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Breast Reduction
Dr. Carp performs breast reduction
surgery, helping women with large
breast, not only feel physically
better, but feel better about
themselves.
Women with large
breast may suffer from several
symptoms, including back and neck
pain, grooving from bra straps,
irritation or infections under the
breast. Breast reduction surgery
helps to decrease the breast volume
and weight, as well as reshape the
breast to a more aesthetic and
youthful form. In many cases breast
reduction surgery may be covered by
your health insurance.
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The best candidates
for breast reduction
surgery
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. |
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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.)
Planning your surgery
In your initial
consultation, it's
important to discuss
your expectations
frankly with your
surgeon, and to listen
to his or her opinion.
Every patient-and every
physician, as well-has a
different view of what
is a desirable size and
shape for breasts.
The surgeon will examine
and measure your
breasts, and will
probably photograph them
for reference during
surgery and afterwards.
(The photographs may
also be used in the
processing of your
insurance coverage.) He
or she will discuss the
variables that may
affect the
procedure-such as your
age, the size and shape
of your breasts, and the
condition of your skin.
You should also discuss
where the nipple and
areola will be
positioned; they'll be
moved higher during the
procedure, and should be
approximately even with
the crease beneath your
breasts.
Your surgeon should
describe the procedure
in detail, explaining
its risks and
limitations and making
sure you understand the
scarring that will
result. The surgeon
should also explain the
anesthesia he or she
will use, the facility
where the surgery will
be performed, and the
costs. (Some insurance
companies will pay for
breast reduction if it's
medically necessary;
however, they may
require that a certain
amount of breast tissue
be removed. Check your
policy, and have your
surgeon write a
"predetermination
letter" if required.)
Preparing for your
surgery
Your surgeon may require
you to have a mammogram
(breast x-ray) before
surgery. You'll also get
specific instructions on
how to prepare for
surgery, including
guidelines on eating and
drinking, smoking, and
taking or avoiding
certain vitamins and
medications. Some
surgeons suggest that
their patients diet
before the operation.
Breast reduction doesn't
usually require a blood
transfusion. However, if
a large amount of breast
tissue will be removed,
your physician may
advise you to have a
unit of blood drawn
ahead of time. That way,
if a transfusion should
be needed, your own
blood can be used.
While you're making
preparations, be sure to
arrange for someone to
drive you home after
your surgery and to help
you out for a few days
if needed.
Where your surgery
will be performed
Breast reduction surgery
may be performed in a
hospital, an outpatient
surgery center or an
office-based surgical
suite. If you are
admitted to the
hospital, your stay will
be a short one. The
surgery itself usually
takes two to four hours,
but may take longer in
some cases.
Types of anesthesia
Breast reduction is
nearly always performed
under general
anesthesia. You'll be
asleep through the
entire operation.
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.
After your surgery
After surgery, you'll be
wrapped in an elastic
bandage or a surgical
bra over gauze
dressings. A small tube
may be placed in each
breast to drain off
blood and fluids for the
first day or two.
You may feel some pain
for the first couple of
days-especially when you
move around or cough-and
some discomfort for a
week or more. Your
surgeon will prescribe
medication to lessen the
pain.
The bandages will be
removed a day or two
after surgery, though
you'll continue wearing
the surgical bra around
the clock for several
weeks, until the
swelling and bruising
subside. Your stitches
will be removed in one
to three weeks.
If your breast skin is
very dry following
surgery, you can apply a
moisturizer several
times a day, but be sure
to keep the suture area
dry.
Your first menstruation
following surgery may
cause your breasts to
swell and hurt. You may
also experience random,
shooting pains for a few
months. You can expect
some loss of feeling in
your nipples and breast
skin, caused by the
swelling after surgery.
This usually fades over
the next six weeks or
so. In some patients,
however, it may last a
year or more, and
occasionally it may be
permanent.
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.
Your new look
Although much of the
swelling and bruising
will disappear in the
first few weeks, it may
be six months to a year
before your breasts
settle into their new
shape. Even then, their
shape may fluctuate in
response to your
hormonal shifts, weight
changes, and pregnancy.
Your surgeon will make
every effort to make
your scars as
inconspicuous as
possible. Still, it's
important to remember
that breast reduction
scars are extensive and
permanent. They often
remain lumpy and red for
months, then gradually
become less obvious,
sometimes eventually
fading to thin white
lines. Fortunately, the
scars can usually be
placed so that you can
wear even low-cut tops.
Of all plastic surgery
procedures, breast
reduction results in the
quickest body-image
changes. You'll be rid
of the physical
discomfort of large
breasts, your body will
look better
proportioned, and
clothes will fit you
better.
However, as much as you
may have desired these
changes, you'll need
time to adjust to your
new image-as will your
family and friends. Be
patient with yourself,
and with them. Keep in
mind why you had this
surgery, and chances are
that, like most women,
you'll be pleased with
the results. |
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