cOSMETIC PROCEDURES > BREAST > BREAST Reduction

Large breasts can cause significant issues for women such as changes in posture, neck, back, and shoulder pain, as well as recurrent skin irritation. Breast reduction can remove the excess weight and help improve the breast size and shape and restore a more proportional and elegant appearance.

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What is Breast Reduction?

Overly large breasts can cause health and emotional problems. In addition to self image issues, you may also experience physical pain and discomfort. The weight of excess breast tissue can impair your ability to lead an active life. The emotional discomfort and self-consciousness often associated with having large pendulous breasts can be as important an issue as the physical discomfort and pain.

Breast reduction, also known as reduction mammaplasty, is a procedure to remove excess breast fat, glandular tissue, and skin to achieve a breast size in proportion with your body and to alleviate the discomfort associated with overly large breasts.

Breast reduction is a good option for you if you:

  • Are physically healthy

  • Have realistic expectations

  • Don't smoke

  • Are bothered by feeling that your breasts are too large

  • Have breasts that limit your physical activity

  • Experience back, neck, and shoulder pain caused by the weight of your breasts

  • Have shoulder indentations from bra straps

  • Have skin irritation beneath the breast crease

Consultation and Preparing for Surgery

    • Your surgical goals

    • Medical conditions, drug allergies, and medical treatments

    • Current medications, vitamins, herbal supplements, alcohol, tobacco, and drug use

    • Previous surgeries

    • Family history of breast cancer and results of any mammograms or previous biopsies - your screening mammogram needs to be up to date if considering breast reduction surgery

    • Evaluate your general health status and any pre-existing health conditions or risk factors

    • Examine your breasts and may take detailed measurements on their size, skin quality, and location of your nipples and areolas

    • Take photographs

    • Discuss your options

    • Recommend a course of treatment

    • Discuss likely outcomes of breast reduction and any risks or potential complications

    • Discuss the use of anesthesia during your breast reduction

    • Get lab testing or a medical evaluation

    • Take certain medications or adjust your current medications

    • Provide the results of your most recent mammogram, or obtain a new mammogram if you are not up to date with recommended guidelines

    • Stop smoking

    • Avoid taking aspirin, anti-inflammatory drugs, and herbal supplements as they can increase bleeding

The Procedure

Breast reduction involves making incisions on the breast skin to remove the excess breast tissue and skin.
In some cases, excess fat may be removed through liposuction in conjunction with the excision techniques described below.

The technique used to reduce the size of your breasts will be determined by your individual anatomy, breast composition, amount of reduction desired, your personal preferences and Dr. Abedi’s assessment and advice.

STEP 1: Anesthesia

Medications are administered for your comfort during the surgical procedure. Your anesthesiologist will make recommendations on the type of anesthesia based on your history and general health.

Step 2: The Incision

Incision options include:

A keyhole or racquet-shaped pattern

An inverted T or anchor-shaped incision pattern

STEP 3: Removing Tissue and Repositioning

After the incision is made, the nipple— which remains tethered to its original blood and nerve supply—is then repositioned. The areola diameter is reduced by excising skin at the perimeter, if necessary. Underlying breast tissue is reduced, and the remaining breast tissue is lifted and shaped. Rarely, in extremely large breasted women, the nipple and areola may need to be removed and repositioned to a higher position on the breast (free nipple graft).

STEP 4: Closing the incisions

The incisions are brought together to reshape the now smaller breast.  Sutures are layered deep within the breast tissue to create and support the newly shaped breasts; sutures, skin adhesives and/or surgical tape close the skin.  Incision lines are permanent, but in most cases will fade and significantly improve over time.

The incision lines that remain are visible and are permanent scars, although usually they are well concealed beneath a swimsuit or bra.

risks and safety

The decision to have breast reduction surgery is extremely personal. You will have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable. Although there is a fair amount of scarring associated with breast reduction surgery, it has one of the highest rates of satisfaction among procedures performed by plastic surgeons. Most women note significant improvement in their neck, back, and shoulder discomfort. They are more able to participate in athletic activities, and their clothing choices are liberalized.

Prior to undergoing breast reduction surgery, you will be asked to sign consent forms to ensure that you fully understand the procedure and any risks and potential complications.

The risks include:

  • Allergies to tape, suture materials and glues, blood products, topical preparations, or injectable agents

  • Anesthesia risks

  • Bleeding

  • Blood clots

  • Breast asymmetry

  • Breast contour and shape irregularities

  • Changes in nipple or breast sensation, which may be temporary or permanent

  • Deep vein thrombosis, cardiac and pulmonary complications

  • Fluid accumulation or seroma formation

  • Infection

  • Persistent pain

  • Poor wound healing

  • Possibility of revisional surgery

  • Potential inability to breastfeed

  • Potential partial or total loss of nipple and areola

  • Skin discoloration, and permanent pigmentation changes

  • Unfavorable scarring

  • Scarring within the breast tissue may cause firmness or lumps know as fat necrosis

  • Inability to breastfeed in the future

These risks and others will be fully discussed prior to your consent. It's important that you address all of your questions directly with Dr. Abedi during your consultation.

You should know that:

  • Your ability to breastfeed following reduction mammaplasty may be limited; talk to Dr. Abedi if you are planning to nurse a baby

  • The procedure can be performed at any age, but is best done when your breasts are fully developed

  • Changes in the breasts during pregnancy can alter the outcomes of previous breast reduction surgery, as can significant weight fluctuations

RECOVERY AFTER SURGERY

After your breast reduction procedure is completed, dressings or bandages will be applied to the incisions.  You'll need to wear a support bra to minimize swelling and support your breasts as they heal.  A small, thin tube may be temporarily placed under the skin to drain any excess blood or fluid that may collect. This is usually only done if significant liposuction is performed with your surgery.

Before leaving the hospital or surgical facility, Dr. Abedi will give you specific instructions that include how to care for your breasts following surgery, medications to apply or take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in your general health, and when to follow up with her office. You will be instructed to wear the surgical bra around the clock for the first 4 weeks depending on your healing. There are tapes on your incision which stay on for 2 weeks or until they fall. You will be instructed to continue taping your incisions with silicone tapes for the first 3 months to optimize the appearance of your scars.

After a post-surgical recovery period of 24 to 48 hours and an additional reduced-activity period of a few days, you will likely experience soreness and swelling for a few weeks. Exercise and normal activity can resume at 3-4 weeks depending on your recovery and extent of your surgery. Dr. Abedi will let you know at your post op visit when you can resume normal activities.

When you go home

If you experience shortness of breath, chest pains, or unusual heart beats, seek medical attention immediately. Should any of these complications occur, you may require hospitalization and additional treatment.

results

The results of your breast reduction surgery are immediately visible. Most patients immediately feel the relief of the excess weight removed. Over time, post-surgical swelling will resolve and incision lines will fade. The final results of your breast reduction will appear over the next few months as breast shape and position continue to settle.  Incision lines are permanent but will continue to fade over time.

The results of your breast reduction surgery will be long-lasting. However, your breasts can continue to change due to aging and gravity. You'll be able to retain your new look longer if you:

  • Maintain your weight

  • Keep a healthy lifestyle

  • Wear a supportive bra at all times (even when sleeping)

Although good results are expected from your procedure, there is no guarantee.  In some situations, it may not be possible to achieve optimal results with a single surgical procedure and another surgery may be necessary.

The medical services plan covers the cost of breast reduction surgery if your breasts are large enough to meet the criteria. However, liposuction or other contouring procedures that may be performed at the same time are not covered. If you decide to perform the surgery privately the cost can vary based on the size of your breasts, any ancillary procedures being performed, and the location of the surgical facility. If you are unsure whether you are a candidate for MSP covered surgery or not, please schedule a consultation with North Vancouver breast surgeon, Dr. Nasim Abedi. Call 604-983-9985. We look forward to meeting you.

Cost may include:

  • Anesthesia fees

  • Hospital or surgical facility costs

  • Medical tests

  • Post-surgery garments

  • Prescriptions for medication

  • Surgeon's fee

  • Follow-up visit fees

cost

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