Breast Reduction Newport Beach
Who is a candiate
Also known as reduction mammoplasty, this is an operation intended to reduce the size of a woman’s breasts and improve their shape and position. Frequently, the areola (dark skin around the nipple) is also made smaller. Functional symptoms (medical disorders) caused by excessive breast weight may be relieved or improved by this operation.
Women who have large, heavy breasts, which may be the cause of movement difficulties, back, shoulder and neck pain, poor posture, bra-strap indentations and chafing under the breasts will benefit from reduction.
Women with excessive breast size, which may decrease a sense of attractiveness and self-confidence, are candidates.
Large breasts that interfere with normal daily activities or with exercise will be more comfortable when reduced.
More attractive contour and smaller breast size.
Freedom from health problems associated with excessively large breasts.
The procedure is done under general anesthesia on an out-patient basis or in the hospital.
There are a variety of techniques for these operations. The most common method we use is the vertical technique. This is called a “lollipop reduction”. The incision goes around the areola and straight down the lower part of the breast. This gives the appearance of a lollipop. This method has half the scar of the standard anchor pattern (inverted “T”). This method also does a better job of narrowing the breast and providing forward projection. The breast therefore has a better shape and less scarring. With more massive breast size, and anchor pattern/inverted “T” procedure may be required; in extreme cases the areola and nipple is transplanted to a preferred position as a graft.
Recuperation and healing
The incisions are covered with light dressings, and the breasts may be placed in a bra. The bra holds the breasts symmetrically during initial healing.
Initial discomfort subsides daily and is controlled with oral medication.
Discomfort, swelling and discoloration of the breasts are expected for several weeks. Usually, our patients return to most normal activity within two weeks. The scars at the incision lines typically become reddish, raised and firm a few weeks after surgery, but during the first several months they become pale and soft. After 8-12 months, the scars are relatively inconspicuous. The nipples and some areas of the skin may be numb or sensitive after surgery. Sensation may return within a few weeks or months, but may be diminished or overly sensitive. Numbness of the areola and nipple may be permanent.
Surgery may reduce and or eliminate the ability to breast feed.
Gravity continues to have its effect, and there is a tendency for the skin of the breast to stretch over a long period of time. Women vary a great deal in this respect. In general, the smaller the breasts the less tendency for sagging to recur. If the breasts sag again, further excision of the skin on an outpatient basis can be used to correct the problem. If we try to lift heavy breasts without making them smaller at the same time, sagging will return soon. Realistic expectations are essential for a satisfying result.
An additional procedure that often enhances the result of Breast Reduction is Liposuction beneath the armpit area and the side of the chest to reduce excess fat deposits.
Large breasts (macromastia or breast hypertrophy) can occur in a variety of conditions (family trait, post pregnancy, excessive adolescent growth). Problems may include neck pain, back or shoulder pain, hygiene difficulty, and breast pain. Other problems include skin irritation, skeletal deformity, breathing problems, psychological/emotional problems, and interference with normal daily activities.
This procedure may be covered by insurance, although insurance criteria are becoming more and more restrictive.
Specific post operative instructions
POSITION: For at least the first week after surgery, try to sleep on your back, instead of your side. Two pillows to elevate and support both your head and your back will help to keep the swelling down. (It is more important for you to sleep than to rigidly adhere to this suggestion.)
DRESSINGS: At the time of surgery, gauze dressings will be applied around the chest. These can be removed 1-2 days after surgery and replaced with clean dressings, which will remain in place. If used, drains are removed 3-7 days after surgery. At that time you may be placed in a surgical bra, which you should wear day and night for 2-3 weeks after surgery. (You may, of course, remove it for laundering and showering.)
DRAIN CARE: If your surgeon places a drain, you will secure the collection bulb to your clothes or dressings with a safety pin. Every four hours, or whenever the bulb is half full, you should empty the bulb by opening the plug at the top and pouring out the contents, keeping track of how much fluid is removed from each drain every 24 hours. Do not attempt to remove the bulb from the tubing. Squeeze the bulb to recompress it, and put the plug back into the hole at the top in order to maintain the vacuum. The doctor or a nurse will remove the drains 4-5 days after surgery, when the fluid begins to turn a clear straw color and/or the amount of drainage has diminished.
SUTURES: Your sutures will dissolve; any suture remnants or knots will be trimmed 2-3 weeks after surgery.
EXPOSURE TO SUNLIGHT: Scars take at least 1 year to fade completely. During this time, it is important that you protect them from the sun. Even through a bathing suit, a good deal of sunlight can reach the skin and cause damage. It is imperative that you wear a sunscreen with a skin-protection factor (SPF) of at least 15 at all times when you are in the sunshine. Be extremely careful if areas of your breast skin have reduced sensitivity.
SHOWERING: Keep the bandages dry to 2 days. You may shower on the 3rd day and wash your breasts. Towel dry the tapes or use a hair dryer on a cool setting.
Specific as you heal information
HEALING OF SENSORY NERVES: Tingling, burning or shooting pains, which will disappear with time and should not alarm you, indicate regeneration of the sensory nerves. If these sensations cause pain, repeated, local self-massage helps.
ASSYMETRY: The two breasts commonly heal quite differently. One breast may swell more, feel more uncomfortable, or have a different initial shape. After complete healing, they will be more similar and natural. You must have patience, but if this causes concern, ask questions of the doctor or the nursing staff.
ACTIVITIES: Any type of strenuous activity can induce swelling and bleeding, especially during the first 10-14 days after surgery. Therefore, limit your exercise to walking during the first month. In general, guide your activities by your discomfort — that is, if an activity hurts, do not do it. If your job keeps you rather sedentary, you may feel well enough to return to work in 7-10 days. You will tire easily and you may want to limit your hours on your first few days back. If the swelling or discomfort increases, you have probably done too much too soon. One month after surgery, you may start easing yourself into your usual exercise routine with strenuous exercises permitted after 6 weeks. Remember; do not push yourself too quickly.