How is breast reduction performed?
Many techniques have been
described to perform breast reduction. Each of the techniques has its
limitation and associated complications. We mainly use three techniques
that are time-tested, produce more consistent results, and associated
with fewer complications.
All techniques reduce the size
of the breast, lift the nipple to a higher position, and reduce the
size of the areola (pigmented area around the nipple). Our goal in
breast reduction is to form a smaller breast that is appropriate in
shape and size relative to the dimensions of your chest. We prefer to
perform breast reductions under general anesthesia. In some patients,
sedation and local anesthesia may be considered.
1. Inverted T method (technically known as an Inferior Pedicle or Wise Pattern
breast reduction) is the most commonly used method for breast reduction
in our practice. This procedure results in a vertical and horizontal
scar. The horizontal scar is hidden under the breast. The areola is
usually enlarged in women with large breasts. The size of the areola is
reduced during breast reduction resulting in a scar around the areola.
The scars are usually hidden within a bra.
2. Some patients with smaller breasts may be candidates for a Vertical Reduction Technique
which avoids a horizontal scar at the bottom of the breast. There will
be a vertical scar and a scar around the areola (pigmented area around
the nipple).
Following the Inverted T technique or Vertical Breast Reduction,
breast feeding may or may not be possible. In some patients
nipple/areola sensation is unchanged, yet in other patients it may be
diminished or completely absent following surgery.
These sensory changes when
occur can be temporary or permanent. We cannot predict who will
experience an inability to breast feed or sensory changes following
surgery.
Certain women with large breast report
diminished nipple sensation before surgery. This is likely related to
nerve stretching by the heavy weight of the breast. Some of these
patients notice improved nipple sensation following breast reduction
using Inverted T or Vertical breast reduction technique.
3. Free Nipple Breast Reduction technique is
used for patients with very large breast. This technique involves
removing the nipple and areola as one complex. The breast is reduced and
the nipple/areola complex is then sutured as a graft to the breast in a
higher position. This technique results in a horizontal scar at bottom
of the breast and a scar around the areola. Women will not be able to
breast feed and will have nipple/areola numbness following this
procedure, which are likely to be permanent.
What should I expect during my consultation?
During your consultation, we
will perform a thorough examination and measurements of your breasts.
Together we will choose the safest technique that would work best for
you.
New position for the nipple/areola and position
of the incisions will drawn for you on your photographs. We will discuss
in detail the anticipated outcome, possible complications, and what to
do to prepare for surgery.
What is recovery like after a breast reduction?
You will have a small drainage
tube the side of the breasts. Those will be removed usually within 7
days. We use absorbable sutures that do not need to be removed.
Within the next several weeks, most swelling and
bruising will resolve. You will notice that the breasts assume a more
natural shape over the first couple of months after surgery.
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