Many women are plagued by a condition known as macromastia (large breasts), also commonly called breast enlargement or hypertrophy of the breasts. This condition may lead to real physical symptoms such as neck pain, back pain, breast pain, rashes beneath the breast folds and bra strap indentations into the shoulders.
These symptoms usually identify a breast size that is out of proportion to the body habitus, but may simply identify large heavy breasts causing symptoms even in larger women. The medical and plastic surgery solution to this sometimes disabling condition is breast reduction surgery (reduction mammaplasty). The procedure has enabled countless thousands of women to become more productive in their daily lives and in society and to generally feel better about their self image.
Breast reduction surgery may take any where from 2 to 4 or 5 hours depending on the amount of tissue to be removed and the technique chosen for the procedure. Sometimes drains (small plastic tubes) are left in place to allow fluids to escape from beneath the newly shaped breast. Usually the surgery requires a general anesthesia, again depending on the amount of tissue to be removed and the technique used. There is about a 2-3 hour recovery room stay, resulting in an 8 hour day, after which the patient is discharged home.
The classic incision (scar) pattern for breast reduction surgery is the inverted T or the anchor shaped incision. This scar encircles the areolar complex, travels vertically down the lower breast and extends horizontally along the lower fold of the breast from the sternum (breast bone) to the axilla (armpit).
The modern trend in techniques for breast reduction surgery is toward procedures which limit the amount of external scarring. These techniques involve incisions that may be called periareolar (around the areolar complex only), or vertical (around the areolar complex and vertically down the middle of the lower breast in a lollipop design). Not every patient is a candidate for these limited incision techniques depending on many factors, such as, skin quality and amount of tissue to be removed. Consultation with your Board Certified plastic surgeon would determine the appropriate incision for your situation.
Many surgeons will place a post surgical bra after your surgery, others will place a circular compression type bandage (i.e. ACE wrap), which may be used for several weeks after, while the breast is healing in its new form, size and position. Generally, one full week off from work is required. Exercise may be resumed anywhere from 2 to 6 weeks after surgery depending on many factors and to be determined by your plastic surgeon. Follow up office visits usually occur a few days after surgery, 1 to 2 weeks after surgery, 6 weeks after surgery and then every 3 to 6 months for one year or so.
As with any surgery there are risks and complications which can occur. A full consultation with your plastic surgeon should allow you the opportunity to learn about these risks before undergoing any surgical procedure.