If You’re Considering Breast Reduction…
Women with very large, pendulous breasts may experience a variety of medical problems caused by the excessive weight-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.
Breast reduction, technically known as reduction mammaplasty, is designed for such women. 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 will give you a basic understanding of the procedure- when it can help, how it’s performed, and what results you can expect. It can’t answer all of your questions, since a lot depends on your individual circumstances. Please be sure to ask Dr. Fugo if there is anything about the procedure you don’t understand.
The Best Candidates for Breast Reduction
Breast reduction is usually performed for physical relief rather than simply cosmetic improvement. Most women who have the surgery are troubled by very large, sagging breasts that restrict their activities and cause them physical discomfort.
In most cases, breast reduction isn’t performed until a woman’s breasts are fully developed; however, it can be done earlier if large breasts are causing serious physical discomfort. The best candidates are those who are non-smokers, mature enough to fully understand the procedure and have realistic expectations about the results.
All Surgery Carries Some Uncertainty and Risk
Breast reduction is not a simple operation, but it’s safe when performed by a qualified plastic surgeon like Dr. Fugo. Nevertheless, as with any surgery, there is always a possibility of complications, including bleeding, infection, or reaction to the anesthesia. You can reduce your risks by closely following Dr. Fugo’s advice both before and after surgery.
The procedure does leave scars, although they’ll be covered by your bra or bathing suit. (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 breast-feeding may not be possible, since the surgery removes many of the milk ducts leading to the nipples
Planning Your Surgery
In your initial consultation, it’s important to discuss your expectations frankly with Dr. Fugo 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. Fugo will examine and measure your breasts, and will probably photograph them for reference during surgery and afterwards. (The photographs may also be used in the processing of your insurance coverage.) He 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 positioned; they’ll be moved higher during the procedure, and should be approximately even with the crease beneath your breasts.
Dr. Fugo should describe the procedure in detail, explaining its risks and limitations and making sure you understand the scarring that will result. Dr. Fugo should also explain the anesthesia he will use, the facility where the surgery will be performed, and the costs. (Some insurance companies will pay for breast reduction if it’s medically necessary; however, they may require that a certain amount of breast tissue be removed. Check your policy, and have Dr. Fugo write a predetermination letter if required.)
Preparing For Your Surgery
Dr. Fugo 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.
Breast reduction doesn’t usually require a blood transfusion.
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.
Where Your Surgery Will Be Performed
Breast reduction surgery may be performed in an outpatient surgery center. The surgery itself usually takes two to three hours, but may take longer in some cases.
Type of Anesthesia
Breast reduction is nearly always performed under general anesthesia. You’ll be asleep through the entire operation.
Dr. Fugo uses Medial-Pedicle Vertical (Short Scar) Mammaplasty approach to breast reduction because of the reduced scarring and improved breast projection. The desirable, upper breast tissue is left in place, and the undesirable, lower breast tissue is removed. The vertical elliptical excision brings the lateral and medial breast tissue together, resulting in improved, more natural breast shape in the long term.
The inverted-T techniques used by many other surgeons usually rely on the skin brassiere to shape the breast, whereas the vertical techniques used by Dr. Fugo allows the breast tissue to shape the skin. Vertical breast reduction leaves tissue attached to the skin in the upper breast, while inferior breast tissue is moved or taken away all together. The skin is then allowed to conform to the new shape.
Sensation in the nipple-areola complex is an important consideration. The Vertical technique used by Dr. Fugo maintains nipple sensation as good as that associated with other techniques.
Breast Reduction surgery likely reduces breastfeeding potential. The Vertical technique used by Dr. Fugo results in approximately 60% of patients able to breastfeed, with 25% needing to supplement. This is irrespective of the native breast size.
After Your Surgery
After surgery, you’ll be wrapped in an elastic bandage or a surgical bra over gauze dressings. A small tube may be placed in each breast to drain off blood and fluids for the first day or two.
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.
The bandages will be removed 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. Your stitches will dissolve on their own.
Your first menstruation 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 usually fades over the first six to eight weeks. 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 immediately following surgery, 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. Fugo 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 4 days. 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.
You will be instructed to avoid sex for 2 weeks, since sexual arousal can cause your incisions to swell, and to avoid anything but gentle contact with your breasts for 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 Dr. Fugo.
Your New Look
Although much of the swelling and bruising will disappear in the first few weeks, it may be three months 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. Fugo will make every effort to make your scars as inconspicuous as possible. Still, it’s important to remember that breast reduction scars are permanent. They often remain red for months, then gradually become less obvious, sometimes eventually fading to thin white lines. Fortunately, the scars can usually be placed 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. Service areas include: Newburgh, New York, New Windsor, Cornwall, Middletown, Poughkeepsie, Monroe, Hudson Valley & Walden NY.