breast reduction

Planning Your Surgery

Honest communication between you and Dr. Chariker is essential to a successful outcome. You must be clear about what you feel is the right size and shape for your breasts. At the same time, you must be willing to accept the doctor’s recommendation about realistic outcome, based on factors such as your age, the size and shape of your breasts, and the condition of your skin. Dr. Chariker will examine and measure your breasts, and will probably photograph them for reference during surgery and afterwards. Some insurance companies will pay for breast reduction if it's medically necessary, but they may require that a certain amount of breast tissue be removed. Check your policy.

In/Outpatient, Anesthesia, Length of Procedure

Dr. Chariker generally performs breast reductions in our private, outpatient surgical facility. You will receive general anesthesia and will be asleep through the entire operation, which usually takes two to four hours.

During and After

The most common procedure involves an anchor-shaped incision that circles the areola, extends downward, and follows the natural curve of the crease beneath the breast. Dr. Chariker removes excess glandular tissue, fat, and skin, moves the nipple and areola into their new position, and then brings the skin from both sides of the breast down to shape the new contour of the breast. He also may use liposuction to remove excess fat from the armpit area. In most cases, the nipples remain attached to their blood vessels and nerves. However, if the breasts are very large or pendulous, Dr. Chariker may need to remove the nipples and areolas completely and graft them into a higher position. (This will result in a loss of sensation in the nipple and areolar tissue.) Stitches are usually located around the areola, in a vertical line extending downward, and along the lower crease of the breast.

After surgery, you'll be wrapped in an elastic bandage or a surgical bra over gauze dressings. A small tube may be placed in each breast to drain off blood and fluids for the first day or two. You may feel some pain for the first couple of days, especially when you move around or cough, and some discomfort for a week or more. Dr. Chariker will prescribe medication to lessen the pain. He’ll remove the bandages a day or two after surgery, the stitches in one to three weeks. You'll continue wearing the surgical bra around the clock for several weeks, until the swelling and bruising subside. Your breasts may ache occasionally for a couple of weeks, and you should avoid lifting or pushing anything heavy for three or four weeks. Most women can return to work and social activities in about two weeks, but you'll have much less stamina for several weeks, and should limit your exercises to stretching, bending, and swimming until your energy level returns.

Side Effects and Risks

Typical temporary side effects include initial pain, swelling, and numbness of the nipples and breasts. This usually fades over the next six weeks or so, but in some patients it may last a year or more, and occasionally it may be permanent. Your first menstruation following surgery may cause your breasts to swell and hurt. You may also experience random, shooting pains for a few months. Some patients develop small sores around their nipples after surgery, which can be treated with antibiotic creams.

Breast reduction surgery leaves noticeable, permanent scars, although they'll be covered by your bra or bathing suit. (Poor healing and wider scars are more common in smokers.) The procedure can also leave you with slightly mismatched breasts or unevenly positioned nipples. Future breast-feeding may not be possible, since the surgery removes many of the milk ducts leading to the nipples. In rare cases, the nipple and areola may lose their blood supply and the tissue will die. The nipple and areola can usually be rebuilt, however, using skin grafts from elsewhere on the body.

Recovery

Of all plastic surgery procedures, breast reduction results in the quickest body-image changes. You'll be rid of the physical discomfort of large breasts, your body will look better proportioned, and clothes will fit you better. Still, while much of the swelling and bruising will disappear in the first few weeks, it may be six months to a year before your breasts settle into their new shape. Even then, their shape may fluctuate in response to your hormonal shifts, weight changes, and pregnancy. Dr. Chariker will make every effort to make your scars inconspicuous, but it's important to remember that breast reduction scars are extensive and permanent. They often remain lumpy and red for months, then gradually become less obvious, sometimes eventually fading to thin white lines.