The surgical procedure is also known as reduction mammoplasty.
The weight of very large breasts can cause back strain and discomfort. The bra straps can indent the skin and fat of the shoulders, producing permanent grooves and even scaring. The contact of the breasts and the lower chest wall can create a chronic skin irritation called intertriginous dermatitis. Very large breasts may interfere with the ability to exercise. They also can make a woman feel "extremely self-conscious."
In breast reduction, excess fat and skin are removed from the breasts. The breasts are reshaped to form smaller breasts and the nipple and areola are repositioned. Breast reduction can also be used to even up the size of the breasts where one is much larger than the other, a condition known as unilateral macromastia (mammary hyperplasia).
Breast reduction is not recommended for young women whose breasts are not yet fully developed or for women who plan to breast feed since the surgery may impair the ability to breastfeed. The surgery may also result in decreased sensation in the breasts or nipples.
The operation of reduction mammoplasty should not be confused with the so called "breast lift" or mastopexy procedure which is done for cosmetic purposes.
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Before getting breast reduction surgery, you will go in for a pre-operative consultation, during which time your surgeon will take a detailed medical history, including whether or not you've ever had a lump removed from your breast or any other medical conditions affecting your breasts. He or she also will take a detailed family history. You should be in good physical and mental shape in order to undergo this surgery.
It's important that you are completely honest during this consultation. That includes being completely open with your medical history. It also means being very open as to why you're seeking a breast reduction . You should expect to discuss the emotional issues you've dealt with; that is, how have you felt dealing with your breast size? How has it made you feel, physically? What types of physical conditions have you experienced?
Your surgeon may take photos of your breasts and measure them. During this time, he or she also will discuss how much breast tissue should be removed to achieve the desired results. You also will learn about how to prepare for the surgery and how to plan for your recovery. Your surgeon may prepare you for this procedure by performing a mammography and breast exam.
Depending on your personal situation, the procedure can be performed in an outpatient facility or you may have to stay at least one night in the hospital. In either case, you will be given general anesthesia, which means you will be put to sleep for the procedure. It's important to have someone with you who can drive you home and stay with you at least the first night if you're not staying in the hospital.
The surgery itself will take about three to five hours. Your surgeon will make an incision around your nipple, then downward on the breast, in a keyhole form. The excess skin, tissue and fat are removed and your nipple is relocated for cosmetic purposes. Your surgeon may use drainage tubes and the incision site is then sutured. Your breasts will be wrapped in special gauze. If required, you may also wear a surgical bra.
You need to be in good physical shape to ensure proper healing, so follow your surgeon's instructions on vitamins you can take before and after the surgery. Likewise, it's very important to eat well-balanced meals. This is no time for a diet!
During your preoperative consultation, your surgeon will ask about your habits, including whether you smoke or what medications you take. You may have to quit smoking for a period before and after surgery to ensure proper healing.
Likewise, you also may have to cease taking certain medications, such as aspirin or certain anti-inflammatory drugs such as Motrin or Aleve. Your surgeon will instruct you on this.
Before you undergo surgery, you'll need to get your home ready for your recovery. This should include:
- Plenty of ice
- Gauze and clean washcloths and towels
- Loose, comfortable t-shirts and blouses
- Soft bras we mentioned above. Your surgeon can recommend where to buy these
- Special ointments or creams as recommended by your surgeon for incision site
- Telephone within reaching distance of your primary rest area
- Magazines, movies, etc.
You will need to take at least one week off from work or school. Some patients require two weeks, but each situation varies. Your surgeon will instruct you on follow up appointments to remove bandages and sutures.
If you are a physically active person, you will not be able to resume your activity for at least one month after surgery. It's very important that you realize the emotional impact of surgery: a lot of people experience depression, but this is normal! Make sure you communicate with your doctor about all your concerns.
- At the first sign of infection, including fever
- If you have any unusual discharge from the incision site (including pus)
- If any of the sutures come out before you are due to have them removed
Doctors who perform this medical procedure
Coordinator of the Plastic Surgery Unit
With a degree in Medicine by Faculdade de Medicina da Universidade do Porto, Dr. António Conde has performed more than 18.000 surgical procedures and is currently the Coordinator of the Plastic Surgery Unit at Hospital Lusíadas Porto (located at Boavista Avenue) and the Director of the Plastic Surgery Unit at Hospital de S. Sebastião.
Responsible for introducing pioneer techniques at a global level in upper and lower members procedures, as well as head and neck. He has written more than 80 essays in portuguese and international meetings and has been published 20 times in specialized publications, either as author or co-author.
Coordinator of the Plastic Surgery Unit
With a degree in Medicine by Faculdade de Medicina de Lisboa since 1988, Dr. Rui Leitão is the Coordinator of the Plastic Surgery Unit at Hospital Lusíadas de Lisboa since 2006. Previously he worked in several other public and private hospitals of Lisbon, Portugal’s capital.
His main interest areas are: Breast reconstruction, Hand surgery, Esthetic surgery, Microsurgery, Dermo-cosmetic procedures and Laser treatments.