Mammoplasty can be done strictly for cosmetic reasons as well. If you feel that your breasts are out of proportion to your body, you may want to have them reduced in size.
However, because most women need breast surgery because of back or other health problems, the American Society of Plastic Surgeons (ASPS) classifies breast reduction surgery as a reconstructive surgery, one done to correct a physical or medical problem, rather than a cosmetic surgery that is done strictly to improve appearance. You can think of it this way: reconstructive surgery is surgery that you need, while cosmetic surgery is surgery that you want.
Whether you are a good candidate for a breast reduction depends on your overall physical and mental health. You should be free of any active diseases or other pre-existing medical conditions that could make you unable to endure the surgery and recovery. These conditions include uncontrolled diabetes, asthma, bleeding disorders or heart problems.
You should also be healthy mentally and emotionally. The healing process can be difficult and tedious and requires a great deal of patience and mental stability. A period of depression is common after having surgery, so you should be mentally prepared for it to help keep this temporary depression from complicating any pre-existing mental problems.
Before you commit to a breast reduction procedure, you should sit with your surgeon and discuss how you want to look. This will help ensure your goals can be attained through surgery. You can look at before-and-after mammoplasty pictures to be sure you are both in agreement about how you want to look after the surgery.
You should consider the cost of a breast reduction procedure. Health insurance will not cover a cosmetic procedure, but breast reduction surgery that is needed to alleviate back pain and skin irritation may be covered. If you are having health problems due to overly large, heavy breasts, contact your health insurer. If your insurance plan will not cover breast reduction surgery, financing is available.
The size of the areola (the dark area around the nipple) can also be adjusted during mammoplasty, if the areolae are too large.
Some surgeons may use liposuction as part of breast reduction surgery. In liposuction, a thin tube called a cannula attached to a vacuum device is used to break up fat and suction it away. Liposuction may be used to remove fat around the breast.
If you have very large breasts and the reduction surgery will be extensive, there is the possibility that you may need a blood transfusion. Your surgeon may suggest that you have a pint of blood drawn a week or two before your surgery. This way, if you need blood, you will get your own.
At your consultation, your surgeon will examine your breasts and look at you to help you decide what size breasts are more proportionate to your body. If your breasts are very tender at certain times of your menstrual cycle, try to schedule this appointment around that. Your surgeon may ask you to have a mammogram done before your breast reduction surgery.
Breast reduction surgery is usually done under general anesthesia, where you sleep through the procedure. Often, it is done in a hospital and you stay at least overnight, although less extensive reductions may be done in a freestanding surgical unit and you go home that day. You will need someone to drive you home in that case.
There are several types of breast reduction surgery. The type chosen by you and your surgeon will depend on the size and shape of your breasts and how much smaller you want your breasts to be. The different basic types of reduction mammoplasty include:
If you have very pendulous breasts, your surgeon may need to completely detach your nipple. The detached nipple is later attached to blood vessels in a new location further up on the breast. In other cases, the surgeon may keep the nipple attached to its underlying blood vessels and milk ducts and simply move it upward and suture it into a new location.
The incision is then closed around the areola and then closed in a line leading down from the nipple to the crease under the breast. The closed incision resembles an anchor or an upside-down T, which is where this method of breast reduction surgery gets its name.
On the day of your surgery, your surgeon will use a pen to mark your breasts to show how much tissue will be removed and where the incisions will be placed. You will usually be standing during this marking procedure. Sometimes this marking is made a day or so before surgery. After marking, you will be prepped for the surgery, which will include having an intravenous (IV) line started and being attached to monitors that will keep track of your vital signs.
Once the incisions are made, the excess tissue is removed to reduce breast size and create a desired shape. Excess skin is removed, and the remaining skin is sutured to lift the breast into the new location. Your surgeon will examine your breasts at this point to ensure they are as symmetrical as possible.
A dressing is then applied to protect the wounds, keep the reconnected tissue securely in place, and reduce swelling. You may be put into a special surgical bra at this point, which is specially made to be supportive and not have seams in places that would irritate your incisions.
After the surgery is complete, you will be moved to a recovery room where you will wake up and where the staff can monitor you. You will stay there for about 2 hours. During recovery, you may feel discomfort, nausea or extreme cold, and you may experience emotional anguish. This is normal. The hospital staff can help you during this time with pain relievers, antinausea medications or warm blankets.
