Details of a Breast Reduction Procedure
Breast Reduction surgery is one of the most common operations performed by plastic surgeons. Some of the problems experienced by patients seeking this operation include back pain, neck pain, deep grooves from their bra straps, and rashes under the breasts. The primary goal of breast reduction surgery is to reduce the overall size of the breast so patients experience symptom relief. Most patients are also satisfied with the shape and appearance of their breasts following surgery.
During the consultation, Dr. Andrade will examine and measure the breasts, take preoperative photos, and provide a detailed discussion of the operation, healing time, risks and benefits. This procedure may be covered by OHIP insurance depending on the overall preoperative size of a patient’s breasts and the degree of symptoms experienced. It is necessary to submit a form to OHIP requesting approval for surgery prior to actually booking the operation. Dr. Andrade recommends that patients aged 50 or older have a mammogram prior to surgery, as per Ontario Guidelines for Breast Cancer Screening (some patients will have a mammogram or other diagnostic tests earlier depending on their risk of breast cancer).
For a good overview of breast reduction surgery written in layperson’s language, click on the Wikipedia link here.
Many different breast reduction techniques are used by plastic surgeons. Dr. Andrade is familiar with several different operations but for most patients a vertical breast reduction is performed. Advantages of this technique include shorter scars, good shape and projection of the breast, and shorter operative time. Disadvantages include the inability to remove as much tissue as other more extensive breast reduction techniques. If patients are seeking to remove as much breast skin and tissue as possible, an inverted-T or Robbins breast reduction may be a better option. For most cases, hidden dissolving sutures are used and wound drains are not required. This greatly simplifies the postoperative care because there is no need for the removal of drains, stitches or staples. If you would like to see an animated video from the ASPS explaining breast reduction surgery, click here.
Day of Surgery
Breast reduction surgery is performed in Newmarket at Southlake Regional Health Centre. The operation takes approximately 1.5 – 3 hours depending on the size of the breasts and technique used. It performed under general anesthetic with the person fully asleep. An overnight stay may be required for certain patients, such as those with multiple medical problems. However, the majority of patients are able to go home the same day. Patients who live out of the region (greater than a 30 minute drive from Southlake Hospital) should stay overnight locally with a relative or in a nearby hotel with another responsible adult, in they require urgent assessment postoperatively.
All patients need to purchase a special surgical bra without any wires, and clasps on the front and on the straps. This is for comfort and safety since this type of bra can be applied after the operation without having to lift the sleeping patient off the operating room table. The bra can be purchased at the office or elsewhere provided it meets all the requirements.
The postoperative care required after breast reduction surgery is usually very straightforward. Most patients are doing their own self-care and other their light activities the day after surgery. The dressings applied in hospital are left intact for 48 hours postoperatively, then showering is permitted. Tapes (Steri-Strips) are adherent to the skin and seal off the wound. They usually remain attached for at least 10-14 days, after which time they may be removed. Patients should wear a supportive bra and avoid heavy lifting or vigorous excercise involving the chest muscles for 4-6 weeks following surgery. A scar reduction program will be prescribed by Dr. Andrade. Scar generally fade for 12-18 months after surgery.
Benefits and Risks of Surgery
Numerous published scientific studies have confirmed the benefits of breast reduction surgery including the positive impact on a patient’s overall health and functioning. Most patients are also happier with the appearance of their breasts.
While good results are usually achieved and complications are uncommon, it is important to understand the risks associated with breast reduction surgery. Potential problems in the immediate postoperative period include significant bleeding requiring surgery (and possibly transfusion), infection, wound healing problems, or loss (necrosis) of the areola. Long-term problems include chronic pain or numbness, asymmetry, puckering or irregularities of the breast or nipple area, or prominent scars. Rarely, life-threatening complications can arise during or after any operation. Dr. Andrade will discuss other specific risks and answer any questions during the consultation.
In Ontario, breast reduction surgery is often a medically insured service that is covered by OHIP. It is important to realize that if you are dissatisfied with the outcome due to the scars or shape of the breasts, OHIP will not cover further surgery that is of a purely cosmetic nature.
Common Questions on Breast Reduction Procedures
Can I have other operations performed at the same time as my breast reduction surgery?
Patients often request to have cosmetic surgery operations performed at the same time as their breast reduction surgery to take advantage of the cost savings and less downtime from work.
The most common surgery performed by Dr. Andrade in conjunction with breast reduction, is liposuction to reduce the rolls of fatty tissue that extend from the lateral aspect of breast under the armpit. Certain patients do not like the appearance of these rolls, and others are bothered rubbing of the arm against the rolls. Liposuction is performed by inserting a long thin tube through the incisions made for the breast reduction procedure, so no additional incisions are required in the armpit area. This procedure is not part of a standard breast reduction operation and extra surgical fees apply. A written quote will be provided by Dr. Andrade at your request.
Another common combined procedure is breast reduction plus tummy tuck surgery (abdominoplasty). If you are interested in learning more about this or other operations, simply ask Dr. Andrade during your consultation for breast reduction surgery.
How much smaller will my breasts be after surgery?
Patients think about their breast size in terms of bra cup size, but unfortunately bra cup sizes are not standardized across different bra manufacturers. Cup size does not correspond to an exact breast size so it is difficult to predict what cup size a patient will wear following surgery. The amount of tissue that can be safely removed is determined by Dr. Andrade during the procedure. A certain amount of tissue must be left behind in order to rebuild a breast mound with a normal shape. Surgeons measure the amount of breast tissue removed by weight, not by volume (i.e. bra cup size). For the “average” patient seeking breast reduction surgery, the amount of breast tissue removed from each breast may be in the range of 350-500g (about 1 pound per breast). It can be significantly more or less depending on the size of the breasts prior to surgery.
I am thinking about having children in the future. Will I still be able to breastfeed?
During breast reduction surgery, much of the glandular tissue that makes breast milk is removed. Since part of the breast tissue deep to the areola is left intact it is still possible for some patients to breastfeed. However, if being able to breastfeed is important to you, it is prudent to wait until you have children before having the operation.