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Breast Reduction in San FranciscoWHAT CHANGES CAN BE EXPECTED? The breasts will be smaller and lighter. Sagging will be reduced or eliminated and the nipple and areola, which have usually settled lower down on the breast, will be placed higher on the breast mound. You may obtain reduction in pains in the shoulders, bra strap regions, neck, and back. Your posture may change. You may be able to wear different fashions. Many women have an easier time finding clothing that fits comfortably. Deciding to have breast reduction is a very personal matter, and different women will approach the operation with different goals. Some complain of embarrassment and feeling stared at. Some want to be able to do high-impact exercise and are physically limited by their large breasts. Some find the appearance unattractive and simply prefer the body proportions that go with smaller breasts. Some women may have had large breasts for many years and want the freedom of having smaller breasts. Some women enjoy the appearance of larger breasts but want just to reduce sagging but not give up any breast volume. For them, a breast lift by itself may be appropriate. Large breasts may be associated with enlargement of the areola, the pigmented skin surrounding the nipple. If you desire, it is possible to reduce the areolar size as part of breast reduction. You should discuss your preferences with Dr. Cedars at the time of office consultation. Nipple and areolar sensation can be reduced or, rarely, increased after breast reduction surgery. WHO IS A CANDIDATE? Any woman with excessively large breasts, at any age, may find breast reduction beneficial. Women in their seventies can have the operation if they are in good health. Infrequently, teenagers as young as thirteen may have uncontrolled breast growth and require surgery. Usually, however, it is best to wait until breast growth has stopped before considering surgery, so that further growth will not undo the effects of the operation. If the operation requires sufficient breast tissue to be removed, your insurance may cover part of the costs of the operation. Dr. Cedars's staff will be happy to submit a request to your insurance company, which should be done well before surgery in order to maximize the chances for coverage. HOW IS THE BREAST REDUCTION DONE? The breast mound is made smaller by removing some of the breast tissue--the breast consists of glands, which can produce milk, and fatty tissue, and some of both are removed with surgery. A lift is part of all breast reductions. A breast lift is achieved by removing some of the breast skin, usually on the lowest part of the breast, so that the remaining breast tissue is fitted into a smaller skin envelope. The nipple and areola are usually left attached to the breast mound but are repositioned higher on the breast. This is done by cutting free and lifting up the skin on the upper breast, moving the reduced breast mound higher on the chest wall, and then draping the upper breast skin down around the nipple/areola and tailoring things into place. Dr. Cedars will explain this to you at the time of consultation. The most common scar pattern has an "anchor" shape--the scars make a circle around the areola, a curving line along the junction of the bottom of the breast with the chest wall (the "inframammary fold"), and a vertical line connecting the two along the central line of the breast. Sometimes a "short scar technique" can be used, which may reduce or occasionally eliminate the scar in the inframammary fold. AFTERCARE The operation is done under general anesthesia as an outpatient. Recovery is typically 10-14 days before returning to desk work, longer for strenuous physical exertion. Patients take narcotics for an average of 5 or 6 days. Unlimited activity is possible when the scars reach nearly full strength, about 6 weeks after surgery. |
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