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Breast Reduction

A Breast Reduction is a surgical procedure designed to reduce the sagging and heaviness of large breast.  Reducing the chest in size, making the breasts more proportionate to the body, and lifting them to a higher position on the chest, the Breast Reduction can provide satisfactory results for women of any age.  A reduction can provide ladies struggling with a large chest dramatic, aesthetically pleasing results, as well as immediate relief from neck, back, or shoulder pain.

The ideal candidate for this procedure will be a woman, in generally good health, dealing with large, heavy, or pendulous breasts.  During the consultation appointment, Dr. Kreithen will review the medical history, perform a physical exam, and discuss the surgical options available.  At this time, it will be determined if surgery is right procedure for the individual patient.

A reduction can produce excellent aesthetic results as well as immediate relief from neck, back, and shoulder strain.  In fact, breast reduction patients are among the happiest of plastic surgery patients.  Good candidates for breast reduction include healthy women with large, heavy, sagging, or pendulous breasts.

Individual results may vary.

Click to view Breast Reduction photos

The Breast Reduction Procedure:

A typical breast surgery will take between one and three hours.  Performed under general anesthesia.  Most breast reduction procedures will be performed as an outpatient procedure.

The surgeon will begin by making an anchor-shaped incision or key-hold shaped incision around the areola.  From this incision, the surgeon will remove excess glandular tissue, fat, and skin.  The nipple will then be repositioned.  The remaining tissue will be pulled to form a pleasant contour for the chest, and the incisions sutured.  Liposuction may be included, to sculpt the breast curvature. Liposuction is usually performed through the armpit area.

Breast Reduction Recovery:

Patients should expect the recovery from this surgery to take from seven to ten days.  After surgery, patients will be asked to wear an elastic bandage or surgical bra.  After 24-48 hours, the bandage will be removed, but the surgical bra will be worn for several weeks.  This will control swelling and promote appropriate healing.  Small drain tubes may be worn for several days to reduce the amount of fluid and blood.  It is common for patients to experience some moderate pain, stiffness, and discomfort for the first week or two; this will be worse when coughing or laughing.

The procedure will result in scarring, although these may be easily covered by a swimsuit or clothing.  The scars will fade some bit, as the breasts continue to heal.  Risks are rare after surgery but can include swelling, infection, bleeding, numbness, asymmetry, and pigmentation changes.  Utilizing a Board Certified cosmetic surgeon will be a patient’s best defense again unwanted complications.

A Breast Reduction can provide a woman improved confidence and self-esteem.  It can also give her a physical well-being that is compromised by large, heavy breasts.  To schedule your consultation at Holcomb and Kreithen Plastic Surgery, call our Sarasota office at (866) 218-4810 today.

In most cases, breast reduction isn’t performed until a woman’s breasts are fully developed; however, it can be done earlier if large breasts are causing serious physical discomfort. The best Sarasota breast reduction candidates are those who are mature enough to fully understand the procedure and have realistic expectations about the results. Breast reduction is not recommended for women who intend to breast-feed. If you smoke, it’s especially important to stop at least one month before and after surgery; smoking inhibits blood flow to the skin, and can interfere with the healing of your incision areas. Breast reduction is also best performed on someone with a Body-Mass Index (BMI) of 30 or less. If the patient’s body mass is higher than this, the complication rate goes up dramatically. For Dr. Kreithen, safety is of utmost importance and he will not perform the operation until your BMI is 30 or less. (To calculate your BMI you can go to http://www.halls.md/body-mass-index/bmi.htm.

Breast reduction is not a simple operation, but it’s normally safe when performed by a qualified plastic surgeon. Nevertheless, as with any surgery, there is always a possibility of complications, including bleeding, infection, or reaction to the anesthesia. Some patients develop small sores around their nipples after surgery; these can be treated with antibiotic creams. You can reduce your risks by closely following your physician’s advice both before and after surgery.

The procedure may leave noticeable, permanent scars, although they’ll be covered by your bra or bathing suit. (Poor healing and wider scars are more common in smokers.) There are newer techniques that leave less scarring. During your consultation, Dr. Kreithen will be able to determine if you are a candidate for one of these newer procedures. 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.

Some patients may experience a permanent loss of feeling in their nipples or breasts. Rarely, 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.)

Planning Your Surgery

In your initial consultation, it’s important to discuss your expectations. Every patient and every physician has a different view of what is a desirable size and shape for breasts.

Dr. Kreithen will examine and measure your breasts, and will photograph them for reference during surgery and afterwards. (The photographs may also be used in the processing of your insurance coverage.) He will discuss the variables that may affect the procedure-such as your age, the size and shape of your breasts, and the condition of your skin. You will also discuss where the nipple and areola will be positioned; they’ll be moved higher during the procedure, and should be approximately even with the crease beneath your breasts.

Dr. Kreithen will describe the procedure in detail, explaining its risks and limitations and making sure you understand the scarring that will result. Some insurance companies will pay for breast reduction if it’s medically necessary; however, they may require that a certain amount of breast tissue be removed. (Check your policy, and Dr. Kreithen will write a “predetermination letter” if required.)

At the completion of your consultation, you will meet with our patient coordinator. You will be given an estimate of the cost of your procedure, and have the option to schedule your procedure if you so choose. You are also encouraged to bring your spouse, significant other, family member, or a friend to your consultation. Dr. Kreithen realizes the importance of your decision, and will be happy to meet with you a second time to discuss the surgery.

Preparing for Your Surgery

Dr. Kreithen may require you to have a mammogram (breast x-ray) before surgery. You’ll also get specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications. You should try to attain your ideal body weight prior to surgery.

Breast reduction surgery usually requires an overnight stay in the hospital. While you’re making preparations, be sure to arrange for someone to drive you home after your surgery and to help you out for a few days if needed.

Where Your Surgery Will be Performed

A breast reduction will most likely be performed at our new state-of-the-art Holcomb – Kreithen Plastic Surgery Medical Center operating room. If you are admitted to the hospital, your stay will be a short one. The surgery itself usually takes two to four hours, but may take longer in some cases.

Types of Anesthesia

Breast reduction is nearly always performed under general anesthesia. You’ll be asleep through the entire operation.

The Surgery

Techniques for breast reduction vary, but the most common procedures involve an anchor-shaped incision or a keyhole shape incision, depending on the shape of your breast. Dr. Kreithen will remove excess glandular tissue, fat, and skin, and move the nipple and areola into their new position. He will then bring the skin from both sides of the breast down and around the areola, shaping the new contour of the breast. Liposuction may be used 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, the nipples and areolas may have to be completely removed and grafted 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 possibly along the lower crease of the breast. In some cases, techniques can be used that eliminate the horizontal part of the scar. And occasionally, when only fat needs to be removed, liposuction alone can be used to reduce breast size, leaving minimal scars.

After Your Surgery

After surgery, you’ll be wrapped in an elastic bandage or wear 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. Your surgeon will prescribe medication to lessen the pain.

The bandages will be removed a day or two after surgery, though you’ll continue wearing the surgical bra around the clock for several weeks, until the swelling and bruising subside. Your stitches will be removed in one to three weeks.

If your breast skin is very dry following surgery, you can apply a moisturizer several times a day, but be sure to keep the suture area dry.

Your first menstruation following surgery may cause your breasts to swell and hurt. You may also experience random, shooting pains for a few months. You can expect some loss of feeling in your nipples and breast skin, caused by the swelling after surgery. This usually fades over the next six weeks or so. In some patients, however, it may last a year or more, and occasionally it may be permanent.

Getting Back to Normal

Although you may be up and about in a day or two, your breasts may still ache occasionally for a couple of weeks. You should avoid lifting or pushing anything heavy for three or four weeks.

Dr. Kreithen will give you detailed instructions for resuming your normal activities. Most women can return to work (if it’s not too strenuous) 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 walking until your energy level returns. You’ll also need a good athletic bra for support. It is not safe to drive a car within 24 hours of taking pain medication, as your reflexes and alertness may be altered.

You may be instructed to avoid sex for a week or more, since sexual arousal can cause your incisions to swell. You should also avoid anything but gentle contact with your breasts for about six weeks.

A small amount of fluid draining from your surgical wound, or some crusting, is normal. If you have any unusual symptoms, such as bleeding or severe pain, please call Dr. Kreithen.

Your New Look

Although 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. Kreithen will make every effort to make your scars as inconspicuous as possible. Still, it’s important to remember that breast reduction scars may be extensive and permanent. They often remain lumpy and red for months, then gradually become less obvious, sometimes eventually fading to thin white lines. Fortunately, the scars can usually be placed so that you can wear even low-cut tops.

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.

However, as much as you may have desired these changes, you’ll need time to adjust to your new image-as will your family and friends. Be patient with yourself, and with them. Keep in mind why you had this surgery, and chances are that, like most women, you’ll be pleased with the results.

As a foremost plastic surgeon Sarasota patients seek out for advanced procedures, Dr. Kreithen offers a wealth of breast enhancement treatments. Among the procedures he recommends and performs are breast augmentation, gynecomastia treatment and breast lift in Sarasota. In addition, he specializes in reconstructive surgery and is recognized as an accomplished Sarasota breast reconstruction surgeon.

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