Breast Reduction

(Reduction Mammoplasty)

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Definition | Body Parts Involved | Reasons for Procedure | Complications | What to Expect | Outcome | Call Doctor If

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Definition

Surgery to decrease the size of one or both breasts

Parts of the Body Involved

Breasts

Reasons for Procedure

• Overly large breasts, resulting in poor body image; back, neck, and shoulder pain; posture problems; abrasions/lacerations from bra straps
• Asymmetric breasts, either due to differential growth or previous surgery to one breast, such as mastectomy or lumpectomy
• Abnormal growth in a male breast, called gynecomastia

Risk Factors for Complications during the Procedure

• Obesity
• Smoking
• Alcoholism
• Diabetes
• Poor nutrition
• Cellulitis (inflammation of underlying breast tissue)
• Intertrigo (cracking and inflammation of the skin over the breast)

What to Expect

Prior to Procedure

You may be asked to provide the surgeon with a picture of a woman whose breasts you want yours to resemble. Or, you may be asked to look through an album of breast sizes and shapes to help the surgeon understand the outcome you desire.

Your physician will likely do the following:

• Physical exam, including breast exam
• Blood tests
• Mammogram
• Take "before" pictures

In the days leading up to your procedure:

• Arrange for a ride to and from the procedure
• Arrange for help at home after the procedure
• The night before, eat a light meal and do not eat or drink anything after midnight
• You may be asked to shower the morning of your procedure, and you may be given special antibacterial soap to use

During Procedure - IV fluids, sedation, anesthesia

Anesthesia - General or local

Description of the Procedure - The surgeon cuts around the nipple and areola. Fat and breast tissue are removed and excess skin is trimmed. Depending on how much breast tissue is removed, the surgeon may need to reposition the nipple and areola higher up on the remaining breast tissue. Liposuction, a vacuum procedure to remove excess fat, may also be used.

Depending on how extensive an operation is required, the surgeon may place a small flexible tube in one or both breasts, in order to drain any fluid build-up during the early phases of healing. These drains may need to stay in place for several days.

The incisions in the breast are closed with tiny stitches. After surgery on one breast is completely finished, the same steps are taken to reduce the other breast.

After Procedure -You'll be tightly bandaged around your chest, or you'll wear a special surgical bra to provide pressure and support.

How Long Will It Take? 2-4 hours

Will It Hurt? Anesthesia prevents pain during the surgery. You will have tenderness, swelling, and bruising of the breasts for several weeks after surgery.

Possible Complications:

• Infection
• Bleeding
• Bruising
• Loss of sensation to the breast, nipple, and/or areola
• Possible inability to breastfeed, especially if surgery involves moving the nipple and areola
• Asymmetry between breasts
• Restricted arm and/or shoulder movement
• Scarring
• Fluid- and/or blood-filled cysts may develop in the healing breast tissue

Average Hospital Stay: 0-4 days, depending on the extent of the surgery and your general health

Postoperative Care:

• Wear a special surgical bra that applies pressure in order to properly shape your breast(s) after the operation
• If drains have been placed in either breast, they'll be removed 2-4 days after surgery
• Stitches will be removed 7-10 days after surgery
• Your doctor will probably advise you to avoid heavy lifting, straining, or strenuous exercise for the first week or two after surgery

Outcome

Your breasts will be smaller, and should reflect the size, shape, and symmetry that you desired.

Call Your Doctor If Any of the Following Occurs

• Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site in either breast
• Nausea and/or vomiting that you can't control with the medications you were given after surgery, or which persist for more than two days after discharge from the hospital
• Signs of infection, including fever and chills
• Cough, shortness of breath, chest pain, or severe nausea or vomiting
• You notice stiffness or pain when moving your arm
• Abnormal scarring
• Fluid- or blood-filled cysts developing in either breast
• You have concerns about the size and/or shape of your breasts
• Pain and/or swelling in your feet, calves, or legs, sudden shortness of breath or chest pain

SOURCE:

Textbook of Surgery, 15th ed. W. B. Saunders Co, 1997.

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Last reviewed February 2001 by Medical Review Board