Breast reduction is a procedure in which excess tissue is removed to make the breast smaller and less heavy. Women who consider this procedure are those who suffer from back and neck pain, grooves in the shoulders from bra straps, pain in the breasts, and rashes that are caused by heavy breasts.

The procedure is usually performed in an outpatient surgical center, either operated by your surgeon or a hospital facility, and takes 2 – 4 hours, but depending on the extent of the procedure, it can take longer. If you are having more than one procedure, overnight hospitalization may be required.

Techniques for breast reduction vary, but 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. Incisions outline the area of skin, breast tissue, and fat to be removed and also outline the new position for the nipple. 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 areola 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.) Thesurgeon removes excess glandular tissue, fat, and skin, and moves the nipple and areola into their new position. Liposuction may be used to remove excess fat from the armpit area. Skin formerly located above the nipple is brought down and together to reshape the breast. Sutures close the incisions, giving the breast it’s new contour.

Stitches are usually located around the areola, in a vertical line extending downward, and along the lower crease of the breast. Scars around the areola, below it, and in the crease under the breast are permanent. In some cases, techniques can be used that eliminate the vertical part of the scar. Occasionally, when only fat needs to be removed, liposuction alone can be used to reduce breast size, leaving minimal or no scaring.

After surgery, you will 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. The extent of the post-operative swelling and bruising is dependent on whether you tend to bruise or swell easily. The amount you can expect varies for each individual but past surgeries or injuries should be a good indication. Applying cold compresses, or ice packs will reduce swelling and relieve discomfort. Many patients use a water-tight plastic sandwich bag filled with frozen berries or peas. Regular icing is the key to relieving swelling.

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

Sometimes the surgeon will use only dissolvable sutures. If breast skin is very dry following surgery, moisturizer can be applied several times a day, but the suture area must be kept dry at all times.

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