BREAST REDUCTION Posted in: Most Frequent Procedures

It is important that you read and re-read this page before you consider undergoing this surgery.

It is important that you know that your surgery is not purely aesthetic, but also functional; that is, you are going to free yourself from mechanical problems, in relation to size and shape, and also get rid of such functional problems as a carrying considerable weight in your chest, shoulder bra marks, pain or burning in the breasts and nipples and irritation of the folds beneath the breasts, among others. Therefore, major medical expenses insurance companies often cover this operation.

The surgery is extensive and is one of the most important within the Plastic Surgeon’s repertoire. This is considered major surgery due to the time required in its execution (of 3 to 3½ hours) and the skill required for both designing the pattern in the skin through which the surgeon will proceed to close. The execution and the finesse of this delicate operation, must end up with a pleasing result for both you and your surgeon.

The usual hospital stay is one night. The operation is done under general anesthesia. Minor bleeding occurs but it does not require a blood transfusion.  Drainage tubes, one from each breast,  will be in place to collect fluid  from within the surgical wounds. These drains are not painful, but you must be careful not to get them dirty or accidentally pull them out. The drainage devices will be removed within 4 to 5 days, and removal is not painful.

Contrary to popular belief, this surgery is vitually painless. If anything, you might feel mild discomfort or pressure from bandaging, which can be alleviated by analgesics. Often I ask patients to purchase a compression garment in advance of the surgery. You should bring this to the hospital and it will be fitted in place at the completion of the surgery. (please click http://www.mentorcorp.com/post-surgery-garments/cs_psg_products_breastchest.htm).

The dressing or garment will be in place for about 10 days, at which time the stitches will be removed. The removal of the stitches is painless and requires no pain medication. In some cases self-absorbing sutures are used.

Scars are usually as follows: A circular scar around the areola as a result of reducing its diameter to a normal size, a vertical one from the lower pole of the new areola down to the fold beneath the breast and one in the fold beneath the breast. In the beginning these marks are reddish and noticeable, then they change to pinkish and then to white at about 12 months after the procedure in fair skin people. Dark brown skinned patients heal in a darker hue.

Sometimes these scars can convert to keloid type (firm, bumpy, with or without pink color, burning or itching). If this happens, unfortunately no treatment can completely improve them, but there are some remedies that can help.  Circular massage on the keloid will diminish its size, and your surgeon will indicate when to use other treatment. Please click Keloids for more information.

The sensation of the nipple and areola in most cases is not affected. However, although rare, it may decrease in one or both nipples and they may even become completely desensitized. Sometimes a completely numb nipple can completely recover after one year.
Breasfeeding following breast reduction surgery is sometimes possible, however the incisions generally cut through the milk ducts so we recommend not to breastfeed. Your surgeon will give you the final word on whether or not you can breastfeed according to the type of surgery, the technique and follow-up.

Below are some important pointers regarding “before and after” a breast reduction:

BEFORE SURGERY:
1. Order a compression garment that you should use for 21 days after the operation. In the office we will give you more information on how to select a good one. Bring this bra to the hospital when you check in.
2. Do not take aspirin or aspirin products for 2 to 3 weeks prior to surgery. (Click Non recommended Medicines for more information.)
3. For three consecutive nights before surgery wash the entire chest, and as far as you can reach towards the back, with Isodine foam (Betadine in the US) shampoo. Your pharmacist may suggest an alternative product if you are unable to find it.
4. Do not eat  food for 8 hours before your operation.
5. For your own convenience, bring loose comfortable clothes with zippers or buttons.

AFTER SURGERY:
1. Go directly home and remain at rest for 24 to 48 hours. You should be resting with pillows under your knees and have your back elevated to a semi-sitting position.
2. You may get up to use the toilet and for meals only.
3. The first day at home you should take sips of fluids, gradually increasing to a soft diet. If you do not have nausea, you can eat normally.
4. Try to avoid sudden movements. Don’t elevate your arms to prevent forming a hematoma. Take care not to  get up suddenly or to stretch completely during the first week.
5. From the first day you should do leg exercises to avoid problems with your veins.
6. Do not take aspirin or aspirin derivatives after your operation. Also check Non recommended Medicines for details on other drugs. Do not use alcohol while you are taking medications.
7. Bathing with warm water is allowed after the drains have been removed at your first post-operative visit. Excessive heat may result in tissue injury.
8. Avoid any strenuous activity for a minimum of two weeks. Lifting heavy weights, carrying your baby or reaching for very high items could result in serious scarring problems, inflammation, bleeding or re-opening the wounds.
9. Wear your bra continously, except for bathing, for the first 10 days after surgery. At your second follow-up visit, non-absorbable stitches will be removed. After 10 to 14 days, you can purchase a bra that fits your new size. (You can go without a bra after 21 days).
10. You may drive after 2 weeks but only for short periods.You may resume social activities in 3 weeks.
11. Refrain from sexual activity during the first 3 to 4 weeks to prevent internal bleeding, infection or re-opening the wounds.
12. Sports or exercise programs may be reumed 6 weeks after surgery.

To view some cases of this surgery click Photo Gallery

Any questions before and after your surgery may be answered in person by calling the office, 684-2551  (US: 619-730-1917) or my cell 664-283-0976 or click Contact us for more information.

I wish you an excellent experience in Plastic Surgery and a speedy recovery

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