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Information, costs, and side effects
Initial consultation:
At the initial visit, your doctor will ask you to describe in detail
what you would like improved. Be specific about what you would like
done. If your surgeon fully understands your expectations, they'll
be able to determine whether your goals are realistic. Your surgeon
will examine your breasts and will talk to you about what size you
want your breasts to be, and will show you where they intend to
position the nipple and areola.
You are at increased risk for
complications if you have diabetes, poor circulation, heart, lung
or liver disease, smoke, have a family history of blood clots, take
certain medications, etc. You'll want to discuss your medical history
thoroughly with your physician before you choose to undergo surgery.
Because the size, shape, and amount of tissue in the breast will
change after reduction, most women are advised to have a preoperative
mammogram and a postoperative mammogram six months to a year after
surgery for comparison.
Good
candidates for breast reduction surgery:
- Women with pendulous breasts ( more glandular tissue than fat)
- Women who are thin
- Women that have excessively dense breast tissue
- Women before menopause ( menopause fat replaces glandular tissue)
- Women with excessively large breasts (liposuction normally only
provides a 30-50% reduction in size)
The average cost of breast reduction
surgery
Cost Range: $5,000-$10,000 Breast Reduction (Mammoplasty)
Surgeons fee: $3,500
Anesthesiologist: $700
Facility fee: $1000
Basic
procedures and techniques
Anesthesia: General
Location: Hospital
Surgery time: 3-4 hours
A mammoplasty is a surgical procedure that reduces, lifts and reshapes
the breasts. It can also reduce the size of the areola (the dark
skin surrounding the nipple). Many women seek breast reduction to
alleviate painful discomfort and other conditions (back pain, shoulder
pressure, rashes, skin tags, etc.) as well as to improve the appearance
of their breasts.
The procedure is usually performed under general anesthesia. The
operation takes about 3-4 hours, and you may require an overnight
stay or be allowed to go home the day of surgery.
During mammoplasty, the surgeon makes an incision which is normally
in a keyhole pattern: a circle around the aerola and two incisions
down the breast which will be closed to form one line. Fat and extra
tissue are removed. The surgeon then repositions the nipple and
areola to a higher position and removes excess skin from beneath
the breast.
The picture below shows where skin, breast tissue, and fat are typically
removed and how the areola and nipple are repositioned. The arrows
show how skin formerly above the nipple is brought down and sutured
together to reshape the breast. After surgery, scars will appear
around the areola and in the crease under the breast.
Source: www.plasticsurgery.org
In some cases, the nipple and areola are transferred as a skin
graft to their new position. This is only done when absolutely necessary
since nipple sensation is almost completely lost. Drains are then
placed on the sides of the breasts to drain blood and excess fluid.
The drains are not removed for 1-2 days. The incisions are then
sutured closed and taped.
Recovery
Pain Level: Moderate to severe discomfort. 1-2
weeks of pain medication
Sutures: Removed after 1 week
Drains: Removed after 1-2 days
Swelling and Bruising: 2-3 weeks
Numbness: 1-2 weeks.
Work: 2 weeks. If job is strenuous or requires
lifting, wait longer.
Exercise: Wait 3-4 weeks
Final result: 6 months
On the day of surgery your chest will be painful, bruised and swollen,
and you may feel nauseated. Pain medication will be prescribed.
You will wear an elastic bandage or surgical bra over dressings
for the first few days. The incisions will be taped to reduce scarring.
You will wear an ace bandage or sports bra worn another 1-4 weeks.
Do not wear an underwire bra during recovery.
According to the American Society of Plastic and Reconstructive
Surgeons, the first menstruation following surgery may cause breasts
to swell and hurt, and the woman may also experience shooting pains
in her breasts for several months.
For faster recovery:
- Keep ice packs applied to your chest on the day of your surgery.
- Sleep in an upright position.
- Moisturize the breasts daily (do not apply lotion to any taped
areas)
- Do not bend over, strain, exercise or do any other activities
that could increase pressure in your chest during the first week.
- Plan not to shower or bathe until the drains are removed
- Wear loose clothing
- Drink plenty of water and be sure to get adequate nutrition
- Maintain a stable weight
Risks
and complications
Asymmetry: Small differences in shape or size of
the breasts are not uncommon following breast reduction surgery.
Wound Separation: Sometimes the incisions will
pull apart. This does not require additional surgery. It is treated
with moist dressings. However, if this occurs, recovery time is
much longer.
Fat Necrosis: "Fat necrosis is more common
in larger resections. A study by Strombeck reported a 16% incidence
of fat necrosis in obese patients having resections of more than
1000 g. However, the incidence of fat necrosis has been reported
as low as 0.8% in 371 patients undergoing an average resection of
870 g per breast".
Nipple Sensation: Most patients will have some
change in nipple sensation following mammoplasty. This is usually
temporary but could take months to return.
Scars
The scars extend around the nipple, vertically down from
the nipple and under the breast. The scars fade in time but tend
to be wide scars and are still visible.
Satisfaction rates: Patient satisfaction rates
range from 80% to 95%, and symptom relief is reported from 70% to
100%.
For more information, see breast reduction before and after
photos.
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