What
can I expect the scars to be like?
The
incisions, and resulting scars, go around the areola (pink part
around the nipple) down the front and underneath in sort of an
inverted T shape. The scar around the areola usually is less
noticeable because it’s at the line of color change and the
one underneath is generally hidden, for the most part, in the
crease. The vertical scar down the front is the one that shows
the most. Generally, after appropriate healing time, just like
any other scar, they fade and aren’t too noticeable. All scars
are permanent and every patient’s healing characteristics are
individual, from those who barely scar to the few who develop
keloids (an over production of scar tissue) but, all in all, the
scars from this surgery are generally viewed as acceptable. I
cannot recall a patient who felt the resulting scars weren’t
worth the many benefits of surgery. The design of the scar is
such that it is covered with a bra or swim suit.
What
about my nipple sensation?
Sensitivity
of the nipple is largely related to the way the nipple is moved.
In moderately large breast, I try to move the nipple with a
section of breast tissue behind it which is called a pedicle. In
this situation, most of the time, after the initial healing
period nipple sensation is present. If the breasts are very
large and droopy the pedicle method doesn’t work very well and
we have to put the nipple on as a free nipple graft which means
you’ll have sensation in the breast mound but not the areola
and nipple. I have had a few patients who had free nipple grafts
say they did get sensation back after a few years, but you
can’t count on it.
What
is the most common complication you’ve seen with breast
reduction?
Complications
are quite rare but, over the years, I have seen a woman or two
develop an area of superficial tissue loss around the nipple.
This is more common in smokers since smoking reduces the blood
flow to the skin surface. This generally makes a heavy, dark
scab which sort of heals from the inside out. If kept clean and
covered, it usually takes care of itself but it can take a long
time and certainly be a nuisance. If this didn’t progress as
expected, it could mean a secondary procedure for closure.
Although it’s more of a consequence rather than a
complication, the breasts I start with are never exactly the
same size and shape before and they won’t be afterwards. After
you have the surgery, you may wish you were larger or smaller.
The "perfect breast" is purely subjective – in the
eye of the beholder, so to speak!
Can
I breast feed after breast reduction surgery?
Probably
not. The surgery removes many of the milk ducts leading to the
nipples.
Will
I have to spend the night at the hospital or surgery center?
Most
patients go home the same day. You’ll come back to the office
the next day for a 24 hour checkup. You’ll need a driver
and someone to help with the dressings for a few days.
Am
I likely to need a blood transfusion for breast reduction
surgery?
No.
Will
my breasts still get sore with my periods?
We
aren’t removing all the breast tissue so what’s left behind
will still respond like usual; however, most patients say breast
tenderness is better – probably just because there’s less of
it.
When
can I go back to work, exercise, etc.?
You’ll
be up and about in a day or two but you’ll have to take it
somewhat easier than usual for a couple of weeks. If your job
isn’t very physical, you’ll be back sooner than some someone
doing hard, physical labor. Most people are back in 7-14 days.
How
long will I have stitches?
Part
of them are removed in about a week and the rest are come out in
about 10-14 days.
When
can I shower?
If
you have a free nipple graft, you have to avoid getting the
nipple wet until the special dressing is removed in about a
week. You can sit in a tub but sponge the upper body, don’t
pour water over it. Those who had their nipples moved by
pedicles start showering, no tub baths, the day
I’m
only 17 but my breasts are huge. I can’t run or participate in
sports and it’s embarrassing. I hate being teased. My mom says
I’m too young for surgery, is this true?
Breast
reductions in younger women can make a big difference in their
comfort ability to be active. Also, there’s probably no time
in a girl’s life when " self image" is more
important. However, there are a few things of importance to be
considered. This is permanent. I can’t put it back. I like to
feel certain that you’ve thought this through. I’m not going
to operate on the 17 y/o who wears a C cup just because she
thinks it’s too large compared to all of her friends. However,
I’m also not going to tell the young girl with truly large
breasts that are causing problems I can’t help her until
she’s older. The type of pain, physical or emotional, from
dealing with large breast has no age limits. In the more
marginal cases, my concern is always that what you perceive as
"too big" at this age may not be "too big"
when you are older. I’ve never had this happen but it does
worry me. Also, you stand the chance of loosing the sensual
sensation in the nipple and the ability to nurse babies.
Do
you submit breast reduction claims to insurance?
I
will only consider this in the patient who has a BMI under 30.
I cannot support a medically necessary stance in a patient who
is not at a weight proportionate to their height.
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