Breast Reduction

Although breast reduction is often performed to address medical issues, patients who do not have the symptoms of macromastia but are unhappy with the size of their breasts can still pursue breast reduction as an aesthetic procedure. Patients choosing to undergo breast reduction surgery for cosmetic reasons may cite any number of factors, including social stigmas and wardrobe concerns.

Overly large breasts can cause health and emotional problems. In addition to self-image issues, you may also experience physical pain and discomfort. The weight of excess breast tissue can impair your ability to lead an active life. The emotional discomfort and self-consciousness often associated with having large pendulous breasts can be as important an issue as the physical discomfort and pain.

You may be a candidate for breast reduction surgery if:

• You are physically healthy
• You have realistic expectations
• You don’t smoke
• You are bothered by feeling that your breasts are too large
• You have breasts that limit your physical activity
• You experience back, neck and shoulder pain caused by the weight of your breasts
• You have shoulder indentations from bra straps
• You have skin irritation beneath the breast crease

One of Dr. Ho’s goals for your breast surgery is to make your incisions as unnoticeable as possible. However, breast reduction surgery cannot be done without creating scars on the breast. There are several techniques that can be used to perform a breast reduction, and this depends on your starting baseline breasts and the extent of the reduction. The most common breast reduction techniques are:

• Vertical  – around the areola with a vertical limb that extends from the 6 o’clock position of the areola to the breast crease, and commonly referred to as a “lollipop” scar. The ideal candidate has a smaller baseline breast size, good skin quality, and requests a modest reduction.
• Wise pattern mastopexy (anchor or inverted-T pattern) which has a scar around the areola, a vertical scar from the 6 o’clock position down to the crease, and along the breast crease.  This technique is ideal for patients with large pendulous breasts, with all skin quality types, requesting a modest to extreme breast reduction.

While the goals of breast reduction are to decrease the size of the breasts to alleviate symptoms associated with large breasts, it is still important to lift and achieve a beautiful shape to the breasts. For some patients, there may be some excess fat or breast tissue that cannot be removed with a breast reduction alone. These areas include the “tank top bulge”, “bra bulge” or “back fat” which can be contoured with liposuction. Liposuction is a powerful tool which will allow for the lateral breast tissue and fat to be contoured, which cannot otherwise be resected unless a lateral scar was extended. Some patients also wish to undergo abdominal contouring, such as abdominal liposuction or abdominoplasty, which can also be done during the same breast reduction surgery, in appropriate candidates.

In the preoperative area, surgical markings are drawn on the breasts to plan the operation.

Breast Reduction Surgery is generally performed at an outpatient surgical facility. Immediately after surgery, you will be taken into a recovery area for close monitoring and will be permitted to go home the same day with a responsible adult when you are stable for discharge, typically after an hour. It is important that you have someone that will stay with you for the first 24 hours. All patients wear a Surgical Couture bra by LaBratory,  to support their breasts during the healing period. Surgical drains will be placed during surgery and will be removed in Dr. Ho’s office after 1 week.  Swelling and bruising in the area of the surgery will be present and generally begins to improve about 1 week after surgery. In general, most women recover well over the first week, and we provide you with all the medication and supplies to help you through this process. When thinking about time off work, or away from social commitments, 2 weeks can be a safer window of down time. Heavy lifting and strenuous exercise should be avoided for 4 weeks. Dr. Ho will see you in the office over the recovery period to review all of the important information with you and ensure you are doing well. The final results can appear gradually over the first few months as the breast tissue settle into the correct position and the swelling subsides. The incisions continue to fade over the first year, and all of the important things you can do to help optimize your results are reviewed during your follow-up visits.

Some of the potential risks associated with breast reduction surgery include hematoma (blood collection), seroma (fluid collection), infection, poor scarring, delayed wound healing, nipple areolar complex loss or numbness, asymmetry, the need for further surgery and medical complications associated with a general anesthetic.