Breast Reduction

If you are wondering about Breast Reduction… Excessive breast size can cause a number of different medical problems, including neck and back pain, skin rashes and irritation, shoulder grooving from bra support straps, to breathing problems and issues with posture. In addition, there may be psychological issues with self-image and self-esteem that can make a woman feel self-conscious about their breasts. The breast reduction procedure is designed to alleviate these problems, providing physical relief whilst improving the aesthetic appearance of the breasts – making them lighter, firmer, and smaller in size. If you are wondering about breast reduction, this section will educate you with a basic understanding of the procedure itself, when to consider breast reduction, the manners in which it is performed, and the type of results that can be expected. If there is anything about breast reduction that you don’t understand after reviewing this article, please feel free to contact Dr. Hankins or Dr. Sohn directly for more information.

Who is a Good Candidate for Breast Reduction?

Breast reduction is an operation that is typically performed for relief of physical maladies brought on by large, pendulous breasts. These physical complaints often interfere with their daily activities, cause actual pain, and limit their ability to function normally. Typically, the procedure is not performed until the breasts are fully developed, however, in select cases it can be performed earlier if the breasts are severely interfering with lifestyle, or causing extreme physical discomfort. Regardless of the age that a patient is prior to a reduction, the best candidates are those individuals mature enough to understand the procedure, risks, and have realistic expectations about the postoperative result.

Risks of Breast Reduction

Breast reduction is a straightforward and safe procedure, and the doctors at Hankins & Sohn Plastic Surgery have an excellent track record of patient safety. However, as with any surgery, there are inherent risks. Risks include but are not limited to bleeding, infection, scarring, numbness, reaction to the anesthesia, wound healing problems, asymmetry, inability to breast-feed, and dissatisfaction with the postoperative size. These risks are real, but rare, and a further informed discussion of the risks and complications will be conducted prior to any planned surgery.

Planning Your Surgical Procedure

At Hankins and Sohn Plastic Surgery, we pride ourselves in our frank discussion with patients regarding surgical procedures, options, and the reality of the achievable postoperative result. During your consultation in our office, we will discuss your expectations of surgery, perform a thorough history examination, as well as perform a physical exam to discern any issues with your anatomy that may alter the surgical plan. Some of the physical concerns that can affect the end-result include the quality of skin, previous surgeries on the breasts, age, position and size of the nipple, and overall breast size and width. There are several options available in the technical types of breast reductions that can be performed. We will custom tailor the optimal procedures for you, to provide you with the optimal result.

Breast reductions are performed under general anesthesia, provided by our Board Certified Anesthesiologists. You will be asleep throughout the entire procedure. Surgeries are performed at Sunrise Hospital and Medical Center, Las Vegas Regional Surgery Center (Pecos and Flamingo) or at Flamingo Surgery Center (Eastern and Flamingo), by our Board Certified Plastic Surgeons, on an outpatient basis.

The costs involved with a Breast Reduction can often be mitigated through your insurance company. However, this may require that a certain minimum of breast tissue be removed at the time of surgery; your insurance policy may vary. A pre-authorization may be needed from your insurance company as well, prior to proceeding. Dr. Hankins and Dr. Sohn do not participate in any insurance plans, but do regularly perform surgeries for patients enrolled in these plans. You may have a higher deductible or copay as a result of using an out-of-network physician. Please discuss this further with one of our insurance specialists for further details.

Preparing For Your Surgery

Depending on your physical condition and medical history, you may be required to undergo a mammogram prior to breast reduction surgery, or undergo other testing such as electrocardiogram, chest x-rays, or other preoperative evaluation and/or clearance may be needed. Labwork will need to be drawn prior to surgery, to ensure that you are not anemic. Our staff will ensure that you receive proper instructions on how to prepare prior to surgery, including information on eating, drinking, smoking, medications/herbal supplements. As this is outpatient surgery, you will need to arrange for someone to drive you home after the procedure, and anticipate that you may need assistance at home for several days afterwards.

The Surgery

There are several prominent techniques for breast reduction, but the procedure most commonly performed by Dr. Hankins and Dr. Sohn is the Vertical or Short-Scar Technique. This involves the use of an incision around the areola, as well as an incision extending downward in a “lollipop” shaped scar. Very rarely, a full “anchor-pattern” incision will need to be used, which will add a horizontal incision in the breast fold. This may be necessary for extremely large breasts, in order to allow the physician to provide for a pleasing shape while removing enough breast tissue and skin to effect a positive change. Through these access incisions, Dr. Hankins or Dr. Sohn will remove excess fat, skin, and breast gland, while moving the nipple and areola up into a higher position. The skin will be redraped over the breast tissue, allowing improved shape and contour. Liposuction may also be utilized during the surgery to remove breast tissue from isolated areas, including the armpits or lateral breast. Almost all sutures used during surgery are dissolvable, so there are no stitches to remove afterwards.

Postoperative Expectations

After the procedure, you will be wrapped in an ACE wrap. Very rarely are any drains placed within the breast tissue, but if so, they are typically removed within the first 24-48 hours. You will feel some discomfort for the first several days, or even a week or more; this is certainly controllable with pain medications. You will follow-up in our office within the first 24-48 hours, to remove the bandage, inspect the suture lines, and you will be wrapped up again in a support bra. The bra will be worn 24-hours a day, except for hygiene, under the swelling resolves. You may have significant bruising and swelling after surgery. You can typically shower 24-48 hours after surgery. Be aware that you menstrual cycle may cause your breasts to become increasingly swollen and painful. You may experience some shooting pain over the next few months or a year or more. You can expect to lose some sensation in your nipples and breast skin. Much of this will resolve over time, but there is a risk of residual numbness that persists.

Getting Back to Normal

After the immediate postoperative period, you should avoid any heavy lifting for 4 weeks after surgery. We do encourage you to be lightly active, however. Most patients are able to return to work or their social schedule in about 2 weeks, but this is dependent on your activity levels. Exercise should be limited to stretching, bending, and light activity until your energy levels return and your stamina increases. During this period, you will need a good athletic bra for support. Sexual contact should be avoided for a period of 6 weeks after surgery, as arousal may cause your incisions to swell, and there may be increased and painful sensitivity to the breasts during this period of time. Crusting, or small drainage from the incisions is normal after surgery, however, if you have any unusual symptoms such as increased or severe pain, bleeding, abnormal swelling, do not hesitate to contact the doctors for evaluation.

The New You!

The majority of the soft tissue swelling and ecchymosis (bruising) will be improved within the first few weeks, however, it may be up to twelve months before your breasts settle into their final expected shape. Even after this period of time, the shape of the breasts can still fluctuate in response to changes in your weight, pregnancy, or hormones. Hopefully your back or neck pain, or other physical complaints will be improved after the surgery. Although we try to hide the scars in as inconspicuous a position as possible, the scars are permanent, and may remain red and visible for a year or more. Eventually, as the scars mature, they become less noticeable. Patients are often very pleased with the improvements attained via breast reduction surgery. Not only will you look better in your clothes, you will have improved proportion and shape. Most importantly, be patient with the process of healing, and give yourself the time you need to acclimate to the New You!