Large breasts can cause pain, improper posture, rashes, breathing problems, skeletal deformities, and low self-esteem. Breast reduction surgery is usually done to provide relief from these symptoms. Performed under general anesthesia, the two- to four-hour procedure removes fat and glandular tissue and tightens skin to produce smaller, lighter breasts that are in a healthier proportion to the rest of the body.
Breast reduction surgery is not recommended for women who intend to breast-feed, since many of the milk ducts leading to the nipples are removed.
During the procedure an anchor-shaped incision is made from the new location of the nipple down to and around the crease beneath the breast. Dr. Bonillas removes excess glandular tissue, fat, and skin, relocates the nipple and areola, and reshapes the breast using skin from around the areola before closing the incisions with stitches. Liposuction may be needed to remove excess fat from the armpit area, and in some cases when only fat needs to be removed from the breasts, liposuction alone is used for breast reduction.
For a few days after surgery the breasts are bound with an elastic bandage or a surgical bra and you may be given surgical drainage tubes for fluid removal. Stitches come out in a week and the surgical bra must be worn for about a month.
A little pain is normal after surgery, whether it's mild discomfort, swelling during menstruation, a measure of numbness or sensitivity, or random, shooting pains that may last for a few months. Swelling, bruising, crusting and slight changes in breast size are also common. Most patients return to work in about two weeks, although you should avoid heavy lifting for three to four and only gentle contact with the breasts should occur for six weeks.
Scars fade with time but will not disappear, although they can be hidden with a bra, bathing suit or low-cut top.
Risks are rare and usually minor but may include bleeding, infection, reaction to the anesthesia, small sores around the nipples, slightly mismatched breasts or unevenly positioned nipples, and permanent loss of feeling in the nipple or breast.
Women with large, disproportionate breasts who experience pain, discomfort, and embarrassment due to their breast size may be good candidates for breast reduction surgery. Ideal candidates for a breast reduction are women who are not pregnant or breastfeeding. Although the procedure is generally recommended for mature women with fully developed breasts, breast reduction surgery can be performed on younger women if their breasts are causing serious pain and physical discomfort.
After breast reduction surgery, it is often possible to return to work within just a couple of weeks, depending on your job. Many patients can resume most of their normal activities, including some form of mild exercise, within a few weeks as well. You may continue to experience some mild, periodic discomfort during this time, but these feelings are normal.
Because sexual arousal could cause incisions to swell and create the possibility of delayed healing, sexual activity should be avoided for at least one week after breast reduction surgery.
Many patients are concerned that limited mobility after surgery may prevent them from showering for several days. Dr. Bonillas actually recommends that patients shower as soon as possible after surgery to help them feel refreshed and able to move up and about.
Breast reductions may be covered by medical insurance if the purpose of the breast reduction surgery is to alleviate physical discomfort and pain caused by oversized breasts. Many factors determine your eligibility, including the specific terms of your insurance policy and the amount of breast tissue to be removed.
After breast reduction surgery, breasts will remain smaller than they would be if the procedure had never been performed. Unless you gain or lose a significant amount of weight or become pregnant, your breast size should remain fairly constant. However, the effects of aging and gravity may cause breasts to sag over time. If, after a period of years, you become dissatisfied with the appearance of your breasts, you may choose to undergo a breast lift procedure to restore their more youthful contour.
The various techniques for breast reductions produce different types of possible scarring. Traditional breast reduction surgery will produce anchor-like scars that extend around the nipple, down the middle of the breast, and under the breast. Vertical incision breast reduction surgery creates shorter scars which also circle the nipple and extend vertically down the breast, but do not continue under the breast. Scar-less breast reduction surgery typically only leaves minor, inconspicuous scars that are usually under the breast crease.