Breast Reduction (Mammaplasty)

Breast reduction or mammaplasty is a surgical procedure that is used to reduce the weight, mass and/or size of the breasts.

Frequently Asked Questions (FAQ’s)

The information presented below is only for informational purposes. Your surgeon will talk to you about details regarding your specific procedure.

Who is a candidate for a Breast Reduction?

Women who want to reduce the weight, mass or size of their breasts are good candidates for this procedure. In addition, they should be healthy, emotionally stable women who are realistic about the outcome of the surgery.

How is the procedure performed?

The exact process for a breast reduction will depend on the type of technique used. For instance, in the liposuction technique, small incisions are made within the natural fold underneath the breast or maybe on the outer side as well. Sometimes the tumescent technique is used where a solution of saline, Lidocaine and epinephrine (are injected into the targeted area. This technique's purpose is to engorge the tissues with the solution for a firmer working area and the fat cells, which are softer, are then suctioned out. The epinephrine prohibits bleeding during the operation and less blood is lost during the procedure.

There is also a liposuction technique which involves ultrasonic energy waves. These ultrasonic waves excite the tissues' water molecules and literally melt the fat into a liquid for ease of removal by suction. Unfortunately, each patient's molecules may react differently or in the case of unskilled surgeons, may improperly handle the equipment resulting in severe burns. In any case, the targeted breast tissue and fat is removed, sutures are sometimes used in the closure of incisions for the smaller, liposuction-assisted breast reduction and most certainly for the traditional breast reduction techniques. Then, a support garment or surgical bra is worn for proper, compact healing. A surgical or soft bra will be worn for several weeks both day and night.

What happens after surgery?

The patient may be placed in two bras as well as an Ace bandage. In some cases you may remove the top bra only and rewrap the breasts with the Ace bandage the day after surgery. Some patients are told not remove the Ace bandage or bra for 3 days. Patients may choose to wear the Ace bandage for up to 10 days if they find it to provide added comfort. Patients are usually instructed to wear their surgical bra for 21 days both day and night. The surgeon will provide specific instructions for you.

Some patients are instructed to ice continuously for the first 48 to 72 hours. If this is the case, you can put an ice bag over the breasts to maintain the coldness continuously. This will reduce any discomfort and swelling significantly. The pain connected with the procedure is minimal to moderate and is controlled with oral pain medication. Your surgeon will prescribe antibiotics that you should take for several days post-operatively to prevent infection. Instructions for the day and night after surgery include bed rest with limited activities. Your surgeon will determine when normal activities can be presumed at your post operative visits -- typically at 3 weeks. Strenuous activities and heavy lifting must be avoided for several weeks.

After a few weeks, you should notice a gradual reduction in discomfort. Sometimes swelling will increase over the first three days. Fever greater than 100.5 should be reported to your surgeon. Marked increases in tenderness after 48 hours along with redness may indicate an infection.

You may only sponge bath for the first 3 days after surgery as you must not get the bandage wet. You can remove the bra after 8 days but only to put on a fresh one. Replace the bra quickly after washing. After 14 days you can take a normal shower. Be sure to replace the bra immediately after showering or bathing.

You should be wearing your bra 24 hours a day for the first 3 weeks. After the 21 day period, the bra should be worn at least during the day time for 6 months. The tapes that are over the suture lines should not be removed as your surgeon will remove them in approximately 10-15 days.

Complications and slow healing are rare, however there are certain inherent risks connected with reduction mammoplasty which will be thoroughly discussed at your consultation. The risks and instances of slow healing are more significant in smokers.

When will I be able to see results?

You should notice the difference in breast volume immediately. After the swelling goes down, you will notice a difference in the compact appearance of your tissues.

When can I return to work?

Generally, most patients can return to work within 2 weeks, however you may still have some bruising for another week or so. Avoid bending over, lifting your arms over your hear or any exercise until 3-4 weeks after your surgery.

What are the risks of a Breast Reduction?

As with any type of surgery, there are certain risks that you should be aware of before undergoing this procedure. One of the main risks regarding this procedure involves the fat and its surrounding tissue potentially becoming necrotic (dead tissue). If the fat becomes necrotic from a lack of blood supply, the fat turns a certain color and then drains from the incision. If this occurs, you should have the tissue removed before a major infection develops.

With the ultrasonic technique, patients can sometimes receive actual burns, because the fat is actually melted within the body by “exciting” the fat molecules with high frequency radio waves and is then suctioned out. There can also be asymmetry, hyper-pigmentation from the bruising. Other major risks include blood loss, hematoma or an infection. Unfortunately, with a breast reduction, it may not be possible for you to breast feed, should you become pregnant after the procedure. However, you should discuss the specifics of this with your surgeon.