Do you have disproportionately large breasts that are causing neck pain, back pain or other physical symptoms? You may want to consider a breast reduction. Most women who undergo breast reduction will notice both physical and psychological benefits from the surgery. 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.
Before getting breast reduction surgery, you will go in for a pre-operative consultation. During this time your surgeon will take a detailed medical history, including asking you what medications you are taking, what allergies you may have, your smoking history and any prior surgeries. Your surgeon will also need specific information regarding pregnancy and lactation, mammograms, personal or family history of any breast problems and any history of breast lumps or biopsies. 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 about your medical history. It also means being very open about why you're seeking a breast reduction. You should expect to discuss the emotional issues you've dealt with. That is, how you have 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 your breasts. During this time, he or she 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 also may prepare you for this procedure by performing a mammography and breast exam.
How is a 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 be put to sleep 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 to a more youthful position and the incisions are closed. Your surgeon may use drainage tubes. The incision site is then sutured, and a dressing applied; if required, you may also wear a surgical bra.
How do I prepare for a 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. Nicotine (smoking, nicotine patches and nicotine gum) interferes with healing and will need to be stopped for a period of time before surgery and after surgery to ensure proper healing. Likewise, you also may have to cease taking certain medications, such as aspirin or certain anti-inflammatories such as Motrin® or Aleve®. Your surgeon will instruct you on this.
Establishing a home recovery area
Before you go in for surgery, make sure you set up a recovery area at home that will suit all your needs. This should include:
- Pain medication prescribed by your surgeon and Tylenol®
- Gauze and clean washcloths and towels
- Loose, comfortable tee shirts and blouses
- Surgical bras provided by your surgeon
- Antibiotic ointments (only if recommended by your doctor)
- Telephone within reaching distance of your primary rest area
- Magazines, movies, etc.
Recovery and follow-up care
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 may not be able to resume your activity for at least one month after surgery. Surgery can be both physically and emotionally stressful. Make sure you communicate with your doctor about all your concerns.
What are the complications and side effects of a breast reduction?
You should expect to feel tired and you will have some breast pain. This is normal! Your surgeon will give you a prescription painkiller to ease you through the first few days after surgery. It's important to note that a breast reduction will cause scars along the incisions as a normal side effect. These scars are permanent; however, they will fade with time. Also, depending on the extent of your procedure, you may not be able to breastfeed.
You should avoid lifting heavy objects during the first few weeks to reduce tension on the incision and decrease your risk of bleeding problems. A loss or change in the feeling to the nipple may also result from breast reduction. In some cases, the change is permanent. Though they are rare, some people may experience certain complications, such as inadequate healing of the nipple area, which may require a skin graft.
Contact your doctor immediately if you experience
- Unusual discharge from the incision site, including pus, (this could be a sign of an infection)
- Release or detachment of any sutures before you are due to have them removed
- Enlargement on one or both breasts associated with pain and pressure
Does insurance cover breast reduction?
The good news is yes, in most cases. Because breast reduction is usually considered medically necessary, your chances of getting insurance coverage are good. But you must be sure to follow all the procedures set forth by your carrier's policy. Your surgeon will need to take photos of your breasts, and detail your physical symptoms caused by enlarged breasts in a letter. But begin communicating early with your carrier and make sure you understand exactly what the carrier will cover, such as lab costs, anesthesiologist, etc. This will save you a headache in the long run, when you have more important things to do, like focus on your recovery.
American Society of Plastic Surgeons.
Breast Reduction: Reduction Mammaplasty
Vasconez HC, Habash A. Chapter 41. Plastic & Reconstructive Surgery. In: Doherty GM. eds. CURRENT Diagnosis & Treatment: Surgery, 13e. New York, NY: McGraw-Hill; 2010.
Gonzalez MA, Glickman LT, Aladegbami B, Simpson RL. Quality of life after breast reduction surgery: a 10-year retrospective analysis using the Breast Q questionnaire: does breast size matter?. Ann Plast Surg. 2012;69(4):361-3.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 4/10/2014...#11025