WHAT IS A BREAST REDUCTION?
HERE ARE 9 THINGS TO KNOW ABOUT BREAST REDUCTION SURGERY
Breast reduction (or reduction mammoplasty) is a day surgical procedure designed to improve and/or eliminate symptoms related to large breasts.
Both can contribute to the symptoms many women complain about who have large breasts.
1) What Causes Large Breasts?
Breast enlargement can occur for a number of reasons:
- Genetic predisposition
- Weight gain
- Hormone sensitivity
- Rare medications
2) What Are the Common Symptoms?
Women with large breasts (called “macromastia” or “hypermastia”) can have a wide range of symptoms due to the excessive breast weight. Most women have back, neck, and shoulder pain. They can have grooves in their shoulders due to the bra straps “digging” into their shoulders. This can result in pain, depressions, irritation, redness and/or pigmentation in the shoulder area. Some woman experience rashes or repetitive irritation underneath their breasts requiring topical treatments including powders and antibiotic or anti-fungal creams. All of the above can create poor posture which can exacerbate the symptoms and result in a vicious cycle.
3) Are there “Non-Surgical” options to improve the symptoms?
They are many things women can try to help improve some of the symptoms they are having. These may include but are not limited to:
- Specialty bras
- Weight loss
- Physical therapy
- Topical medications for rashes
While some of these may help the symptoms some women are experiencing, they may not help all and really serve as a temporizing mechanism for the main issue which remains: Large Breasts
4) What is the “Surgical” option?
Breast Reduction Surgery is commonly performed as a “day surgery” procedure. Our patients usually arrive 90 minutes prior to their surgical start time to allow them to be “checked in” and seen by our operating room staff and anesthesiologist. It is a 2.5- hour procedure where the patient is asleep. As mentioned above, the goal of the procedure is two- fold: to reduce the size of the breasts and to reshape the breasts (breast lift). Both of these contribute the symptoms the patients are experiencing.
Depending on the size of the patient’s breasts and what their goals are we achieve our goals through one of two different incision types:
The incisions we create are closed with dissolvable sutures on the inside and glue is placed on the outside. We place the patient in a supportive bra after the surgery is completed. Patients stay in the recovery room for 60-90 minutes following the procedure until they are awake enough to go home.
5) How Do We Determine What Size to Go To?
Unfortunately, we live in a world of “cup” sizes that are not standardized in any way. That means a “D” cup is different for each store such as Victoria’s Secret, Dillards, and Nordstrom. That being said we do discuss it and most often aim to make the “reduced” breasts more proportionate to the patient’s body frame. The key is to relieve the symptoms and get patient’s active again. We do have some flexibility especially for some women who would like to be on the “smaller” side.
6) What Should I Expect After the Surgery?
Breast Reduction Surgery results in immediate improvement in our patient’s symptoms. I have had many patients over the years tell me that their back or neck pain was gone while they were in the recovery room. Of course, patients experience some discomfort from the surgery but in many cases their symptoms are all gone! We use a special recovery program that is designed to speed our patient’s recovery, diminishing the need for narcotics. (See Dr. Kenkel’s Rapid Recovery Program).
Many of our patients are driving in 3-5 days and go back to work anywhere from 1-3 weeks after surgery depending on what their job requires. No heavy lifting ( > 5lbs) for the first 3 weeks and no getting the heart rate up during that time. At 3 weeks we will slowly start to introduce activity and get our patients back to their normal activity.
Our patient’s wear a supportive bra day and night for the first two months. Gravity is strong and we need to externally support the breast until it has regained its strength. It is important to understand that it will take about 4-6 months to get to the final shape of the breasts and up to a year for full maturation of the incisions.
Lastly, I have had many patients tell me that they can see their tummy and even feet for the first time and in a long time! They become motivated to take better care of themselves and in many cases, lose weight.
7) What Are the Risks of the Surgery?
Any procedure we do carries with it some risk. Fortunately, the risks involved with breast reduction are small and infrequent. They are influenced by our patient’s general well-being as well as what size person they are. In general, if patients have other health issues or if they are obese, they will carry with them a higher risk of the procedure. We do not operate on smokers and require all patients who smoke to stop at least one month ahead of time and be off of all nicotine products (including vaping and patches).
Risks include bleeding and infection, which can happen with any procedure. Most women are asymmetric, meaning one side is larger than the other. We try to compensate for this, but some asymmetry will likely persist. There is a chance that the patient will lose sensation to the nipple or other parts of the breast. Probably the most common complication is just some minor healing problems around the incisions. Women who are interested in breast feeding have about a 75% chance of doing so after a breast reduction.
8) Does Insurance Cover Breast Reduction Surgery?
In many cases, one’s insurance may cover the procedure. Each carrier is different and have specific inclusion and exclusion policies. It is important to check with your provider or your HR department to see if this a potential benefit of your insurance plan.
9) When is the Right Time to Have a Breast Reduction?
There is no ideal age to undergo a breast reduction. I cannot tell you how many times I have heard some of my patient’s state that they wish they would have had it earlier in their life. I have operated on teenagers and all age groups into the 80’s. If women are about ready to have children or if they are actively losing weight, I do encourage them to wait until they are complete. That being said, for many women, they are not sure when they are going to have kids and should think about feeling better first!
We have a wonderful team here at UT Southwestern that is dedicated to making your experience before, during and after your breast reduction seamless and uneventful. Should you have any questions regarding breast reductions, you can find further information and photos on our website at drkenkel.com. To schedule an appointment please call the clinic during business hours (8-5pm) at 214-645-2353 or online here.