Breast Reduction

Definition

Breast reduction is a surgical procedure performed in order to decrease the size of the breasts.

Purpose

Women with very large breasts (macromastia or mammary hyperplasia) seek breast reduction for relief of pain in the back, shoulder, and neck. They may also feel uncomfortable about their breast size and have difficulty finding clothing that will fit properly. Additionally, breast reduction may be needed after reconstructive surgery following the surgical removal of cancerous breast tissue (mastectomy), to make the breasts more symmetric.

Men who have enlarged breasts (gynecomastia) may also be candidates for breast reduction. However, excessive alcohol intake, smoking marijuana, or using anabolic steroids may cause gynecomastia, and surgery is not recommended for men who continue to use these products.

Precautions

Breast reduction is not recommended for women whose breasts are not fully developed or who plan to breast feed.

Description

Breast reduction may also be called reduction mammaplasty. It is most often done in the hospital, under general anesthetic. However, studies have suggested that an outpatient procedure, using local anesthetic and mild sedation may be appropriate for some patients. The operation takes approximately two to four hours. The most commonly made incision encircles the areola (darkened area around the nipple) and extends downward and around the underside of the breast. This produces the least conspicuous scar. The excess tissue, fat, and skin are removed, and the nipple and areola are repositioned. In certain cases, liposuction (fat suctioning) is used to remove extra fat from the armpit area. A hospital stay of up to three days may be needed for recovery.

If deemed medically necessary, breast reduction is covered by some insurance plans. However, a specified amount of breast tissue may need to be removed in order to qualify for coverage. Surgeon's fees range from $4,800-$6,500 and up.

Preparation

Consultation between surgeon and patient is important to ensure that the woman understands and agrees with the expected final results of the procedure. Measurements and photographs may be taken. Many doctors also recommend a mammogram before the operation, to make sure there is no cancer.

Aftercare

After the surgery, an elastic bandage or special supportive bra is placed over gauze bandages and drainage tubes. The bandages and tubes are removed in a day or two. The bra will need to be worn around the clock for several weeks. Stitches are removed one to three weeks after the operation. Normal activities, including sexual relations may be restricted for several weeks. Scars will typically remain red, and perhaps lumpy for up to several months, but will gradually fade and become less noticeable. It may take up to a year before the breasts achieve their final position and size.

Risks

Risks common to any operation include bleeding, infection, anesthesia reactions, or unexpected scarring. Breast reduction may result in decreased feeling in the breasts or nipples and/or impaired ability to breastfeed. When healing is complete, the breasts may be slightly uneven, or the nipples may be asymmetric.

Normal results

Smaller breast size should be achieved, and with that, the accompanying pain and discomfort should be alleviated.

BOOKS

Love, Susan M., with Karen Lindsey. Dr. Susan Love's Breast Book. Reading, MA: Addison-Wesley, 1995.

ORGANIZATIONS

American Society of Plastic and Reconstructive Surgeons. 44 E. Algonquin Rd., Arlington Heights, IL 60005. (847) 228-9900. <http://www.plasticsurgery.org>.

Ellen S. Weber, MSN

KEY TERMS

Gynecomastia—Overly developed or enlarged breasts in a male.

Macromastia—Excessive size of the breasts.

Mammary hyperplasia—Increased size of the breast.