Breast reduction, or reduction mammaplasty, is a surgical procedure which involves the reduction in the size of breasts by excising fat, skin, and glandular tissue; it may also involve a procedure to counterract drooping of the breasts. As with breast augmentation, this procedure is performed most often on women.
Breast reduction surgery is oriented toward women with large, pendulous breasts, since the weight of their breasts may cause neck, back, shoulder, circulation, and/or breathing problems. The weight may also cause discomfort as a result of brassiere straps abrading or irritating the skin. Even if physical discomfort is not a problem, some women feel uncomfortable with the large size of their breasts in proportion to the rest of their bodies. Reduction mammoplasty affords the recipient smaller, lighter, and firmer breasts. The surgeon may also reduce the size of the areola or nipples.
Except in extreme cases, this procedure is only performed on individuals with fully developed breasts. It is not recommended for women who intend to breastfeed. Doctors almost always perform breast reductions while the patient is under general anesthesia. During pre-operative visits, the doctor and patient may decide on new (usually higher) positions for the areolas and nipples.
The most common procedure involves an anchor-shaped incision which circles the areola. The incision extends downward, following the natural curve of the breast. Excess glandular tissue, fat, and skin is removed. Next, the nipple and areola are moved into their new position. Finally, remaining skin from both sides of the breast are brought down around the areola and reattached. Recently there has been increasing interest in limited scar techniques which leave only a vertical scar, known as the Le Jour method.
In some extreme cases, the areola and nipple may need to be completely removed for relocation. In these cases, sensation from the areola area will be lost.
Patients may take a few weeks for initial recovery, however it may take from six months to a year for the body to completely adjust to the new breast size. Some women may experience discomfort during their initial menstruation following the surgery due to the breasts swelling.
Scarring from this procedure may be extensive and can be permanent. Initially the scars are lumpy and red, but gradually subside into their final smaller sizes as thin white lines. Though permanent, the surgeon can generally make the scars inconspicuous to the point that even low-cut tops may be worn without visible scars. Other common problems include: asymmetry, delayed wound healing, altered nipple sensation, fluid retention in the breast, altered erogenous function, late changes in shape and recurrent ptosis (drooping.)
- In-depth discussion of reduction mammaplasty, including illustrations from the American Society of Plastic Surgeons
- Clinical Outcomes in Reduction Mammaplasty from the Mayo Clinic (PDF file)
- Breast Reduction and Lift - Pictures of Healing Tissue Evolution
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