Houston Breast Reduction (Reduction Mammaplasty)

Breast reduction, technically known as reduction mammaplasty, is a surgical procedure designed to remove fat, glandular tissue, and skin from the breasts, making them smaller, lighter, and firmer. This procedure can also reduce the size of the areola, the darker skin surrounding the nipple.

Women with extremely large, pendulous breasts experience a wide array of medical problems including, but are not limited to, back and neck pain; skin irritation; physical deformities; and breathing problems. Once breasts are fully developed (usually at age 18), women may elect to have this procedure to alleviate the serious physical discomfort having extremely large breasts create.

Gynecomastia (enlargement of the male breast) is not an uncommon condition, affecting as many as 40 percent of men. This condition may affect either one or both breasts. The majority of the cases have no known cause while the others might be related to the use of certain drugs and or medical conditions.

The goal of breast reduction is to create smaller, better-shaped breasts in proportion with the rest of the body.

• How is breast reduction surgery performed?
• How long does breast reduction surgery take?
• What type of anesthesia is used?
• Where is the procedure performed?
• When can I return home and resume normal activities?
• How do I prepare for breast reduction surgery?
• What precautions are necessary during recovery?
• What are the possible complications after breast reduction surgery?
• What results can I expect after breast reduction surgery?
• Choosing the right surgeon

How is breast reduction surgery performed?

Your surgeon will make the first incision around the dark pigmented area around the nipple (areola) so that it can be repositioned to a higher location. The nipple itself is not removed, however. Then, a second incision is made horizontally in the crease line under the breast. The third incision will go vertically from the nipple to the crease line. Excess fatty tissue will be removed and skin will be trimmed away to reduce, tighten, and reshape the breasts. Finally, the incisions are closed with small sutures (stitches). Bandages are applied to the breasts and you will be placed in a surgical bra for support.

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How long does breast reduction surgery take?

Breast reduction surgery generally takes about one to three hours per breast, depending on extent of the repair and the techniques being used.

What type of anesthesia is used?

Breast reduction is most often performed under general anesthesia, causing you to be asleep during the whole procedure.

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Where is the procedure performed?

Most breast reduction surgeries are performed as outpatient procedures, allowing you to go home within hours of the operation. However, if an extremely large amount of breast tissue will be removed, the doctor may want you to stay overnight in the hospital where medical personnel can monitor your initial recovery.

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When can I return home and resume normal activities?

Generally breast reduction is done on an ambulatory basis but in some cases may require an overnight stay. However, it is necessary that you have someone to pick you up after the procedure, take you home, and stay with you for at least 24 hours.

Most women return to their usual activities in one week. However, you must not lift anything for the first two weeks and do no heavy lifting for the first four weeks. Avoid raising your arms above your head for at least two weeks.

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How do I prepare for breast reduction surgery?

During your initial consultation, your surgeon will discuss the changes that you would like to make to your appearance. Since the appearance of your breasts is a matter of personal perception and preference, you will need to discuss your concerns in detail so your surgeon can determine the appropriate alternatives. Your surgeon will explain how your age, the size and shape of your breasts, and the condition of your skin may affect the results of this procedure. You also should make arrangements ahead of time for someone to drive you to and from your procedure and to assist you with your daily activities during your recovery period.

Prior to your surgical procedure, the surgeon will perform a complete health history and physical. This will include examining and measuring your breasts, as well as photographing them as a frame of reference during the surgery and afterwards. Your surgeon may also require you to have a mammogram (breast x-ray). Knowledge of your allergies, medications and previous surgeries should be brought to your surgeon's attention at this time. Specific instructions to assist you in preparing for this procedure will be given to you after the health history and physical is complete. Depending on your individual health status, the instructions may include guidelines regarding your diet, alcohol intake, smoking and which medications to take or avoid. Your experience will be much smoother if you remain compliant with your surgeon's instructions.

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What precautions are necessary during recovery?

It is important to wear your surgical bra for seven to ten days after your procedure. At approximately the fifth postoperative day, your bandages will be removed. Your surgeon may recommend a particular style of bra be worn for the two to three weeks following the wearing of the surgical bra. Your stitches will be removed in stages during the second week after your procedure. It takes six-eight weeks after your procedure for your breasts to obtain their final shape. At first, they may be somewhat bruised and swollen; but gradually the swelling will decrease and your supportive bra will help shape the breasts. Additionally, you will receive specific instructions to follow during your recovery including rest and sleeping positions, bathing and showering techniques, and caring for your incision area.

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What are the possible complications after breast reduction surgery?

The scars in breast reduction procedures are placed in natural skin demarcation lines around the areola, down the breast, and across the bottom of the breast. In most women, the scars from the incisions will be pink for about six months and gradually fade thereafter. It is important to know that all scars are permanent and their height, width and final color are never completely predictable.

As with any surgical procedure, small nerves to the skin are interrupted during surgery. Portions of the nipple area may feel numb or have less than full feeling. Sensitivity returns over several weeks, but some diminished feeling may last indefinitely. This does not usually interfere with erotic sensation and many women even report an increased erotic sensitivity with their new breasts.

No procedure is without risks; however, the majority of complications known to be associated with a breast reduction are minor when the procedure is performed by an experienced board certified plastic surgeon. It is always important to be informed about the possible complications before any surgery. Be sure to discuss any concerns you may have with your surgeon.

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What results can I expect after breast reduction surgery?

After your procedure, you will experience some discomfort for a few hours when the anesthesia wears off. Your surgeon will give you medication to relieve any distress. Most women require very little pain medication after the first 24 hours.

Please note that the loss of elasticity that caused the original sagging of the breast can recur. Occasionally women lose part of their improvement over variable periods of time. Rarely, a woman will request another procedure to reduce the breasts again; or perhaps request a breast lift to correct undue sagging. The vast majorities of women maintain their results and do not require any other procedures.

Most women report that the results from breast reduction are so favorable that concern about scars is minimal. Your breasts may not attain their final shape for up to ten weeks. Be sure to address any questions or concerns to your surgeon immediately. Your health and happiness are the most important considerations any time.

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