Breast Reduction FAQs

 

How many techniques are there for breast reduction?

Is breast reduction permanent?

What does a typical breast reduction consultation entail?

How is breast reduction performed?

Where are the incisions made? Are there any visible scars?

What should I expect postoperatively?

Is it quite painful? Is there much bruising?

When will I be able to return to work?

When will I be able to see the results?

What are the risks of breast reduction?

 

How many techniques are there for breast reduction?
There is a manual technique where surgeons remove tissue after having opened the breast along the tissue lines where surface tissue will be removed as well as lifted. There is the tumescent technique that is basically a form of liposuction, and a liposuction technique can also be used.

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Is breast reduction permanent?
Yes, breast reduction is almost always permanent. Remaining fat cells will enlarge if you overeat and gain weight. Breast tissues will swell and store milk during pregnancy or if a woman is taking natural or synthetic hormones. The exception to breast reduction being permanent is in cases of virginal hyperplasia/hypertrophy when the estrogen levels are high and the development of the breast is ongoing.

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What does a typical breast reduction consultation entail?
The surgeon will discuss your goals with you and explain what can realistically be achieved. He or she surgeon will show you photos of his or her work, and you may wish to share photos that you have brought to the consultation of what you do and do not like. The surgeon should discuss the benefits and risks of breast reduction at length, and answer all your questions. This is the time for you to get to know the surgeon and get a feel for whether or not there's a good working relationship between the two or you, which is very important for a successful surgical outcome.

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How is breast reduction performed?
For the liposuction technique, small incisions are made within the natural fold underneath the breast or the outer edge. A tumescent technique may be used where a solution of saline, lidocaine, and epinephrine are injected into the targeted area. The goal is to engorge the tissues with the solution for a firmer working area so that fat cells (which are softer) are suctioned out. The epinephrine prohibits bleeding during the operation. There is another liposuction technique which involves ultrasonic energy waves. These ultrasonic waves excite the fat molecules and literally melt the fat into a liquid for ease of removal by suction. There is also a manual removal technique which is similar to a breast lift operation but with more internal tissue removed. The excess tissue is removed and proper repositioning and recontouring of the breast is performed.

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Where are the incisions made? Are there any visible scars?
The incisions for a breast reduction are made within the natural folds under the breasts, sometimes around the areolae and in a line from the crease to the areolae. Some procedures require only a keyhole incision. The breast reduction procedure is not a minor one and scars should be expected. Discuss with your doctor his or her incision placement of choice and why, and remember to get several opinions.

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What should I expect postoperatively?
The patient may be placed in two bras and an elastic bandage. In some cases, you may remove the top bra only and rewrap the breasts with the bandage the day after surgery. Patients are usually instructed to wear their surgical bra for 21 days both day and night. However it is advised to wear a high quality support garment until the scar matures, which may take up to a year.

During recovery, the patient is carefully monitored and is allowed to be driven home a few hours later, although some patients are required to stay in the hospital. If you are discharged, you should remain in the area in case you experience complications. Some patients are instructed to ice continuously for the first 48 to 72 hours to reduce discomfort and swelling. The pain connected with the procedure is minimal to moderate and is controlled with oral pain medication. Antibiotics are prescribed to prevent infection. Instructions for the day and night after surgery include bed rest with limited activities. Normal activities can be usually be resumed at 3 weeks after surgery, although strenuous activities and heavy lifting must be avoided for several more weeks.

You should notice a gradual reduction in discomfort. Sometimes swelling will increase over the first three days. A fever greater than 100.5 degrees should be reported to your surgeon. Marked increases in tenderness after 48 hours along with redness may indicate an infection and should be reported immediately.

Your surgeon will instruct you on what type of support bra you should wear, how to deal with your incisions, and when you can resume normal activities like bathing and exercising.

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Is it quite painful? Is there much bruising?
It takes about a week and a half for most of the swelling to subside. Some people are more prone to bruising than others. You should take your prescribed pain medication to alleviate any pain or discomfort that you may experience. If you feel that your pain is severe, do not hesitate to call your surgeon or the staff member on call.

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When will I be able to return to work?
Most patients return to work within 2 weeks, although some go back sooner. It is a highly individual call that should be after conferring with your surgeon. Discomfort is the main reason women tend to delay returning to work. You will be instructed not to bend over, lift your arms over your head, or exercise until your surgeon clears you for those activities.

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When will I be able to see the results?
You should notice the difference in breast volume immediately. For some patients, if the procedure was due to back pain associated with very large breasts, the pain relief is immediate. After the swelling subsides you will begin to notice a difference in the compact appearance of your breast tissues. It will take several months for the final results to emerge.

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What are the risks of breast reduction?
One major risk of breast reduction is necrotizing fat and/or tissue; that is, they die. If fat becomes necrotic from lack of blood supply, it turns orange-ish clear and drains from the incision. If the tissue becomes necrotic, immediate treatment is necessary. You must have the tissue removed before a major infection develops. There may also be breast asymmetry, hyperpigmentation (permanent dark spots), major blood loss, hematoma, infection, the loss of the ability to breastfeed, a loss of blood supply to the treatment area, and permanent numbness due to nerve damage. Another risk of breast reduction is pulmonary Thromboemboli, a blood clot that breaks free and travels to the lungs.

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