Introduction

If you've got disproportionately large breasts that are causing neck pain, back pain or other physical symptoms, you may want to consider a breast reduction.

According to the American Society of Plastic Surgeons, there are more than 90,000 breast redction procedures a year. The procedure carries tremendous psychological effects and most women who undergo breast reduction are very satisfied with the results.

It is also important to note that this surgery isn't just for women, either. Men who have conditions such as gynecomastia (where male breasts are enlarged abnormally) also may seek a breast reduction. According to the American Society of Plastic Surgeons, there are more than 20,000 breast reduction procedures in men.

Your consultation for breast reduction surgery

Before getting breast reduction surgery, you will go in for a pre-operative consultation, during which time your surgeon will take a detailed medical history, including whether or not you've ever had a lump removed from your breast or any other medical conditions affecting your breasts. He or she also will take a detailed family history. You should be in good physical and mental shape in order to undergo this surgery.

It's important that you are completely honest during this consultation. That includes being completely open with your medical history. It also means being very open as to why you're seeking a breast reduction . You should expect to discuss the emotional issues you've dealt with; that is, how have you felt dealing with your breast size? How has it made you feel, physically? What types of physical conditions have you experienced?

Your surgeon may take photos of your breasts and measure them. During this time, the surgeon also will discuss how much breast tissue should be removed to achieve the desired results. You also will learn about how to prepare for the surgery and how to plan for your recovery. Your surgeon may prepare you for this procedure by performing a mammography and breast exam.

Quick GuidePlastic Surgery: Before and After Photos of Cosmetic Surgeries

Plastic Surgery: Before and After Photos of Cosmetic Surgeries

How is breast reduction done?

Depending on your personal situation, the procedure can be performed in an outpatient facility or you may have to stay at least one night in the hospital. In either case, you will be given general anesthesia, which means you will sleep through for the procedure. It's important to have someone with you who can drive you home and stay with you at least the first night if you're not staying in the hospital.

The surgery itself will take about three to five hours. Your surgeon will make an incision around your nipple, then downward on the breast, in a keyhole form. The excess skin, tissue and fat are removed and your nipple is relocated for cosmetic purposes. Your surgeon may use drainage tubes and the incision site is then sutured. Your breasts will be wrapped in special gauze. If required, you may also wear a surgical bra.

How to prepare for the breast reduction

You need to be in good physical shape to ensure proper healing, so follow your surgeon's instructions on vitamins you can take before and after the surgery. Likewise, it's very important to eat well-balanced meals. This is no time for a diet!

During your preoperative consultation, your surgeon will ask about your habits, including whether you smoke or what medications you take. You may have to quit smoking for a period before and after surgery to ensure proper healing. You may also be asked to lose weight because being overweight can increase your risk for complications after breast reduction.

Likewise, you also may have to cease taking certain medications, such as aspirin or certain anti-inflammatory drugs such as Motrin or Aleve. Your surgeon will instruct you on this.

Before you undergo surgery, you'll need to get your home ready for your recovery. This should include:

  • Plenty of ice
  • Gauze and clean washcloths and towels
  • Loose, comfortable t-shirts and blouses
  • Soft bras. Your surgeon can recommend where to buy these
  • Special ointments or creams as recommended by your surgeon for incision site
  • Telephone within reaching distance of your primary rest area
  • Magazines, movies, or other quiet forms of relaxation.

Recovery and follow-up care for breast reduction

You will need to take at least one week off from work or school. Some patients require two weeks, but each situation varies. Your surgeon will instruct you on follow up appointments to remove bandages and sutures.

If you are a physically active person, you will not be able to resume your activity for at least one month after surgery. It is very important that you realize the emotional impact of surgery. A lot of people experience depression, but this is normal! Make sure you communicate with your doctor about all your concerns.

Complications and side effects of breast reduction

You should expect to feel tired and you will have breast pain. This is normal!

Your surgeon will give you a prescription antibiotic ointment and oral painkiller to ease you through the first few days after surgery. You should avoid heavy lifting at all costs, as this can promote scarring.

It's important to note that a breast reduction will cause scars as a normal side effect. However, the scars can be made worse if you lift heavy objects prematurely. Though they are rare, some people may experience certain complications such as inadequate healing of the nipple area, which may require a skin graft.

When should I call my doctor after breast reduction surgery?

  • At the first sign of infection, including fever
  • If you have any unusual discharge from the incision site (including pus)
  • If any of the sutures come out before you are due to have them removed

Does insurance cover breast reduction?

The good news is yes, in most cases. Breast reduction is considered reconstructive, your chances of getting insurance coverage are good. however, you must be sure to follow all the procedures set forth by your carrier's policy.

Your surgeon can take photos of your breasts, detailing your physical symptoms caused by enlarged breasts in a letter. Begin communicating early with your insurance carrier and make sure you understand exactly what the carrier will cover, such as lab costs, anesthesiologist, and other expenses. This will save you a headache in the long run, when you have more important things to do, like focus on your recovery.

Reviewed by the doctors at The Cleveland Clinic, Department of Plastic Surgery.
Edited by Charlotte E. Grayson , MD, Sept. 2003.

Portions of this page © The Cleveland Clinic 2000-2003.

REFERENCE:

"Management of gynecomastia"
uptodate.com

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Reviewed on 1/31/2005
References
REFERENCE:

"Management of gynecomastia"
uptodate.com

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