Breast Reduction

Breast ReductionBreast Reduction in Beverly Hills – Mammaplasty

Breast reduction, technically known as reduction mammoplasty, is a surgery for women with exceptionally large, pendulous breasts. These women may experience a variety of medical problems due to the size and excessive weight of the breasts—from back and neck pain and skin irritation to skeletal deformities and breathing problems. Bra straps may leave indentations in their shoulders. And unusually large breasts can make a woman—or a teenage girl—feel extremely self-conscious.

The procedure removes fat, glandular tissue, and skin from the breasts, making them smaller, lighter, and firmer. It can also reduce the size of the areola, the darker skin surrounding the nipple. The goal is to give the woman smaller, better-shaped breasts in proportion with the rest of her body.

If you’re considering breast reduction, this page will give you a basic understanding of the procedure—when it can help, what this surgery entails, and what results you can expect. It can’t answer all your questions, since a lot depends on your individual circumstances. Please be sure to ask your doctor if there is anything about the procedure you don’t understand.

Good candidates for Breast Reduction

Breast reduction usually aims to provide physical relief, versus a dramatic cosmetic improvement. Most women who have the surgery are troubled by disproportionally large, sagging breasts that restrict their activities and cause them physical discomfort.

In most cases, Dr. Kim doesn’t perform breast reduction until a woman’s breasts have fully developed; however, it can take place earlier—as teen breast reduction—if large breasts are causing serious physical discomfort.

The best candidates are those who are mature enough to fully understand the procedure and have realistic expectations about the results. We don’t recommend breast reduction for women who intend to breastfeed.

Consultation

In your initial consultation, it’s esential to discuss your expectations frankly with Dr. Kim, and to listen to his opinion. Every patient—and every physician, as well—has a different view of what is a desirable size and shape for breasts.

Dr. Kim will examine and measure your breasts, and will probably photograph them for reference during and after surgery. (The photographs may also be a requirement in the processing of your insurance coverage.) Dr. Kim will discuss the variables that may affect the procedure—such as your age, the size and shape of your breasts, and the condition of your skin. You should also discuss where the nipple and areola will be after your surgery; Dr. Kim will move them higher during the procedure, making them approximately even with the crease beneath your breasts.

Dr. Kim will describe the procedure in detail, explaining its risks and limitations and making sure you understand the scarring that will result. He will also explain the anesthesia he’ll use, the facility where he’ll perform the surgery, and the costs. (Some insurance companies will pay for breast reduction if it’s medically necessary; however, they may require the removal of a specific amount of breast tissue. Check your policy, and have your surgeon write a “predetermination letter” if required.)

Preparing for your surgery

Dr. Kim may require you to have a mammogram (breast X-ray) before surgery. You’ll also get specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications. Dr. Kim may suggest that you lose weight before the operation. While you’re making preparations, be sure to arrange for someone to drive you home after your surgery and to help you out for a few days if needed.

Surgery Location and Anesthesia

Dr. Kim may perform your breast reduction surgery in a hospital, an outpatient surgery center, or an office-based surgical suite. If you are in the hospital, your stay will be a short one. The surgery itself usually takes two to four hours, but may take longer in some cases. Breast reduction nearly always takes place while the patient is under general anesthesia. You’ll be asleep through the entire operation.

The Procedure

Techniques for breast reduction vary, but the most common procedure involves an anchor-shaped incision that circles the areola, extends downward, and follows the natural curve of the crease beneath the breast. Dr. Kim removes excess glandular tissue, fat, and skin, and moves the nipple and areola into their new position. He then brings the skin from both sides of the breast down and around the areola, shaping the new breast contour. Dr. Kim may use liposuction to remove excess fat from the armpit area.

In most cases, the nipples remain attached to their blood vessels and nerves. However, if the breasts are massive or pendulous, Dr. Kim may have to remove the nipples and areolas and graft them into a higher position. (Doing so will result in a loss of sensation in the nipple and areolar tissue.)

Stitches are usually around the areola, in a vertical line extending downward, and along the lower crease of the breast. Some techniques can eliminate the vertical part of the scar. And occasionally, when Dr. Kim determines he only needs to remove fat, liposuction alone can reduce breast size, leaving minimal scars.

After your surgery

After surgery, you’ll be wrapped in an elastic bandage or a surgical bra over gauze dressings. Dr. Kim may place a small tube in each breast to drain off blood and fluids for the first day or two, but in most cases, tubes are not necessary.

You may feel some pain for the first couple of days—especially when you move around or cough—and some discomfort for a week or more. Your surgeon will prescribe medication to lessen the pain.

You can remove the bandages a day or two after surgery, though you’ll continue wearing the surgical bra around the clock for several weeks, until the swelling and bruising subside. You’ll have your stitches removed in one to three weeks.

If your breast skin is very dry following surgery, you can apply a moisturizer several times a day, but be sure to keep the suture area dry.

Your first period following surgery may cause your breasts to swell and hurt. You may also experience random, shooting pains for a few months. You can expect some loss of feeling in your nipples and breast skin, caused by the swelling after surgery. This lack of sensation usually fades over the six weeks or so. In some patients, however, it may last a year or more, and occasionally, it may be permanent.

Getting back to normal

Although you may be up and about in a day or two, your breasts may still ache occasionally for a couple of weeks. You should avoid lifting or pushing anything heavy for three or four weeks.

Dr. Kim will give you detailed instructions for resuming your normal activities. Most women can return to work (if it’s not too strenuous) and social activities in about two weeks. But you’ll have much less stamina for several weeks, and should limit your exercises to stretching, bending, and swimming until your energy level returns. You’ll also need a good athletic bra for support.

Dr. Kim may instruct you to avoid sex for a week or more, since sexual arousal can cause your incisions to swell, and to avoid anything but gentle contact with your breasts for about six weeks.

A small amount of fluid draining from your surgical wound, or some crusting, is normal. If you have any unusual symptoms, such as bleeding or severe pain, don’t hesitate to call your doctor.

Your new look

Although much of the swelling and bruising will disappear in the first few weeks, it may be six months to a year before your breasts settle into their new shape. Even then, their shape may fluctuate in response to your hormonal shifts, weight changes, and pregnancy.

Dr. Kim will make every effort to make your scars as inconspicuous as possible. Still, it’s important to remember that breast reduction scars are extensive and permanent. They often remain lumpy and red for months, then gradually become less obvious, sometimes eventually fading to thin white lines. Fortunately, Dr. Kim can usually make the incisions so that you can wear even low-cut tops.

Of all plastic surgery procedures, breast reduction results in the quickest body-image changes. You’ll be rid of the physical discomfort of large breasts, your body will look better-proportioned, and clothes will fit you better.

However, as much as you may have desired these changes, you’ll need time to adjust to your new image—as will your family and friends. Be patient with yourself, and with them. Keep in mind why you had this surgery, and chances are that, like most women, you’ll be pleased with the results.

Frequently Asked Questions About Breast Reduction

How much smaller will my breasts be after breast reduction?

Dr. Kim will work with you to determine your ideal breast size, based on your goals for the procedure and his expert guidance on what is possible and advisable. His aim will be to resize your breasts to be more comfortable and in better proportion to your body. Breast reduction surgery can significantly reduce the size of your breasts, but Dr. Kim will not make changes that increase the risk of complications.

Will breast reduction also lift my breasts?

Yes. A breast reduction procedure includes the same changes that occur in a breast lift, raising and re-sculpting the contours of the breasts to give them a young, perky look. The procedure may include repositioning the nipples and reducing the size of the areolas.

Is it possible for my breasts to grow larger again?

Breast reduction will permanently reduce the size of your breasts, but future changes, including pregnancy, breastfeeding, or weight gain, can cause them to grow larger. They still won’t be as large as they would have been without the reduction.

Will breast reduction help with back and neck pain?

If you have back or neck pain as a result of the weight of large breasts, surgically making your breasts smaller should lessen or eliminate that pain. If back or neck pain is your main reason for considering breast reduction surgery, it’s best to consult with an orthopedist to find out if there may also be other causes for your discomfort.

How much does breast reduction surgery cost?

The cost of your surgery will vary with its extent. If the procedure surgery corrects medical problems, your insurance may cover the costs. Dr. Kim will explain the costs and the possibility of insurance coverage in his consultation with you.

Risks and safety

Breast reduction is not a simple operation, but it’s normally safe when performed by a qualified plastic surgeon. Nevertheless, as with any surgery, there is always a possibility of complications, including bleeding, infection, or reaction to the anesthesia. Some patients develop small sores around their nipples after surgery; antibiotic ointments can treat these. You can reduce your risks by closely following Dr. Kim’s advice both before and after surgery.

The procedure does leave noticeable, permanent scars, though your bra or bathing suit will cover them most of the time. (Poor healing and wider scars are more common in smokers.) The procedure can also leave you with slightly mismatched breasts or unevenly positioned nipples. Future breastfeeding may not be possible, since the surgery removes many of the milk ducts leading to the nipples.

Some patients may experience a permanent loss of feeling in their nipples or breasts. Rarely, the nipple and areola may lose their blood supply and the tissue will die. (However, a skilled breast surgeon can usually rebuild the nipples and areolas using skin grafts from elsewhere on the body.) Though rare, this will happen more commonly in smokers or diabetics.

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