Overly large breasts can be burdensome, causing neck and back pain, difficulty fitting in clothes and skin irritation where the breasts rub against the skin of the chest and belly. For some teenagers and women, large breasts can be a source of social discomfort, attracting unwanted attention. Exercising may be more difficult too as large breasts can “get in the way.” The proper medical term for problems caused by large breasts is “symptomatic macromastia.” For a woman experiencing any combination of these symptoms, breast reduction surgery may be a good choice.
Breast reduction is a plastic surgery procedure that makes breasts smaller by removing a combination of excess skin, fat and breast tissue. Low lying nipples are lifted to a prettier position higher on the breast, and the whole breast is reshaped to a smaller, perkier, more comfortable size.
While breast enlargement tends to get more “wow” press, breast reduction is a very popular surgery, with over 100,000 procedures done each year according to the American Society of Plastic Surgeons.
The decision to have breast reduction is a very personal one and not for everybody, but for those choosing this procedure for the right reasons, breast reduction can be a liberating change, improving the level of comfort with which a woman moves through her world.
A breast reduction is a fantastic solution for women who are trying to live an active, pain-free life but are hindered by the strain of overly large and heavy breasts, a condition known as “symptomatic macromastia.” Besides breast pain, macromastia can cause neck pain, pain in the back and shoulders, headaches, and poor posture. Pressure from bra straps required to support large breasts may cause permanent marks and indentations on the shoulders. Large breasts may interfere with exercise and make it difficult to maintain a healthy body weight. Skin irritation can occur where breasts rub together or against the skin of the chest and belly. While most women are a little asymmetric from one side to the other, some have one breast a lot larger than the other. In this case, breast reduction on one side can correct this unevenness, making the larger breast match the smaller.
A personal consultation with Dr. Elizabeth Lee in our Bay Area location is the best way to determine if breast reduction surgery is right for you.
Techniques and Types of Reduction
Dr. Lee does her breast reductions as a come and go surgery; you will be cared for in a fully accredited surgical facility and get to go home afterwards to sleep in your own bed that same night. She will design your breast reduction to best meet your individual needs.
Most reduction procedures begin with the creation of a “pedicle.” This is a portion of breast tissue is kept in one piece with the nipple attached and becomes the portion of breast that is left in place. This design protects the sensation to the nipple and maintains the continuity of the breast gland-duct-nipple unit. The orientation of this pedicle may be called “superior” “inferior” “medial” “lateral” or “central” depending on the best way to reshape the now smaller breast. The extra breast tissue around the pedicle is removed, decreasing the volume of the breast.
Excess skin is then taken out to further firm and shape your new breast. Skin removal is done through different types of incisions, depending on what is best for your individual needs. Some of the designs are called anchor, lollipop, Wise pattern or LeJour. Smaller breast reductions may be better served by one incision type, larger reductions by another.
In certain situations the nipples may be separated from the pedicle completely. This technique is called “free nipple grafting” and may allow for the creation of smaller breasts. While this method of breast reduction is not ideal for most women, in some older women with very large breasts and very low nipples, this may be the procedure of choice.
Dr. Lee will explain the benefits of each incision and which one will work best for you.
Alternatives to Breast Reduction
Breast size can change with weight loss or gain, pregnancy and nursing and as we age. But for those with symptomatic macromastia, breasts will not generally get small enough to be comfortable just by losing a couple of pounds. In unusual cases, liposuction can be used to decrease the volume of breasts. This process will not tighten loose skin, reshape the droopy breast or move the nipple to a higher, more aesthetic position. CoolSculpting and other non-invasive fat reduction techniques may appear as tempting alternatives, but are not safe for treating breast tissue.
During your private breast reduction consultation with Dr. Lee in Lafayette you and she will discuss your concerns about, and your wishes for your breasts. An examination will help determine the best way to reduce and reshape. This is the time to share and review your medical history and any difficulties with surgery or anesthesia. You will learn about the pros and cons of the various approaches and any non-surgical options. This visit is your opportunity to ask Dr. Lee all the questions you have so you best understand her recommendations for your breast reduction.
Surgery is the start of your path to fabulous results. Recovery planning is key to healing well and Dr. Lee will explain what to expect immediately after surgery and in the weeks following. She will advise you on how much time to take off work and on how to prepare for your recovery.
No consultation would complete without a discussion of the costs of surgery. Dr. Lee will provide a quote so that you know what to expect financially.
You may be all set to schedule your surgery at the conclusion of your consultation. Other patients want to go home and consider options. Wherever you are in your breast reduction process, we at ArtfulSurgery are here to provide you with all the support you need to have the best outcome possible. Call us with questions, come in for a follow up visit. When you are ready to schedule surgery, a call to the office will get you set on Dr. Lee’s schedule.
Once you are ready to proceed with your breast reduction, a call to the office will get you on the schedule at a fully accredited surgical facility. Breast reductions are done most commonly as outpatient procedures so you will be able to come in the morning of the procedure and go home to your own bed after.
At about 2 weeks before the surgery, you will see Dr. Lee for a preoperative visit. She will review postoperative instructions, write prescriptions for the medications you will need and review any additional questions you may have. The office will provide you with a set of written instructions to take home.
For surgery on the breasts, you will need to have a mammogram per the recommendations of the national surgical and cancer associations. Depending on your age and other medical conditions, blood tests, EKG, and clearance from your primary care physician may be required.
In general, Dr. Lee will recommend a full week at home off of a desk job. If your work is highly physical, additional days off may be necessary. Plan for enough relaxation time and help with the kids and home and your recovery will be smoother.
You will come to the office the day after the surgery for your first postoperative visit. Dressings are changed and you will be put in your new, supportive bra. Drains are usually taken out at this first appointment. Visits to the office will be frequent during the next several weeks to ensure that your healing is going well. Return to your regular activities is individual. Dr. Lee will help guide you with this process during these postoperative meetings.