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Breast Reduction Surgery


Although very different from one another, women share a mix of medical problems and cosmetic concerns that lead them, and thousands of other women across the country, to undergo breast reduction surgery.
In some women, breast examination and mammography may be easier to perform after reduction.

Patricia McGuire, M.D., a board-certified plastic and reconstructive surgeon on staff at Parkcrest Surgical in St. Louis, says she prefers not to perform breast reduction on women who are heavy smokers because of a loss of blood supply, or on those with diabetes, since they may not heal well. Also, if a woman is really overweight, I encourage her to get her weight down first. This is particularly a problem with teens with large breasts, since they may try to gain weight so that their bodies look more balanced.

Both physicians believe it is best to wait until a young woman's breasts are fully grown, usually by age 18, before doing a reduction. The procedure is not recommended for women who intend to breast-feed, according to the American Society of Plastic and Reconstructive Surgeons.

During the initial consultation, the surgeon explains the surgery in detail, including risks, limitations and scarring, which is an inevitable consequence of the procedure. The surgeon also discusses where the surgery will take place, how long the woman will remain in the facility, any steps that need to be taken preoperatively, and what to expect postoperatively. Any questions a woman has are answered at this time.

In preparation for surgery, the woman has a complete physical examination. The surgeon measures the woman's breasts and usually photographs them for reference during surgery and afterwards. These photographs can also serve as documentation for insurance purposes.

Unlike a rhinoplasty (nose reduction), in which computer imaging may be used to show a prospective patient what her nose is likely to look like after surgery, the new breast size and shape, as well as positioning of the nipple and areola (the darker skin around the nipple), are usually determined during a discussion between the physician and patient.

Most surgeons provide guidelines for eating, drinking, smoking, taking medication, and other activities before surgery. Generally, the patient should not take aspirin or similar medications for a week or two before surgery, since these medications may lead to increased bleeding. Some physicians suggest women take 1,000 milligrams of vitamin C daily to promote healing, but avoid vitamin E supplements, which may also lead to increased bleeding.

If a patient smokes, she may be advised to stop. This is always a good idea, but it's especially important when general anesthesia is used, since smoking limits the amount of oxygen the body has available during surgery and recovery.

Because the size, shape, and amount of tissue in the breast will change after reduction, most women are advised to have a preoperative mammogram and a postoperative mammogram six months to a year after surgery for comparison.

According to the American Society of Plastic and Reconstructive Surgeons, the first menstruation following surgery may cause breasts to swell and hurt, and the woman may also experience shooting pains in her breasts for several months. Patients may be advised to avoid sex for a week or so to avoid arousal that can cause the incisions to swell.

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