Dallas Plastic Surgeon – Breast Reduction

• Introduction
• Is breast reduction right for me?
• What should I expect from the consultation?
• How is breast reduction performed?
• How will I learn about the safety of breast reduction?
• What can I do to prepare for my surgery?
• How will I be cared for on the day of surgery?
• How will I look and feel right after surgery?
• What should I know about my results?
• How long will I continue to see my plastic surgeon?
• Choosing a plastic surgeon
• It's advisable to consider the following points before scheduling a consultation
• Ask about the surgeon's hospital privileges

Introduction

If you are a woman with overly large breasts, breast reduction surgery can be a tremendously life-enhancing option. Having the procedure will give you far more than just smaller, firmer breasts. You'll also get significant relief from many physical and emotional discomforts, a new sense of freedom in your exercise and physical activity, and the ability to wear a greater variety of clothing styles. In fact, of all the procedures that plastic surgeons perform, breast reduction ranks among the highest in patient satisfaction.

Breast reduction, also called reduction mammoplasty, is a procedure that removes excess breast tissue and skin, making your breasts more proportional to the rest of your body. The areola (the pigmented skin surrounding the nipple) may be reduced and repositioned as well.

You'll find basic information about breast reduction surgery in this brochure. However, the best way to get complete answers to specific questions that relate to your individual needs is to have a personal consultation with a plastic surgeon certified by the American Board of Plastic Surgery.

Is breast reduction right for me?

Breast reduction can be performed at any age, but plastic surgeons usually recommend waiting until breast development has stopped. Childbirth and breast-feeding may affect the size and shape of your breasts. If you plan to breast-feed in the future, you should discuss this with your surgeon.

You may be a good candidate for breast reduction if you have any of the following conditions:

• Back, neck or shoulder pain caused by the weight of your breasts
• Heavy, sagging breasts with very low nipples and areolas
• Breast that are too large in proportion to your body frame
• Skin irritation beneath the breasts
• Indentations in your shoulders caused by tight bra straps
• Restriction of physical activity due to the size and weight of your breasts
• Feelings of self-consciousness about the large size of your breasts
• One breast that is much larger than the other

What should I expect from the consultation?

A personal consultation is the first step for every patient considering breast reduction. During this meeting, your surgeon will assess your physical and emotional health and discuss your specific goals for the surgical procedure.

You should arrive at the consultation prepared to provide complete information about:

• Previous surgical procedures
• Past and present medical conditions
• Medications you are taking, including herbal remedies or nutritional supplements
• Past experience with weight loss and the effect it had on your breast size

When examining your breasts, your plastic surgeon will consider their size and shape, the quality of your skin and the position of the nipples. Measurements and photographs may be taken for your medical record.

Some insurance companies will pay for breast reduction to relieve medical symptoms; however, coverage may depend on a significant amount of breast tissue being removed. A letter of predetermination may be required by your insurance company prior to surgery. Your surgeon's office staff will help you with insurance matters related to the procedure. If you are seeking a purely cosmetic change in your breast size, you will pay for the procedure yourself.

How is breast reduction performed?

The specific method chosen for your breast reduction will be determined by your anatomy, your surgeon's preferences and your desired results.

The most common method uses a three-part incision. One part of the incision is made around the areola (nipple area). Another runs vertically from the bottom edge of the areola to the crease underneath the breast. The third part is a horizontal incision beneath the breast, which follows the natural curve of the breast crease.

After the surgeon has removed the excess breast tissue, fat and skin, the nipple and areola are shifted to a higher position. The areola, which is usually larger than ideal, is reduced in size. Skin that was formerly located above the nipple is brought down and together to reshape the breast. Liposuction may be used to improve the contour, especially on the sides of the breast.

The nipples and areolas usually remain attached to their underlying tissue as they are moved to their higher position—much like a button being moved to a higher buttonhole—and this may allow for the preservation of sensation. This method may also preserve the ability to breast-feed, although it is not guaranteed.

The type of incision used for your breast reduction may vary, depending on the size and shape of your breasts and the desired amount of reduction. Women who seek a smaller reduction in size may be able to avoid the horizontal incision that runs underneath the breast. Other incisional techniques may be used in some instances. Women whose breasts contain a significant amount of fatty tissue may find that liposuction alone can be used to reduce breast size with only minimal scars.

How will I learn about the safety of breast reduction?

Each year, thousands of women undergo breast reduction and experience no major complications. However, it is important for you to be informed of the risks as well as the benefits. One of the most important parts of your consultation is the discussion that you and your surgeon will have about the possible complications of breast reduction surgery. In addition to listening carefully to what our surgeon tells you, be sure to raise any questions or concerns that you may have about the safety of the procedure.

Remember, by carefully following your surgeon's advice and instructions—both before and after surgery—you can do your part to minimize some of the risks.

What can I do to prepare for my surgery?

When the date for your surgery has been set, your plastic surgeon will provide you with specific instructions for the days immediately before and after your surgery. A number of points will be covered, including:

• Avoiding medications that may complicate surgery or recovery
• Stopping smoking for a period of time before and after surgery
• Arranging for help or special care following surgery
• Having a baseline mammogram before surgery (if you have a family history of breast cancer)

How will I be cared for on the day of my surgery?

Breast reduction surgery may be performed in a hospital, and outpatient surgery center or an office-based surgical suite. If you are admitted to the hospital, your stay will be a short one.

Medications are administered to keep you comfortable during the procedure. Usually a general anesthetic is used so that you'll sleep throughout the entire surgical procedure.

How will I look and feel right after surgery?

When surgery is complete, you'll be taken to a recovery area. In some cases, small drainage tubes will have been placed beneath the breast skin to help prevent fluids from accumulating. Gauze dressings will be placed on your breasts and covered with an elastic bandage or surgical bra.

On the day of surgery, you'll be encouraged to get out of bed for short periods of time. Most of the discomfort you feel in the days following the procedure can be controlled with medications prescribed by your plastic surgeon.

Although everyone heals at a different rate, you can expect that your recovery will follow this general time line:

Within the first week:

• You will begin to move about more comfortably and perhaps even return to (non-strenuous) work
• Surgical drains will be removed and dressings will be changed

After several weeks:

• Bruising, swelling and normal periodic discomfort will diminish
• Sensation within the nipple and areola area will gradually improve
• You may return to most of your normal activities, including mild exercise

After a few months:

• Your breast will start settling into a more natural shape
• Incision lines will begin to fade
• If you haven't felt it sooner, you will notice relief from neck, back and shoulder pain

What should I know about my results?

Without the excessive weight of large breasts, you may find that you enjoy life more. Your body will look better proportioned, clothes will fit you better, and you'll have greater freedom to enjoy physical activities.

Although the incision lines will be permanently visible, they will fade over time and are easily concealed by clothing—even most swimsuits and tops with low-cut necklines.

Breast reduction typically makes a dramatic change in your body image, and it may take some time to adjust to your new appearance. However, most women soon become comfortable with their smaller, more proportional breasts and feel very pleased with the results of surgery.

You can expect to maintain your new breast size, unless you gain or lose a significant amount of weight or become pregnant. If, over time, the effects of gravity and aging cause your breasts to lose their shape or firmness, you may choose to undergo a cosmetic breast lift to help restore a more youthful contour.

How long will I continue to see my plastic surgeon?

After the initial healing period, you will return to your plastic surgeon's office for a postoperative follow-up visit so that your healing and progress can be evaluated. In the following months, your surgeon may ask you to return for periodic checkups. It's important to keep these appointments so that your surgeon can assess your long-term results and address any questions or concerns you may have.

Choosing a plastic surgeon

No matter what type of plastic surgery you're considering, one of the most important factors in its success is the surgeon you choose. Although it may seem hard to believe, some of the physicians who are performing cosmetic surgery today have had no formal surgical training at all.

It's advisable to consider the following points before scheduling a consultation:

Find out if your doctor is certified by the American Board of Plastic Surgery. Surgeons with this certification have completed a minimum of five years of surgical training following medical school, including a plastic surgery residency program. During this intensive program, surgeons learn to perform surgical procedures for the entire body and face. At the same time, they develop their technical skill and aesthetic judgment. After training, a surgeon must pass comprehensive oral and written exams before being granted certification.

The two organizations that have prepared this brochure, the American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery, require their members to be certified by the American Board of Plastic Surgery. Plastic surgeons with this certification have completed approved training and examinations in plastic surgery including both cosmetic and reconstructive procedures.

Ask about the surgeon's hospital privileges

Even if you are planning to have your surgery in your doctor's office or at a surgery center, it is important to find out if your surgeon has operating privileges in an accredited hospital for the same procedure that you would like to have performed. Before granting privileges, hospital review committees evaluate a surgeon's training and competency for specific procedures.

To find out more, click on Making Sense of Certification.

• Link to Breast Reduction Before and After Photos
• Contact us for additional information or to schedule a consultation

       

STEVEN J WHITE, MD
PRESBYTERIAN HOSPITAL OF DALLAS
PROFESSIONAL BUILDING 3, SUITE 814
8230 WALNUT HILL, DALLAS, TEXAS 75231

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