. Jensen, both before and after surgery.
Your surgical experience
The goal of Dr. Jensen and his entire staff is to make your surgical experience as easy and comfortable for you as possible.
Preparing for surgery
After your initial consultation you will be given written instructions on how to prepare for surgery and how to take of yourself after surgery (what you can and cannot do). You should read these instructions carefully and write down any questions you may have and bring them with you to your pre-operative consultation.
Depending on your age, or if you have a history of breast cancer in your family, Dr. Jensen may recommend a baseline mammogram prior to surgery. This will help to detect any future changes in your breast tissue. Following breast reduction, you will still be able to perform breast self-examination. Breast reduction surgery does not increase the risk of developing breast cancer.
If you are a smoker, you will be required to stop smoking well in advance of surgery. Aspirin and all other anti-inflammatory drugs cause increased bleeding, so you should stop taking these medications for a period of 2 weeks before surgery.
Breast reduction surgery may be performed in the Hospital (Rogue Valley Medical Center or Providence Hospital) or in our own outpatient surgery center. If you are to stay in the hospital or surgical facility, it will most likely be for only one night. Whether you are released the day of surgery or the following day, you will need someone responsible to drive you home and to stay with you for the next day or two.
What will the day of surgery be like?
Usually, a general anesthetic is administered, so that you will be sleeping throughout the procedure. When surgery is completed, you will be taken into a recovery room where you will be closely monitored. Small drain tubes will have been placed in your breasts to help avoid the accumulation of fluids. Gauze dressings will be placed on your breasts and covered with an elastic bandage or surgical bra.
How will I look and feel initially?
The day after surgery, it is important to get out of bed for short periods of time. After several days, you will be able to move about more comfortably. Straining, bending and heavy lifting must be avoided, however, since these activities might cause bleeding. You should sleep on your back to avoid pressure on your breasts.
The surgical drains will be removed a day or two after surgery, at which time your dressings may also be change. You will be instructed to wear a support bra (sports bras work best) for a few weeks, until the swelling and discoloration of your breasts diminishes. Stitches are of the dissolving type and, therefore, do not require removal.
You may notice that you feel less sensation in the nipple and areola areas. This usually is temporary. More frequently, however, you will have increased sensitivity of the nipples. It may take weeks, months or even more than a year before sensation returns to normal.Your breasts may also require some time to assume a more natural, rounded shape. Incisions will initially be red or pink in color. They may remain this way for many months following surgery.
When can I resume my normal activities?
After breast reduction surgery, it is often possible to return to work within just a couple of weeks, depending on your job and motivation. In many instances, you can resume most of your normal activities, including some form of mild exercise, after three weeks. You may continue to experience some mild, periodic discomfort during this time, but such feelings are normal and will diminish with time. Severe pain should be reported to Dr. Jensen.
Any sexual activity should be avoided for a minimum of one week, and Dr. Jensen may advise you to wait longer. After that, care must be taken to be extremely gentle with your breasts for at least the next three weeks.
Results of breast reduction
Breast reduction surgery will make your breasts smaller, firmer and lifted. Without the excessive weight of large breasts, you will find greater enjoyment in playing sports and engaging in other physical activity.
The incisions from your breast reduction surgery will heal and fade over time. It is important to realize, however, that the scars will be permanently visible, more so in some individuals than others. Fortunately, the incisions for breast reduction are in locations easily concealed.
Breast reduction often makes a dramatic change in your appearance. For this reason, it may take some time to adjust to your new body image. Most women, however, eventually become comfortable with their breast size and feel very pleased with the results of surgery. In fact, the level of patient satisfaction resulting from breast reduction is among the highest of any plastic surgery procedure.
How long will the results last?
Unless you gain or lose significant amounts of weight or become pregnant, your breast size should remain constant. However, gravity and the effects of aging will eventually alter the size and shape of virtually every woman's breasts. If, after a period of years, you become dissatisfied with the appearance of your breasts, you may choose to undergo a "breast-lift" procedure to restore a more youthful contour.
Maintaining a relationship with Dr. Jensen
You will return to Dr. Jensen's office for follow-up care at prescribed intervals, at which time your progress will be evaluated. Once the immediate postoperative follow-up is complete, we encourage our patients to come back for periodic checkups to observe and discuss the long-term results of surgery.
Please remember that the relationship with Dr. Jensen does not end when you leave the operating room. If you have questions or concerns during your recovery, or need additional information at a later time, you should contact Dr. Jensen's office.