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BREAST
REDUCTION - MAMMAPLASTY
Breast
reduction is performed to reduce the size of the breasts. It may
be desired for cosmetic, emotional, and/or physical reasons. Many
women do not like the way they look because of their excessively
large breasts, and their breasts may also cause physical problems
such as back and/or neck pain, poor posture, and notches in the
shoulders caused by bra straps. Breast reduction, commonly known
as mammaplasty, relieves the physical discomfort of excessively
large breasts, and also improves appearance.
Some
important facts about mammaplasty:
- Breast
reduction is one of the few cosmetic surgery procedures that
is performed on teenagers (once their breasts have developed
completely).
- Breast
reduction changes the volume and the shape of the breast and
the size of the areola, if desired.
- The
areola usually has to be repositioned because large breasts
most often are "ptotic (sagging).
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Are
There Any Alternatives to Surgery?
How
Can I Prepare for Surgery?
How
is the Procedure Done?
What
Can I Expect Pre- and Postoperatively?
Tell
Me About Recovery
What
Kind of Risks / Complications Are There?
Still
You
Only Better!
ALTERNATIVES
TO SURGERY
There are no
alternatives to surgery. Many women tend to wear baggy or
loose-fitting clothing before turning to reduction surgery.
PREPARING
FOR SURGERY
When
considering breast reduction surgery you want to ask your doctor
about the surgical options available. Your initial consultation will
include a review of your medical history, discussing the results
youd like to achieve and to explain the procedure to be
performed.
You
will also be given pre-and postoperative instructions which will
include information on eating and drinking and what prescription
medications to take and those to avoid. Be sure you and your
physician agree on the surgical approach and understand the
potential risks and complications involved with the procedure.
Bring
pictures from magazines of your desired look. Your physician should
assess the size and laxity of your breasts. Be absolutely clear and
in agreement with your doctor about what look and size you want for
your breasts. Discuss with your physician the location of the
incisions.
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PROCEDURE
While
you are upright, your breasts should be very precisely marked with a
permanent marker. The anesthesia will then be administered. The
surgeon makes a continuous incision around the areola, with a
vertical incision below it (known as an "inverted keyhole
incision"), connected to a horizontal incision made in the
crease underneath the breast. This last incision is usually the
whole width of the breast. Most surgeons do not completely detach
the nipple. It is freed via the circumareolar incision, but
attachment to the tissue (which includes milk ducts, blood supply,
and nerve endings) is maintained.
Excess
breast tissue, fat, and skin are removed above, below, and on either
side of the nipple. Some surgeons use liposuction to remove fatty
breast tissue in the underarm area. The areola may or may not be
reduced and is then repositioned and sutured into place. The tissue
and skin on both sides of the breasts are brought together and
sutured (some physicians use only dissolvable sutures; some use a
combination of dissolvable and non-dissolvable).
An
elastic bandage or surgical bra will be placed on you after surgery.
Drains may be placed in each breast to allow for drainage of any
excess blood or fluid. The bandages will be removed in about one or
two days and you will continue to wear the bra foe several weeks.
Anesthesia
Breast
reduction is usually performed under general anesthesia. However,
the type of anesthesia used is dependent on the procedure to be
performed, the doctors choice, and the patients medical
history or desires.
Length
of Procedure
The Breast
reduction takes approximately three to five hours.
Level
of Pain/Discomfort
Generally
with a breast reduction there is moderate pain during the
postoperative period, which may be controlled with prescribed pain
medications or Extra-Strength Tylenol.
PRE-
AND POSTOPERATIVE INSTRUCTIONS
The
following suggestions are intended to make you feel more
comfortable and help you heal:
- If you
have regular mammograms or are over the age of forty, schedule
a mammogram prior to your procedure, and then again after the
swelling and tenderness have disappeared completely (three to
six months). This way, the changes from your surgery can be
documented.
- Dressings
this procedure requires a supportive bra or dressing,
which should be provided, to wear for four to six weeks after
surgery. You may want to purchase a second garment to wear
while you launder the other. Do not wear an underwire bra for
six weeks.
- You must
sleep on your back, with your upper body elevated, for at
least the first week to ten days.
- Do not
lie face down for at least three weeks.
- The
breasts must not be exposed to the sun and tanning beds,
especially while bruising is visible (the pigmentation of the
skin may change permanently). Optimally, these should be
avoided completely for skin care and health.
RECOVERY
The initial
healing period for a breast reduction can take, on average, from one
to two weeks, however everyone heals differently. Healing is
affected by many factors, including your genetics, whether you smoke
and/or drink alcohol, pain tolerance, and the extent of the surgery.
The
first day after surgery, you will probably experience soreness and
tenderness and will probably want to sleep. You can expect some
swelling and bruising, which usually heals in two to three weeks.
Minor swelling can last as long as six to nine weeks. Bruising can
last up to six weeks. You may also experience some temporary
numbness, and itching around the incision sites. Finally, keep in
mind that the body does not always heal symmetrically.
RISKS
/ COMPLICATIONS
Although
problems are unlikely, you need to be aware of what can happen and
what action you should take. Most risks/complications will be
avoided if you make an informed decision, choose a qualified
physician, and follow your physicians instructions.
Complications
that can occur include bleeding, infection, hematoma (a collection
of blood under the skin that must be removed by the surgeon) changes
in nipple sensation, scarring, and asymmetry. Scars as a result of
breast reduction surgery are permanent, however they generally fade
over time.
STILL
YOU
ONLY BETTER
Breast
reduction surgery carries with it physical as well as the emotional
relief. Many patients are extremely happy with their new look,
especially since clothes fit in a more pleasing manner. The physical
reminders of too much breast tissue such as notches in the shoulders
from bra straps begin to dissipate.
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