BREAST REDUCTION OR
REDUCTION MAMMOPLASTY
Women with large or heavy breasts may experience several health concerns related to their breasts: back pain, neck pain, grooves in the shoulders from bra straps, pain in the breasts, and rashes under the breasts. Women with arthritis of the spine and shoulders may have more symptoms than usual because of the added weight of heavy breasts. Some women are bothered by the psychological embarrassment of large breasts. In other situations, athletic, active women and women who are trying to lose weight are inhibited by the size of their breasts. Often, it is difficult and expensive to find clothes that fit.
Breast reduction can minimize or eliminate these problems. During the procedure, excess skin and breast tissue are removed and the breasts reshaped to be smaller and more attractive. The procedure is performed at the hospital under the general anesthesia. When only a small amount of tissue is removed, the procedure can be performed under local anesthesia with intravenous sedation as an outpatient procedure.
During the procedure, the surgeon makes incisions so that scars form around the areola, vertically below the areola, and in the crease beneath the breasts. Scars are an unavoidable drawback to the procedure, but typically quite acceptable to most patients. The incisions are deigned so that the scars will not be visible while wearing normal clothing. Then the surgeon repositions the nipple and areola to a higher position on the breast, and removes excess breast tissue and skin. A drain may be left in place at the time of surgery and removed several days later. The patient can be up and about the day after surgery, and can go home in a few days. Sutures are removed within the first two weeks following surgery.
Potential complications of breast reduction include postoperative bleeding, infection and healing problems. These complications may result in more conspicuous scars. When the nipple and areola are transferred to their new position, it may not "take" or heal, and a portion or all of it may be lost. This in uncommon. Smoking immediately before and after surgery may contribute to this problem.
Although every attempt is made to obtain symmetry and a natural shape, there may be some irregularities in the final size and shape of the breast or in the positioning of the areola and nipple. Because separating the nipple from the breast tissue during the procedure disturbs the superficial nerves of the nipple, patients may experience a decrease in sensation. Patients also may also experience a permanent inability to breast-feed after having a surgery. Because these symptoms are normal side effects of breast reduction surgery, patients should consider these factors seriously before deciding to undergo the procedure.
Since reduction mammoplasty is often performed for the relief of physical symptoms, some insurance companies may pay for the procedure. However, insurance companies differ widely in their policy of payment for this procedure. Patients should check with their carriers about coverage before having surgery.
Following surgery, most women report that their back and neck pain are reduced. Typical scars are a well-accepted trade-off for most patients. Patients also have fewer problems finding suitable clothes and are able to become more involved in sports.