Breast Reduction (Reduction Mammoplasty)}
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Breast Reduction (Reduction Mammoplasty)
Dr. Jay Orringer
Large, heavy breasts can cause such medical issues as neck and back pain, postural changes, deep bra strap grooves in the shoulders and frequent rashes beneath the breasts. In addition, they can make a woman feel her body is “out of proportion” and can make finding clothing that fit properly difficult. Larger breasts may also interfere with exercise and other normal activities.
Breast reduction reduces the size and weight of a woman’s breasts. It also offers improved shape by reducing excess skin and underlying tissue, as well as elevating the nipple position. The reduction in weight previously supported by the shoulders, neck and upper and lower back can reduce painful symptoms and allow patients to resume normal activities with greater comfort. Reductions are usually performed in fully-developed women. Ideally this procedure is not performed on women still planning future pregnancies and nursing. However, due to psychosocial issues and medical symptoms exceptions are sometimes made. The ConsultationAs a plastic surgeon, I feel it’s important to spend at least an hour discussing goals and medical history with potential patients. Examination should evaluate current skin tone, size, shape and degree of ptosis (droop). Sensation, scars and nursing issues, as well as issues of proportion and degree of reduction desired should be thoroughly discussed. Because potential patient has specific goals and unique anatomical considerations, a detailed consultation is essential to attaining optimal results.Health insurance may cover a portion of reduction mammoplasty surgery. Issues such as a patient’s insurance plan, as well as her height, weight and the amount of tissue removed all play a role in the level of coverage. It should be understood the insurance approval process can take several weeks to months, and requires documentation and photos from the surgeon.The SurgeryThe surgery should be performed in a hospital or a fully-accredited surgical facility. Issues such as the extent of tissue being removed, a patient’s overall health and her insurance plan may determine where the procedure should be performed. No matter where it is performed, anesthesia should be administered by board certified anesthesiologists. Before the surgery begins the new nipple position, skin and underlying tissue removal will be discussed. Incisions and resulting scars will vary according to the issues being addressed, such as degree of “droop” to be corrected and the amount of tissue and skin to be removed. The repositioning of the nipple requires an incision be made around its circumference. The nipple it is not actually removed however, but left attached to the underlying breast and repositioned to a higher location. The least extensive option results in a “lollipop” like scar, while more extensive reductions use an “anchor” type scar. The anchor technique adds a scar to the fold in addition to the “lollipop” incision. At the completion of the surgery, light tapes are placed over the incisions and a support bra is applied. The patient usually goes home, stays overnight at the hospital or a post-operative facility. The Recovery Early post surgical discomfort is controlled by nerve blocks administered during surgery. Oral medications can be used to control later post-op pain, which is most severe during the first 3 days after surgery. Most pain generally subsides by the end of the first week. Driving should be avoided until a patient no longer requires oral narcotics for pain control. Though recoveries vary from individual to individual, patients are generally free to shower after the second day. Lifting associated with straining is not recommended for at least 2 weeks, though less strenuous arm use and motion are not restricted after surgery. In most cases, exercise and other strenuous activity is not recommended for approximately 3 to 4 weeks after surgery. It is recommended for the first post-operative month that a support bra is worn at all times except while showering.What are some of the Particular Concerns regarding Breast Reduction surgery?Though reduction patients tend to be very pleased with their surgical results, there are some very important considerations to take into account before to proceeding. For instance, this procedure results in permanent visible scarring. Though the scars do fade over the first 1 to 2 years, they never disappear completely. In addition, there is a risk of sensation loss to the nipple and to other areas of the breast. Because loss of sensation cannot be predicted, the procedure should not be performed on those who find this risk unacceptable. It should also be noted that the procedure does not typically result in a long-term increase in upper breast volume as many patients want. This procedure merely elevates nipple position and reduces the amount of excess skin hanging below the fold. Although the breasts are reduced in size and weight, recurrent drooping will occur due to the effects of gravity on the tissue and skin. Before surgery, the degree of desired reduction should take into account abdominal contour. Body proportions must be taken into account. While some patients ask to be made “as small as they can be,” reduction to that degree tends to make a protruding abdomen look larger. Making the decisionEvery surgical procedure has inherent benefits, risks and limitations. Patients should feel comfortable asking any and every question they may have during consultation and pre-operative visits to determine whether the procedure is right choice for them.
For women in
Beverly Hills, breast reduction
can achieve a more pleasing size and shape and can also improve asymmetry. Dr. Jay Orringer has two decades of experience creating breast reduction results geared toward an aesthetic, proportionate and natural results.
Breast Reduction (Reduction Mammoplasty)}