Breast Reduction Surgery
Most patients can perform routine daily activities on their own after a week and resume light activities two weeks after surgery. Complete recovery after breast reduction usually takes around 8-12 weeks.

Following breast reduction, most patients are usually discharged 24-48 hours later. The doctor provides medication and several supportive measures. Most patients can perform routine daily activities on their own after a week and resume light activities two weeks after surgery. Complete recovery after breast reduction usually takes around 8-12 weeks.

What is a breast reduction?

Breast reduction is also called reduction mammoplasty. It is performed by a plastic surgeon to reduce the size of large breasts. People who undergo reduction mammoplasty tend to be the most satisfied patients treated by plastic surgeons. It can be performed at any age following puberty. Patients, including older ones, tend to experience immediate relief from their neck, shoulder, and back pain. Scars that result from this procedure usually heal very well. Occasionally, some redundancy may be present that may require liposuction additionally.

Why is breast reduction done?

This procedure may prove useful for women with

  • Large breasts, disproportionate to the body frame.
  • Large, heavy breasts causing significant neck, back, and shoulder pain.
  • Grooves in the shoulders from the weight of bra straps.
  • Difficulty wearing and fitting in clothes.
  • Breasts that interfere with sports and exercise.
  • Skin irritation beneath their breasts.
  • Asymmetrical breasts.
  • Self-consciousness or aesthetic concerns.

Who should not undergo breast reduction?

Some people are medically unable to undergo the surgery when other systemic diseases are present. Smokers should quit smoking prior to the procedure because it increases the risk of complications.

Breast reduction and age:

  • Patients may seek reduction mammoplasty starting at puberty. If reduction mammoplasty is performed at an early age, such as 14 years, patients may require an additional procedure.
  • If breasts are significantly large, surgery can be performed in the teenage years.
  • Patients should undergo a preoperative mammogram if they are older than 35 years.

How is breast reduction performed?

In breast reduction, the most important goal is re-establishing a functional breast with normal sensitivity and saving the nipple-areola complex (NAC), with the ability to breastfeed, which is proportionate in size to the woman's body. 

There are several techniques to perform a breast reduction. One of the preferred techniques is the inferior pedicle technique. “Pedicle method” means the surgeon leaves an attached tissue graft (pedicle) with the nerves and blood vessels that supply the breast.

A pedicle can be superior, lateral, medial, inferior, or central. With the inferior pedicle technique, the blood supply to the nipple and areola remains generous. As a result, the inferior pedicle has proven sufficient to sustain NAC with good circulation, good sensation, and breastfeeding ability. In patients with extremely large breasts, the surgeon may consider a free nipple graft to avoid the loss of NAC. 

During the procedure:

  • The surgery is performed under general anesthesia.
  • Breast reduction reduces the skin envelope and volume of the breast tissue, and the nipple is repositioned.
  • The breasts are not reduced to a standard size but to one that is compatible with the patient's body.
  • The breast tissue is carefully preserved, marked, and protected so that each specimen from each breast can be evaluated by a pathologist to detect malignancy of the breasts.
  • The incision is closed in layers, which heals with minimal scarring in most people.
  • Some surgeons opt for surgical drain placement to drain excess blood or fluid accumulation.

QUESTION

A lump in the breast is almost always cancer. See Answer

How long does it take to recover from breast reduction?

The recovery process following breast reduction is as follows:

  • Painkillers and antibiotics may be administered after surgery.
  • Patients may be advised to wear a surgical bra to provide support and help to heal.
  • They should rest upright with their back elevated.
  • They can be discharged 24-48 hours after surgery.
  • Swelling and bruising resolve in one or two weeks.
  • Assistance with routine activities such as bathing and dressing may be required in the first week.
  • The surgeon may advise certain exercises and self-massage techniques for the first two to three weeks.
  • Light activities can be resumed after two weeks.
  • Avoid rigorous exercises, sports, and lifting heavy objects for the first 8-12 weeks.
  • After four to six weeks, patients can switch from surgical bras to bras of their choice.
  • Patients can resume work depending on the nature and requirement of the job, their own comfort level, and the surgeon’s approval.
  • The scars generally heal well and are barely visible with time.
  • Regular follow-up with the surgeon is required to monitor healing.

What are the complications of breast reduction?

Some possible complications following breast reduction include:

  • Hematoma (blood clot) formation 
  • Bleeding
  • Infection
  • Possible asymmetry
  • Loss of sensation around the incision
  • Problems with breastfeeding
  • Keloid formation (scarring)
  • Lack of fullness and poor projection
  • Poor reaction to anesthesia

The most devastating potential complication is the total loss of the nipple-areolar complex (NAC). This is extremely rare.

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Medically Reviewed on 10/9/2020
References
References:

https://emedicine.medscape.com/article/1274506-overview

https://www.plasticsurgery.org/reconstructive-procedures/breast-reduction

https://medlineplus.gov/ency/presentations/100189_1.htm
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