Patients with large breasts often cite back pain, neck pain, inability to run or play tennis, social embarrassment and poor clothing fit as their reasons for choosing breast reduction. Women, as well as men who suffer from gynecomastia, typically report a sense of freedom, lightness and improved confidence after having the procedure with Dr. Donaldson at Donaldson Plastic Surgery.
What is Breast Reduction?
Breast reduction, also known as reduction mammaplasty, is a surgical procedure for reducing the size of large breasts. It removes excess breast fat, skin, and glandular tissue to create a breast size that is in proportion with the body and alleviates the discomfort often associated with overly large breasts. Breast reductions can also be performed in conjunction with a breast lift or as a surgical solution for gynecomastia.
Is Breast Reduction Surgery Right For You?
Breast reduction can help heal patients physically and psychologically, as the procedure tends to decrease pain, improve mobility and enhance self-esteem. Several scientific papers report overall improvement in “quality of life” among large-breasted individuals who undertake breast reduction. You may be a good candidate for the procedure if:
- You are generally physically healthy
- Your breasts are fully developed
- Your expectations are realistic
- You do not smoke
- You breasts limit your physical activities or social engagement
- You feel that your breasts are too large or pendulous
- The weight of your breasts causes back, neck, or shoulder pain
- You regularly get indentations from bra straps supporting your large breasts
- Your breasts have stretched skin and hang low
- Your nipples are below the breast crease when your breasts are unsupported
- Your areolas are enlarged due to stretched skin
- You often have skin irritation beneath the breast crease
If you can identify with any combination of these descriptors, your next step may be scheduling a consultation for breast reduction surgery.
What Should I Expect During My Breast Reduction Consultation?
Dr. Donaldson will ask about your aspirations, lifestyle, and health. Together you will decide your optimal breast size as well as any other improvements that can be made during your breast reduction surgery. Come into your consultation prepared to discuss:
- Your reasons for surgery, your desired outcome, and your expectations
- Any medical conditions, including drug allergies and medical treatments
- You current medications, vitamins, and herbal supplements
- Your use of alcohol, tobacco, and drugs
- Any previous surgeries
- Your family history of breast cancer and personal history of mammograms, ultrasounds, MRI’s or previous breast biopsies
Dr. Donaldson may also talk to you about any emotional issues you have dealt with relating to your breasts and whether your breasts physically limit you. He will take measurements and photographs, and discuss how much tissue, fat, and skin will need to be removed to achieve your goal. He will describe the surgical technique and typical scars. Lastly, Dr. Donaldson will provide you with specific information about how to prepare for your surgery, which may include referrals for imaging, or stopping certain medications or habits.
The consultation also provides the perfect opportunity to discuss your fears and concerns with Dr. Donaldson, and to ask any questions you may have related to the surgery.
What Questions Should I Ask My Surgeon About Breast Reduction?
It is important for you to actively participate in your surgical plan. Here are some questions that should hopefully be answered during your consultation:
- Do you think I’m a good candidate for this procedure?
- What will I be expected to do to achieve the best results?
- What surgical technique do you recommend for me?
- What will my recovery be like?
- What are the risks and complications of this procedure and how are they handled?
- Will I still be able to breastfeed?
- How will my breasts look over time?
- Do you have a gallery of before and after photos for this procedure that I can look at?
- What are my options if I’m unhappy with the outcome?
This list is incomplete, and not necessarily specific to your individual needs. After some research, you will identify the informational categories that seem most important. Some patients come prepared with a list of topics or questions so they don’t forget anything!
How Should I Prepare For My Breast Reduction Procedure?
Many patients want to know more about how they can best prepare for breast reduction. Although Dr. Donaldson will provide you with specific recommendations and instructions, prior to your surgery, you may be asked to:
- Undergo lab tests or a medical evaluation
- Adjust your current medications or begin taking certain medications
- Get a mammogram
- Stop smoking, usually at least two to four weeks before the procedure
- Avoid taking aspirin, herbal supplements, and anti-inflammatory drugs, which may increase bleeding
It is important to prepare for your recovery so that you are not scrambling to make arrangements after surgery. You will need a driver to and from surgery, as well as someone nearby for the first 24-48 hours after surgery.
You will also want to get your home ready for your recovery, and have some of the following things on hand:
- Lots of ice
- Clean washcloths, gauze, and towels
- Comfortable, loose t-shirts and tops
- Any recommended special ointments or creams for bruising and incision sites
Dr. Donaldson and his staff will explain any other specific instructions or materials that may be necessary for your recovery.
Are There Any Risks With Breast Reduction?
Although complications stemming from breast reduction surgery are typically fairly rare, they do exist, as with any major surgery. During your consultation, Dr. Donaldson will highlight the most common risks which may include:
- Prominent scarring
- Changes in breast or nipple sensation
- Anesthesia complications
- Blood clots
- Breast contour and shape irregularities
- Breast asymmetry
- Potential inability to breastfeed
- Fluid accumulation
- Allergies to tape, glues, suture materials, or injectable agents
- Possibility of revision surgery
It is important to consider pregnancy status and planning, tattoo locations, nipple piercings and other breast conditions in advance.
About the Breast Reduction Procedure
Dr. Donaldson performs breast reduction surgery under general anesthesia. This means that you will be asleep for the surgery, which usually lasts between two and three hours.
There are three primary options for incisions, all of which involve cutting around the pigmented area or nipple-areolar complex (NAC). Dr. Donaldson will recommend the best choice for you. Incision options include:
- A circular pattern around the areola, where the incision lines can usually be concealed beneath a bra or swimsuit
- A keyhole-shaped pattern, with an incision around the areola and down to the breast crease
- An anchor-shaped or inverted T shaped incision
Throughout the surgery, the nipple remains tethered to its original nerve and blood supply. After the incision is made, the nipple is then repositioned. If necessary, the areola is reduced by excising skin at the perimeter.
Underlying breast tissue is then reduced, lifted, and shaped. Occasionally, if breasts are extremely large and pendulous, the areola and nipple may need to be removed and replaced to a higher position on the breast. This is known as a free nipple graft.
After this, Dr. Donaldson will then close your incisions. Bringing the incisions together reshapes the new, smaller breast. Sutures are layered deep to superficial in order to create and support the new breasts. All sutures are dissolvable under the skin, and a final layer of skin adhesive (surgical-grade super glue) is used to protect the skin. These incision lines become permanent scars, but they usually fade and improve over time.
Although the steps listed above describe the typical breast reduction procedure, there are exceptions. In some cases, excess fat may also be removed through liposuction — particularly to the sides of the breasts, under the armpits.
What Will Breast Reduction Recovery Be Like?
After your surgery, your incisions will be covered with light dressings and a supportive sports-style bra that detaches in front. This bra is worn during recovery to minimize swelling, support the breasts as they heal, and hold breasts symmetrically during the healing process without an irritating underwire.
Dr. Donaldson will prescribe pain medication to minimize discomfort, as well as provide you with specific post-operative instructions. His staff will assist you in coordinating follow-up appointments. Typically, you can resume your normal activities within 1-2 weeks and rigorous athletics within 4-6 weeks. Scars should fade within 6-12 months.
Why Should I Choose Dr. Donaldson?
Patients throughout Ohio and across the country have trusted Dr. Donaldson to help them look and feel their best. In addition to being board certified by the American Board of Plastic Surgery, a member of the American Society for Aesthetic Plastic Surgery, and a member of the American Society of Plastic Surgeons, Dr. Donaldson has received many accolades and awards. Recent honors include Columbus’ “Forty Under 40”, one of America’s Top Plastic Surgeons, and one of America’s Most Compassionate Doctors.
Schedule a Breast Reduction Consultation
Take the first step by scheduling your consultation today and learning how you can change your life with a breast reduction. Columbus, Ohio residents continue to recommend the personalized care and comfort they receive from Dr. Donaldson and his staff at Donaldson Plastic Surgery. Call us now to find out more.