Large breasts prevent many patients from participating in
exercise or other athletic activities. Breast self-examination and mammography
are more difficult.
Breast reduction improves the functional problems of excess
breast size by:
- Reducing the excess size and weight of the
breast
- Tailoring the lower skin envelope to reposition
the breast mound upward
- Repositioning the nipple and areola upward on
the newly shaped breast mound.
Most patients experience a dramatic improvement in their
symptoms immediately after reduction mammaplasty, and are able to wear many
types of clothing styles for the first time. In addition, they can often
participate in many activities that were impossible before surgery.
In order to remove excess tissue from the breasts and
reposition the nipple and areola, incisions must be made in the lower part of
the breast. These incisions produce scars, which are visible, but improve
significantly over 6-12 months. The scars are usually located around the
nipple, from the lower center of the areola to the fold beneath the breast, and
in the fold beneath the breast. The extent and location of the scars depends to
some degree on the size and shape of your breasts, and the procedure necessary
to correct them.
Limitations and Risks
Differences always exist between your two breasts - they are
different sizes, shapes, and the nipple locations are also different. After
breast reduction, these differences will be less, but will always exist to some
degree.
In order to reposition the nipple upward onto the new breast
mound, some of the surrounding breast tissue must be detached. The nipple is
generally left attached to a stalk of tissue within the breast. This is
designed to include blood supply and nerve supply, but both may be decreased
after reduction. Most patients experience return of sensation over a few
months, but some loss of sensation is possible following a breast reduction.
For very large breasts, or breasts with certain configurations, the nipple may
have to be completely detached and replaced as a graft.
When reducing the amount of milk-producing tissue within the
breast, it is necessary to divide some of the milk ducts that converge at the
nipple. For this reason, the ability to nurse may also be decreased following
breast reduction. However, most patients desiring to breast feed have nursed
successfully after reduction.
The Operation
Prior to your breast reduction, Dr. Morris will make several
measurements and mark specific areas of your breasts with you sitting. These
markings are precise guidelines, which are used when your breasts shift and
change shape when you lie down. Dr. Morris will also refer to your
pre-operative pictures during surgery to assure the best possible result he can
achieve in your situation.
During the reduction procedure, the stalk of tissue carrying
the nipple is designed and prepared, and the excess loose skin (mostly in the
lower portions of the breast) is then removed. Excess breast tissue and fat are
removed, with the amount and location of removal based on the configuration of
your breast.
To reposition the breast mound upward, the skin of the lower
portion of the breast is tightened, tailored, and then sutured. The nipple and areola
are repositioned upward into the proper position on the new breast and sutured
into place. Dr. Morris precisely weighs the amount of tissue removed, sits you
up on the operating table, and carefully compares your breasts to assure as
much symmetry as possible before closure.
After surgery you will wear a special bra for a few days.
You may then wear or not wear a bra as you desire. All of your incisions will
be carefully closed with sutures placed beneath the skin, so there is no chance
of you having "railroad track" type marks, but we hope for fine line
scars. You'll be able to shower or bathe the next day, unless you have had a
nipple grafting procedure.
Recovery
Following breast reduction procedures, most patients have
minimal pain, but rather experience nuisances such as tightness or fullness.
Most patients require medication for only 2-3 days, if at all.
Your breasts may feel tight to you for 48-72 hours, and this
sensation will gradually resolve over the next several days as the swelling
decreases. You may develop slight bruising on the breasts, which will resolve
in approximately one week.
The Stages of Recovery
