Excessive breast volume (hypermastia) is not always welcome. Candidates for a breast reduction (reduction mammoplasty) may have experienced functional impairment of the following systems: a) musculoskeletal: shoulder, neck, arm, back pain; b) dermatological: heat rash and/or friction from the weight of the breasts over the rib cage and/or bra strap grooving; c) respiratory: postural changes and loading of heavy breasts may impede breathing, which in turn limits physical activity; d) psychological: dissatisfaction with body image because of limitation of clothing & decreased self-esteem. Breast Reduction is a reconstructive procedure, which has significant cosmetic benefits because it includes not only reduction of excess breast tissue, skin, downsizing of areolar complexes but also a lift, which can produce breasts which are more attractive and in proportion to your frame. You’ll be healthier, happier, and your clothes will fit better too.
Breast reduction techniques have improved vastly and can be offered to any woman, provided she enjoys good health, is not obese, is a nonsmoker and has realistic expectations. Younger women are advised that they may experience “regrowth” of their breasts, after pregnancy and their ability to lactate should not be compromised.
Reduction mammoplasty can be scheduled under monitored anesthesia care or general anesthesia, and generally requires two and four hours. Goals include: a) preservation of the blood and nerve supply to the nipple-areolar complex; b) reduction of excess breast tissue and skin; c) reduction of areolar complex diameter; d) equalization of volumes of breasts & position of nipples; e) creation of a more attractive, rounder, higher breast mound; f) providing acceptable scars; g) minimizing risk of fat necrosis; h) sending resected breast tissue to Pathology for analysis. Drains are rarely used.
Patients are pleasantly surprised that post-op pain isn’t as extensive as they may have imagined. Generally most patients wean off pain medications, within 3-5-days. We make recommendations for activity restriction, wound care, and supportive bras, which should be worn for a minimum of 2-4 weeks, postop. No external sutures are utilized. The average time to return to normal activity 7-10 days and full exercise 30 days.
Dr. Chong is deeply committed to providing optimal care for her patients to ensure that they are able to make informed decisions and understand all of the options available. She will be happy to personally consult with you to help guide you to the best treatment plan to fulfill your goals.
Can you change the size/ location of my nipples?
Yes. The diameter of the NAC (nipple-areolar complex), as well as the location of the nipples, are positioned to a more superior position in a breast reduction. There are at least 4 different techniques for breast reduction, which are based on conserving both the nerve and blood supply.
Will my breasts grow again?
Generally, the female breasts develop under hormonal stimulation, which occurs during puberty, pregnancy/lactation and menopause. It is always advisable to inform breast reduction patients that they may experience a certain amount of “regrowth” during these phases, as well as periods of weight gain.
Will my insurance cover this procedure?
Patients must understand that insurance companies will cover surgeries to correct congenital anomalies, traumatic, post-oncologic (cancer) and functionally impacting conditions. Breast reduction is intended to alleviate “symptomatic macromastia”, however this diagnosis must be established by patient history, physical exam, letters of support from other physicians (Dermatologists, Orthopedic surgeons, Pain management) and verification of “failure” of conservative measures, such as Chiropractor, Massage therapy and/or use of supportive bras. Pre-authorization letters, including photos should be submitted and acknowledged, prior to scheduling surgery.
Can you see if I have breast cancer?
Not really, although all excess breast tissue is sent to Pathology to be examined for breast cancer. It is impossible to completely inventory and clear the breast tissue, which is reshaped during a breast reduction, without interrupting blood and nerve supply. Occult breast cancers are rarely encountered unless the breast reduction is in excess of 700gm/side.
Will I be able to breastfeed?
Conservation of lactation potential is done by preserving blood, nerve and lactiferous duct structure by careful design and surgical technique.
When can/should I get a mammogram?
Pre-op mammograms are recommended for women who are over 40, have a family history of breast cancer and/or have discrete palpable masses. Post-op mammograms should be delayed at least a year. Occasionally palpable masses may be appreciated, post-op; these usually represent areas of fat, which have lost their blood supply, fat necrosis. The body will routinely “dissolve” these masses, however, ultrasound is useful to make the diagnosis and document resolution.
Can you guarantee my cup size?
Cup size varies according to bra manufacturer and guaranteeing a cup size is impractical if not impossible. Ideally a breast reduction will resolve symptoms, reshape the breast & be proportionate with her build.
Do you always do a lift with a reduction?
Yes. Breast reduction removes excess breast tissue and reshapes the breast to a higher position on the chest wall.
Can you do a reduction with just liposuction?
It is possible to reduce the bulk of breasts with liposuction, alone, however since the skin isn’t reduced or nipples migrated upwards, the eventual result will be a smaller, relaxed version.
How long do I have to sleep on my back?
Sleeping at a 30 degree incline is recommended for a week post-op to facilitate resolution of swelling and getting out of bed.