Breast reduction, technically known as reduction mammaplasty, is a surgical procedure that removes fat, glandular tissue and skin from the breast making them smaller, lighter and firmer. Breast reduction will also reduce the size of the areola and will help to restore sagging breasts by adjusting and repositioning the breast tissue to an appropriate place on the chest.
Dr. Jeffrey Kenkel is a *Board-certified plastic surgeon specializing in cosmetic surgery. He is Chairman of the Department of Plastic Surgery and Director of the Clinical Center for Cosmetic Laser Treatment at UT Southwestern Medical Center at Dallas.
* Board-certified by the American Board of Plastic Surgery
Am I a good candidate for the surgery?
Your visit with Dr. Kenkel will determine if you are a good candidate. If you are in good physical and mental health, have no breast disease and have reasonable expectations then you will be an appropriate candidate. You will be required to have a mammogram before your surgery.
Before you decide to have surgery, think carefully about your expectations and discuss them with Dr. Kenkel.
What should I expect from my consultation?
During the consultation, you will be asked about your desired breast size and anything else related to the appearance of your breasts that you feel is important. This will help Dr. Kenkel understand your expectations and determine whether they realistically can be achieved. He will examine your breasts and will consider such factors as the size and shape, the quality of your skin and the placement of your nipples and areolas. Measurements will be taken which are necessary for insurance approval and planning of the surgery. He will explain which surgical techniques are most appropriate for you, based on the condition of your breasts and skin tone. Afterwards a photographer will take photographs for your medical record.
You should come to the consultation prepared to discuss your medical history. This will include information about any medical conditions, drug allergies, medical treatments you have received, previous surgeries including breast biopsies, and medications that you currently take. You will be asked whether you have a family history of breast cancer and about results of any mammograms. It is important for you to provide complete information.
How is the surgery performed?
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 skin from both sides of the breast is brought down and around the areola, shaping the new contour of the breast. Liposuction may also be used to remove 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 areola tissue.
Sutures 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 to eliminate the vertical part of the scar. Occasionally in breast reductions when only fat needs to be removed, liposuction can be used to reduce the breast size leaving minimal scars.
What happens the day of surgery?
Your breast reduction will be performed in a hospital and you will stay overnight . Be sure to arrange for someone to drive you home from the hospital and to stay with you at least the first day following surgery. The "Patient Care" link provided will give you instructions to prepare for surgery, including guidelines on eating, drinking and smoking. If you are a smoker, you will be asked to stop smoking well in advance of surgery. Aspirin and certain anti-inflammatory drugs can cause increased bleeding, so you should avoid taking these medications for a period of time before surgery.
Prior to the procedure, medications are administered for your comfort and to lessen the anxiety if need be. General anesthesia and intravenous sedation are used for patients undergoing breast lift. The surgery usually takes 3-4 hours and you will awake in a recovery area where you will continue to be closely monitored. Your breasts will be wrapped in gauze dressings or a surgical bra.
What is the recovery like?
You will have some discomfort and/or pain following surgery. You will feel tired and sore for 1-3 days following your surgery. Depending on the extent of your surgery, your breasts will feel bruised, swollen and uncomfortable for a day or two but the pain shouldn't be severe. While you are in the hospital your pain is controlled intravenously. When you are discharged, you will be given prescriptions for pain medication and antibiotics as well.
The surgical bra will be removed after 2-3 days and you will be permitted to shower after removal of your drains. Steri-strips should be worn to decrease the appearance of scars. Your sutures will come out in 7-10 days. You may have drains that will require you to measure and record the fluid that your body expresses. You will be given instructions on how and when to report it during your recovery.
Plan on having limited physical activity for at least six weeks. No lifting over ten pounds for 4-6 weeks and no workouts or activities that increase your heart rate above 100 beats per minute or stretching exercises for at least 3 weeks.
What should I know about my results?
Whenever surgery is performed on the body a scar will result. Your incision will be around your nipple and down the center of your breast. These scars will become pale-pink to white in color, depending on your skin color, for 6-12 months.
Dr. Kenkel may recommend a baseline mammogram before surgery and another mammography examination some months after surgery. This will help to detect any future changes in your breast tissue. Following breast reduction, you will still be able to perform breast self-examination.
How many visits do I have after surgery?
You will usually return in 3-4 days following surgery then in 7-10 days for suture removal. During your postoperative visits, Dr. Kenkel will discuss further postoperative activity and concerns you may have. Following this visit you will return in approximately 3 weeks, 6 weeks, 3 months, 6 months and one year.
Please remember that your relationship with Dr. Kenkel does not end when you leave the operating room. If you have questions or concerns during your recovery, or need additional information at a later time, you can always contact Dr. Kenkel.
What does the surgery cost?
Breast reduction is sometimes covered by insurance and Dr. Kenkel's administrative assistant will help in coordinating insurance approval and payment. You will be responsible for your deductible, percentage and co-pay.