Large breasts may cause significant discomfort (especially from the pressure of bra straps on their shoulders), result in changes in posture, interfere with physical activities, and make it difficult to find clothes that fit properly. Women with unusually large, sagging, or uneven breasts may be helped through breast reduction surgery, reducing their discomfort and giving them the confidence they need to live a more carefree life.
A breast reduction surgery involves the removal of extra breast fat, skin, and glandular tissue.
The typical breast reduction technique is performed by making an incision around the areola. The incision is extended downward to the base of the breast where it joins with a horizontal incision in the crease. The incision below the areola forms an upside-down T.
Another method of breast reduction is vertical mammoplasty. A vertical mammoplasty is the best way, in Dr. English’s opinion, to lift and/or reduce a breast with less scarring while achieving a more aesthetically pleasing outcome. This style of procedure was and has been championed by female breast surgeons for these very reasons. The traditional techniques usually left a large “boat anchor” scar on each breast while this newer procedure leaves, in the majority of cases, a “lollipop” scar. This translates to approximately nine to 12 inches of incisional scar left off of each breast when utilizing the vertical mammoplasty technique. At English Plastic and Cosmetic Surgery Center, Dr. English has used this type of procedure almost exclusively for the past several years and has found the long-term results and patient satisfaction much improved. The trade-off is that the breasts may look distorted early on while the swelling subsides and the incisions heal. This usually lasts several days to a few weeks. However, patients are willing to accept this inconvenience in order to limit their length of scars and obtain a more natural appearance.
When this surgery is performed, two things are accomplished. The first is that loose breast skin is removed. The second and most important step is that the internal breast tissue is “remodeled” into a better shape. This allows the breasts to take on a much more youthful appearance with a tighter skin envelope. Whether the patient is looking for a smaller breast or a less saggy one, the results produced are better, in Dr. English’s opinion.
The elevated and remodeled breasts following this procedure can be augmented at a later date if desired. The reason that the two procedures are not performed at the same time has to do with the amount of skin removed. If you place an implant within the breast at the same time the lift is performed, less skin is removed, and this will ultimately compromise the overall results. Many of our patients are happy with their vertical mammoplasty results, not wanting breast implants after seeing their surgical results.
If reduction is the goal, this procedure produces a more conical and youthful breast post-operatively than the more traditional techniques. With the “boat anchor” scar technique, the breasts can look more elevated and smaller at one year post-operatively but can also look flattened and “bottomed out”. Again, this is another reason why this vertical style of reduction is much more appreciated today because of the more coned shaped and youthful breasts achieved following this newer technique.
During your initial consultation, Dr. English will examine your breasts and discuss your desired results. He will also review your medical history and lifestyle choices while conducting a physical exam to determine your skin quality, elasticity, and thickness for optimal results. You may be a candidate for breast reduction surgery if you:
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are a woman of adult age who has a fully developed bosom;
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are in good physical (at or near your ideal weight, without dramatic fluctuations in weight) and mental health, with good elasticity of the skin;
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do not anticipate breastfeeding in the future (because significant amounts of breast tissue are removed, breast reduction may impair the ability to breastfeed);
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are a non-smoker or committed to refraining from smoking;
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have realistic expectations of the outcome of your surgery; and
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understand the recovery process.
Following a breast reduction, Dr. English will apply a light dressing over top of your incisions. You might notice some light swelling and moderate discomfort, both of which can be controlled with an over-the-counter medication such as ibuprofen. Dr. English may also advise you to keep your stitches very clean, and will provide you with specific instructions for doing so.
Most of our vertical breast reduction patients are ready to return to work after about 7 - 10 days.