The goal of breast reduction surgery is to reduce the size of your breasts and reshape them so that they are proportionate to the rest of your body and are no longer a source of physical discomfort. This commonly requested, predictable procedure has the dual benefits of improving your appearance while relieving the physical and emotional burden of overly large breasts.
When to Consider Breast Reduction
- If your breasts are too large for your body frame and create neck, back, or shoulder pain
- If you have heavy breasts with nipples and areolas (pigmented skin surrounding the nipples) that point downward
- If one breast is much larger than the other
- If you are unhappy and self-conscious about the large appearance of your breasts
- Your breasts will be in better proportion with your body and will feel firmer.
- Surgery will alleviate neck, back, and shoulder pain and make it easier to breathe and exercise.
- Your clothes will fit better and you will feel more confident about your appearance.
- You may have decreased sensation in some areas, including the nipples and areolas.
- Some women complain that their breasts and nipples look slightly uneven.
- Breast-feeding may be a problem.
These are the top three pros and cons to weigh when considering breast reduction. If you want to focus on those specifically unique to you, please feel free to discuss with your aesthetic plastic surgeon.
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Am I a good candidate for breast reduction?
Women who seek breast reduction often have had children, are overweight, have a predisposition for large, disproportionate breasts, or are sensitive to estrogen. Big breasts often run in a family, inherited from mothers and grandmothers.
Following are some common reasons why you may want to consider breast reduction:
- You have backaches, neck aches, or skin irritation under your breasts.
- You have difficulty breathing and notice grooves in your shoulders from your bra straps.
- You have poor posture or numbness in parts of your breasts and upper chest from excessive breast weight.
- You find it nearly impossible to buy dresses and blouses and difficult to find tops that fit.
- You are very unhappy with your appearance because of your breast size.
- You are in good health with no active diseases or pre-existing medical conditions.
- You have realistic expectations of the outcome of your surgery. You must be able to discuss what you want with your plastic surgeon so that you can reach an understanding of what can realistically be achieved.
- Your skin has adequate elasticity, so it can resume its former tightness following surgery.
- You are mentally and emotionally stable. Breast reduction requires patience and stability to deal with the healing period.
- You are old enough that your breast development has stopped.
- You have finished having children and breastfeeding, because this can have significant and unpredictable effects on the size and shape of your breasts. Nevertheless, many women decide to undergo breast reduction before having children and feel that they can address any subsequent changes later. If you plan to breast-feed in the future, you should discuss this with your plastic surgeon
A history of irregular mammograms, undiagnosed lumps or other types of masses, severe obesity, diabetes, wound healing disorders, current breast-feeding, smoking, clotting disorders or a family history of them, and heart or circulatory disorders are all contraindications for breast reduction.
If you are in good general health and have a positive attitude and realistic expectations, you are most likely a good candidate for this procedure.
What are my options?
The size and shape of your breasts and how much reduction you desire are factors that will help your plastic surgeon determine the best technique for you. In some cases it will be possible to avoid the vertical incision that runs from the bottom edge of the areolas to the breast crease or the horizontal incision underneath the breast (typical components of the anchor incision).
Rarely, if your breasts are extremely large, the nipples and areolas may have to be completely detached before they are shifted to a higher level. In such a case, you will have made the decision to sacrifice sensation and the possibility of breast-feeding to achieve your desired breast size. Another breast reduction option, which is appropriate only in a select group of women, is liposuction alone.
Liposuction for breast reduction
Breast liposuction may be right for you if you have fatty breasts, need a minor-to-moderate reduction, and do not need to correct sagging. Here are some considerations:
- Results may be acceptable for women who need significant reduction but do not want the scars and loss of sensation and are willing to accept some sagging.
- With the onset of menopause, breast tissue is gradually replaced by fat, so postmenopausal women are among the best candidates for liposuction-only breast reduction.
- Patients with fibrous tissue and minimal fat in their breasts are not good candidates.
- Ptosis (sagging), poor skin condition with little tissue elasticity, and low nipple position are also contraindications.
- Liposuction alone may be used to treat asymmetry up to one cup size.
- Following liposuction of the breast, the elastic qualities of the skin cause it to contract, and subsequent uplifting of the breast contour should occur to some extent.
Your initial consultation appointment
During your initial consultation, you will have the opportunity to discuss your cosmetic goals. Your surgeon will evaluate you as a candidate for breast reduction and clarify what a breast reduction surgery can do for you. Once your surgeon understands your goals, he or she may suggest additional or related procedures such as breast lift, liposuction, or an upper body lift. Your plastic surgeon will examine, measure, and photograph your breasts for your medical record.
Your surgeon will consider:
- The current size and shape of your breasts
- The breast size and shape that you desire
- The quality and quantity of your breast tissue
- The quality of your skin
- The placement of your nipples and areolas
You should come to the consultation prepared to discuss your complete medical history. This will include information about:
- Past and present medical conditions
- Drug allergies and current medications
- Medical treatments you have received
- Previous surgeries, including breast biopsies
- Family history of breast cancer
- Current mammogram results
If you are planning to lose a significant amount of weight, be sure to tell your plastic surgeon. The surgeon may recommend that you stabilize your weight before undergoing surgery. If you think that you may want to become pregnant in the future, discuss this with your surgeon. Pregnancy can alter breast size in an unpredictable way and could affect the long-term results of your breast reduction.
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