BREAST REDUCTIONWomen with very large,
pendulous breasts may experience a variety of medical
problems caused by the excessive weight-from back and
neck pain and skin irritation to skeletal deformities
and breathing problems. Bra straps may leave
indentations in their shoulders. And unusually large
breasts can make a woman-or a teenage girl-feel
extremely self-conscious.
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Before |
After |
Breast reduction, technically known as reduction
mammaplasty, is designed for such women. The procedure
removes fat, glandular tissue, and skin from the
breasts, making them smaller, lighter, and firmer. It
can also reduce the size of the areola, the darker skin
surrounding the nipple. The goal is to give the woman
smaller, better-shaped breasts in proportion with the
rest of her body.
The Best Candidates For Breast Reduction
Breast reduction is usually performed for physical
relief rather than simply cosmetic improvement. Most
women who have the surgery are troubled by very large,
sagging breasts that restrict their activities and cause
them physical discomfort.
In most cases, breast reduction isn't performed until a
woman's breasts are fully developed; however, it can be
done earlier if large breasts are causing serious
physical discomfort. The best candidates are those who
are mature enough to fully understand the procedure and
have realistic expectations about the results. Breast
reduction is not recommended for women who intend to
breast-feed.
All Surgery Carries Some Uncertainty And Risk
Breast reduction is not a simple operation, but it's
normally safe when performed by a qualified plastic
surgeon. Nevertheless, as with any surgery, there is
always a possibility of complications, including
bleeding, infection, or reaction to the anesthesia. Some
patients develop small sores around their nipples after
surgery; these can be treated with antibiotic creams.
You can reduce your risks by closely following your
physician's advice both before and after surgery.
The procedure does leave noticeable, permanent scars,
although they'll be covered by your bra or bathing suit.
(Poor healing and wider scars are more common in
smokers.) The procedure can also leave you with slightly
mismatched breasts or unevenly positioned nipples.
Future breast-feeding may not be possible, since the
surgery removes many of the milk ducts leading to the
nipples.
Some patients may experience a permanent loss of feeling
in their nipples or breasts. Rarely, the nipple and
areola may lose their blood supply and the tissue will
die. (The nipple and areola can usually be rebuilt,
however, using skin grafts from elsewhere on the body.)
The Surgery
Techniques for breast reduction vary, but the most
common procedure involves an anchor-shaped incision that
circles the areola, extends downward, and follows the
natural curve of the crease beneath the breast. The
surgeon removes excess glandular tissue, fat, and skin,
and moves the nipple and areola into their new position.
He or she then brings the skin from both sides of the
breast down and around the areola, shaping the new
contour of the breast. Liposuction may be used to remove
excess fat from the armpit area.
In most cases, the nipples remain attached to their
blood vessels and nerves. However, if the breasts are
very large or pendulous, the nipples and areolas may
have to be completely removed and grafted into a higher
position. (This will result in a loss of sensation in
the nipple and areolar tissue.)
Stitches are usually located around the areola, in a
vertical line extending downward, and along the lower
crease of the breast. In some cases, techniques can be
used that eliminate the vertical part of the scar. And
occasionally, when only fat needs to be removed,
liposuction alone can be used to reduce breast size,
leaving minimal scars.
Getting Back To Normal
Although you may be
up and about in a day or two, your breasts may still
ache occasionally for a couple of weeks. You should
avoid lifting or pushing anything heavy for three or
four weeks.
Your surgeon will give you detailed instructions for
resuming your normal activities. Most women can return
to work (if it's not too strenuous) and social
activities in about two weeks. But you'll have much less
stamina for several weeks, and should limit your
exercises to stretching, bending, and swimming until
your energy level returns. You'll also need a good
athletic bra for support.
You may be instructed to avoid sex for a week or more,
since sexual arousal can cause your incisions to swell,
and to avoid anything but gentle contact with your
breasts for about six weeks.
A small amount of fluid draining from your surgical
wound, or some crusting, is normal. If you have any
unusual symptoms, such as bleeding or severe pain, don't
hesitate to call your doctor |
