Breast Reduction (Reduction Mammaplasty)
Large breasts can cause pain, improper posture, rashes, breathing problems, skeletal deformities, and low self-esteem. Breast reduction surgery is usually done to provide relief from these symptoms. Performed under general anesthesia, the two- to four-hour procedure removes fat and glandular tissue and tightens skin to produce smaller, lighter breasts that are in a healthier proportion to the rest of the body.
Breast reduction surgery is not recommended for women who intend to breast-feed, since many of the milk ducts leading to the nipples are removed.
Breast Reduction Procedure
During the breast reduction procedure an anchor-shaped incision is made from the new location of the nipple down to and around the crease beneath the breast. The surgeon removes excess glandular tissue, fat, and skin, relocates the nipple and areola, and reshapes the breast using skin from around the areola before closing the incisions with stitches. Liposuction may be needed to remove excess fat from the armpit area, and in cases when only fat needs to be removed from the breasts, liposuction alone is used for breast reduction.
Recovery from Breast Reduction Surgery
For a few days after surgery the breasts are bound with an elastic bandage or a surgical bra and you may be given surgical drainage tubes for fluid removal. Stitches come out in a week and the surgical bra must be worn for about a month.
A little pain is normal after breast reduction, whether it's mild discomfort, swelling during menstruation, a measure of numbness or sensitivity, or random, shooting pains that may last for a few months. Swelling, bruising, crusting and slight changes in breast size are also common. Most patients return to work in about two weeks, although you should avoid heavy lifting for three to four and only gentle contact with the breasts should occur for six weeks.
Scars fade with time but will not disappear, although they can be hidden with a bra, bathing suit or low-cut top.
Risks of Breast Reduction
Risks are rare and usually minor but may include bleeding, infection, reaction to the anesthesia, small sores around the nipples, slightly mismatched breasts or unevenly positioned nipples, and permanent loss of feeling in the nipple or breast.
Gynecomastia, which is the overdevelopment of male breasts, affects an estimated 40 to 60 percent of men. It can be the result of hormonal imbalance, obesity, certain drugs or heredity, and can affect one or both breasts.
Candidates for breast reduction are men who have large or sagging breasts that make them feel physically and/or emotionally uncomfortable. Breast reduction can be performed on men whose breast development is complete; are in good health, both physically and emotionally; do not smoke; and are not overweight. Ideally, candidates have firm, elastic skin that will reshape itself to fit the contours of their breasts postsurgery.
Male Breast Reduction Procedure
Male breast reduction is usually performed under general anesthesia on an outpatient basis, and typically takes 1 to 3 hours. Male breast reduction is performed using liposuction or surgery, or a combination of the two.
If the enlarged breasts are caused primarily by excessive fatty tissue, the tissue is typically removed with liposuction, during which a cannula (a thin, hollow tube) is inserted through extremely small incisions, and then moved back and forth to loosen excess fat, which is suctioned out using a vacuum or a cannula-attached syringe. The incisions are made around the lower halves of the areolas or in the underarms.
If the enlarged breasts are caused primarily by excess glandular tissue, surgery is required. Incisions are made to allow for tissue to be removed. Repositioning the areolas/nipples and excising excess skin also requires incisions. Sutures are used to close the incisions, which are then bandaged, and the area is typically covered by a compression garment.
Recovery from Male Breast Reduction Surgery
Following male breast reduction surgery, there is bruising, swelling and discomfort. Discomfort usually dissipates after a few days, and can be lessened with prescribed pain medication. To help reduce swelling, the compression garment is worn for about 2 weeks, and at night for several additional weeks. Swelling and any skin discoloration partially subside after 1 or 2 weeks, at which time stitches are removed.
Patients typically return to work within a week. Light aerobic exercise can be performed after a week, but strenuous activities should be avoided for 4 to 6 weeks.
Risks of Male Breast Reduction
In addition to the risks associated with surgery and anesthesia, those related to male breast reduction include the following:
- Skin injury
- Loss of nipple sensation
- Asymmetrical breasts or nipples
The results of gynecomastia surgery are usually permanent, as long as the patient's weight remains stable. If drugs were the cause of the condition, the patient must permanently stop taking them to maintain results.