Large breasts can be the source of problems in many aspects of a woman's life. Women with large, heavy breasts may have symptoms caused by the size, weight and position of the breasts. They may have back and neck pain, grooves in the shoulders from bra straps and rashes under the breasts due to moisture collection and heat. Some women with arthritic conditions of the back and shoulders may have more symptoms than usual because of the added weight and pull of the breasts. These symptoms may contribute to limited performance in certain occupations and in sports.
Some full-breasted women may appear heavier than they really are and may have difficulty obtaining stylish clothing. In some cases, it may even be difficult to find a properly fitting bra. Often, women with large breasts feel very self-conscious. Teenagers may not develop proper poise and posture as they try to hide the fullness of their breasts, a subject they may be unlikely to discuss freely with their parents.
Finally, large breasts may be difficult to assess for lumps or masses, thus making cancer detection much more difficult for the patient or for her physician. This may well be a source of further anxiety in a patient who is already embarrassed about her condi-tion. Breast reduction can eliminate or minimize these problems. Because of these medical problems, in many cases, medical insurance will cover the cost of breast reduction.
The goal of reduction mammoplasty is to reduce and recontour the breasts. The excess skin and tissue can be removed and the mounds reshaped into smaller, more attractive breasts. The procedure is performed in the ambulatory surgery unit or hospital under general anesthesia. The nipple areola complex is repositioned upward, and if indicated, reduced in size. Excess skin and breast tissue is removed from the lower and/or outside portion of the breast. A preoperative plan is made which allows both the surgeon and the patient to share in the decision as to the proposed size of the breast after surgery. The surgeon will attempt to make the breasts as identical as possible, but some asymmetry often remains. It is also not possible to pre-dict exactly how large the breasts will be after surgery, as there is some contraction, swelling and tissue reorganization after surgery. The incisions are designed so that the scars will not be visible with normal clothing. In time they fade and become less noticeable. Drains may be left in at the time of surgery and removed in a few days. The patient is usually up and about the day of or the day after surgery. With the advent of managed care, this surgery is performed more and more on an outpatient basis. Sutures are removed in approximately one week following surgery.
Potential complications include postoperative bleeding, infection and healing problems, which may result in heavy scars. When the nipple/areola complex is transferred to its new position, it may not 'take' or heal, and a portion or all of it may be lost. This is uncommon; smoking may contribute to this problem. As the nipple is repositioned with the breast tissue during the procedure, this can lead to disturbance of the superficial nerves to the nipple, and a decrease in sensation may occur. Ability to breast-feed will also be lost in most women undergoing this operation. Since these conditions are usually expected side effects of breast reduction surgery, a woman should consider these factors seriously before deciding to have the surgery. Although every attempt is made to obtain symmetry, there may be some irregularities in the size and shape of the breasts and in the position of the areola and nipple.
Most women report that their back and neck pain is reduced. They have fewer problems finding suitable clothes and are able to become more involved in sports. There is always a time of adjustment, and breast reduction usually results in the quickest body-image change. Therefore, most women need time to adjust to their new look. Most women are very pleased with the results.
*If you meet your insurance criteria, insurance companies may cover your procedure. You will need to see the physician for a consultation and notify your insurance for pre-authorization.
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