How is breast reduction performed?
Many techniques have been described to perform breast reduction. Each of the techniques has its limitation and associated complications. We mainly use three techniques that are time-tested, produce more consistent results, and associated with fewer complications.
All techniques reduce the size of the breast, lift the nipple to a higher position, and reduce the size of the areola (pigmented area around the nipple). Our goal in breast reduction is to form a smaller breast that is appropriate in shape and size relative to the dimensions of your chest. We prefer to perform breast reductions under general anesthesia. In some patients, sedation and local anesthesia may be considered.
1. Inverted T method (technically known as an Inferior Pedicle or Wise Pattern breast reduction) is the most commonly used method for breast reduction in our practice. This procedure results in a vertical and horizontal scar. The horizontal scar is hidden under the breast. The areola is usually enlarged in women with large breasts. The size of the areola is reduced during breast reduction resulting in a scar around the areola. The scars are usually hidden within a bra.
2. Some patients with smaller breasts may be candidates for a Vertical Reduction Technique which avoids a horizontal scar at the bottom of the breast. There will be a vertical scar and a scar around the areola (pigmented area around the nipple).
Following the Inverted T technique or Vertical Breast Reduction, breast feeding may or may not be possible. In some patients nipple/areola sensation is unchanged, yet in other patients it may be diminished or completely absent following surgery.
These sensory changes when occur can be temporary or permanent. We cannot predict who will experience an inability to breast feed or sensory changes following surgery.
Certain women with large breast report diminished nipple sensation before surgery. This is likely related to nerve stretching by the heavy weight of the breast. Some of these patients notice improved nipple sensation following breast reduction using Inverted T or Vertical breast reduction technique.
3. Free Nipple Breast Reduction technique is used for patients with very large breast. This technique involves removing the nipple and areola as one complex. The breast is reduced and the nipple/areola complex is then sutured as a graft to the breast in a higher position. This technique results in a horizontal scar at bottom of the breast and a scar around the areola. Women will not be able to breast feed and will have nipple/areola numbness following this procedure, which are likely to be permanent.
What should I expect during my consultation?
During your consultation, we will perform a thorough examination and measurements of your breasts. Together we will choose the safest technique that would work best for you.
New position for the nipple/areola and position of the incisions will drawn for you on your photographs. We will discuss in detail the anticipated outcome, possible complications, and what to do to prepare for surgery.
What is recovery like after a breast reduction?
You will have a small drainage tube the side of the breasts. Those will be removed usually within 7 days. We use absorbable sutures that do not need to be removed.
Within the next several weeks, most swelling and bruising will resolve. You will notice that the breasts assume a more natural shape over the first couple of months after surgery.