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Surgery
Breast reduction surgery is usually
performed under general anesthesia in an inpatient or outpatient clinical setting. Many
women spend one to three nights in the hospital after surgery, although some may be driven
home a few hours after the procedure if no complications occur.
Before the procedure, the surgeon may
mark incision lines on the breast while the patient is sitting up to ensure that the
breasts are proportioned correctly. During the surgery, the plastic surgeon will make
incisions around the areola (the dark pigmented area around the nipple), down the mid-line
of breast and in the fold beneath the breast. In small reductions, incisions may not be
necessary in the fold beneath the breast. All incisions will leave scars once healed.
There are two main types of breast
reduction surgeries. In the first procedure, the surgeon removes excess breast tissue and
skin but preserves the tissue where the nipple and areola are attached. This technique
helps maintain optimal blood circulation to the nipple and areola and may allow women to
breast-feed after surgery (although some milk ducts are removed with this technique). In
the second technique, the breast ducts and nerves are cut and the nipple and areola are
completely removed while the tissue is removed, and they are grafted to a higher position.
Women will usually not be able to breast-feed if a free-nipple technique is performed.
Small drainage tubes are also placed in the breast or
under the arm to help remove blood or other fluids which may accumulate during the healing
process. The tubes are usually removed within a few days after surgery, depending on the
amount and rate of fluid drainage. Incisions will be closed with stitches, and gauze
bandages may be placed over the breasts to facilitate healing. Breast reduction surgery
usually takes approximately three hours but may take longer if a large amount of breast
tissue is removed.
Side
Effects
Most women will experience fatigue and
breast pain for a few days after breast reduction surgery. Heavy lifting, pushing, or
pulling should be avoided for four to six weeks after surgery; these activities may delay
wound healing and cause more prominent scars. Moderate breast
pain and sores around the nipple are usually controlled by prescription antibiotics,
though some women experience random shooting pains in their breasts for the first several
months after surgery. Drainage tubes and stitches will be removed within a few days after
surgery (unless the surgeons uses dissolvable stitches). Severe complications are not
common after breast reduction, but as with any surgical procedure, some women may
experience problems.
Side effects of breast reduction
surgery may include:
- Bleeding or infection
- Delay in healing
- Abnormal scarring
In rare cases, the breast or nipple
skin does not heal properly and an additional surgery to graft the skin is necessary.
Approximately 10% of women experience some loss of sensation in the nipple. The first
menstrual cycle after surgery may cause the breasts to swell and become temporarily
painful. As the breasts heal, swelling will subside and the breasts will become smaller.
The breasts will also descend slightly as gravity acts on the new breast envelope. Most
patients are pleased with this effect since it makes the breasts look more natural.
Breast reduction surgery leaves
permanent scars. The scars will usually appear red and lumpy at first but will become less
obvious over time. Women who smoke often have wider scars, since smoking interferes with
the healing process. Women should continue to perform breast
self-examinations each month and have annual mammograms
if they are 40 years of age or older or at high risk of breast cancer, as determined by a
physician.
Nursing After Breast Reduction
Breast-feeding is possible in some
cases after breast reduction surgery if the nipple and areola (dark pigmented area around
the nipple) remain intact during surgery. Research has also shown that the less breast
tissue removed, the higher the chances women may establish lactation. Many women who have
had breast reduction surgery are not able to produce enough milk for their children. If
the woman is able to produce some milk, she may use a nurse supplementer if she wishes to
breast-feed. A nurse supplementer is a device worn around the neck like a necklace. It
consists of a container that holds the supplemental milk, and thin tubes that may be taped
to the woman’s breasts. When the woman breast-feeds, the baby will receive the small
amount of milk that the woman is able to produce along with the milk from the nurse
supplementer. Many women feel that this helps them establish a bond with their children as
they would if they breast-fed.
Additional Resources and References
Updated: July 28, 2008
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