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Breast Reduction

Breast Reduction Surgery

Breast reduction surgery, also known as reduction mammaplasty, is a plastic surgery procedure designed to reduce the size of the breasts while providing a cosmetic pleasing size and shape. Both men and woman seek breast reduction surgery for a number of reasons.

For woman excessively large breasts may cause symptoms of back pain, shoulder pain, and neck pain, as well as bra strap grooving and skin irritation. Teenage women may feel self conscious and socially inhibited by their unusually large breasts. Some women may feel the need to hide the size of their breasts and may choose clothing to hide their appearance. Some women are prevented from participating in exercise or are physically inactive due to the large size of their breasts. Breast reduction surgery may also be performed solely for cosmetic reasons for women who desire a smaller, more proportioned breast, or a breast lift.

Men typically seek breast reduction surgery for a condition known a gynecomastia, which is enlargement of the breasts in males. This can occur due to hormonal abnormalities or with massive weight gain. Men desiring breast reduction surgery typically desire a more contoured, male appearing chest and pectoral area.

Optimal Candidates for Breast Reduction Surgery

Breast Reduction surgery is performed for both relief of physical symptoms and for cosmetic improvement of the breasts. The procedure is designed to remove excess breast tissue, excess skin, and raise the nipple and areola. Many women have tried to relieve their symptoms with over the counter medications or physical therapy. When these non-surgical methods fail to provide relief surgical treatment may be necessary. Common symptoms prompting breast reduction surgery include:

  • Breast pain
  • Long term back, neck, or shoulder pain
  • Shoulder grooving and skin irritation caused by bra straps
  • Skin rashes under the breasts
  • Numbness of the upper extremities
  • Poor posture
  • Headaches
  • Weight gain due to the inability to participate in exercise
  • Undesired attention
  • Difficulty in finding proper fitting clothes or bras

Candidates for breast reduction surgery should also have a thorough understanding of the procedure as well as realistic expectations. Candidates must be relatively healthy and mentally fit for the operation.

Consultation with Dr. Zemmel

Dr. Neil J. Zemmel will initially see you in consultation for an initial evaluation. He will assess your goals and desires. Dr. Zemmel believes safety is the number one priority, and each patient will undergo a complete history and physical before surgery. He will discuss your symptoms due to large breasts as well as review your medical history and any medications you may take.

Dr. Zemmel will then perform a physical examination and take measurements of the breast that will include:

  • Your initial bra cup size
  • Your height and weight
  • The size of your rib cage
  • The overall shape of the breasts
  • The strength and elasticity of the skin
  • The shape and size of your areola and nipple

Based on his findings, Dr. Zemmel will then recommend a procedure to fit your needs and desires. The different techniques recommended are based on how much excess skin and breast need to be removed.

Vertical Breast Reduction

breast-red2If a moderate level of skin and breast tissue needs to be removed, then a vertical breast reduction may be performed. This technique uses an incision around the areola and nipple and down the center of the breast, taking a “lollipop” shape.

Wise Pattern Breast Reduction

breast-reductionIf a large amount of skin and breast need to be removed, then an inferior pedicle Wise pattern breast reduction may be offered. This procedure uses and incision around the nipple and areola, an incision down the center of the breast, as well as a horizontal incision under the breast fold. The final incision takes the shape of an “anchor.”

Liposuction Breast Reduction

Liposuction breast reduction is used in women and men with breasts that are not as large and do not require a removal of large amounts of skin. Patients who are a higher risk for anesthesia also may be candidates. The result is not as dramatic as other excisional techniques, but it liposuction gives a much quicker healing time and little scarring. This is a technique typically used in conjunction with some direct excision of dense tissue for male gynecomastia surgery.

Risks of Breast Reduction Surgery

Breast reduction surgery is a complex procedure that has inherent risks. When performed by a Board Certified Plastic Surgeon it is usually safe. However, all surgical procedures are subject to complications including but not limited to infection, excessive scarring, and bleeding. Other rare complications occurring with breast reduction surgery include loss of nipple sensation, skin and nipple-areola loss, asymmetry, inability to breast, hypertrophic scarring, and breast tissue necrosis.

Dr. Zemmel will discuss the entire procedure in great detail during your consultations. Please write down any questions you may have and he will be happy to answer them for you.

Recovery After Surgery

Dr. Zemmel typically admits his breast reduction patients overnight in the hospital. You will be able to rest comfortably in the hospital overnight. This allows the patient to have IV pain medicines and medication for nausea if needed. Dr. Zemmel will then see you the following morning and discharge you. A follow up appointment is made 1 week later.

Most patients experience some pain after surgery. The discomfort is typically soreness and tightness and is easily controlled with pain medicine by mouth. After 1 week the swelling begins to resolve and you can perform your activities of daily living. Dr. Zemmel will assess your progress and increase your activity level gradually over the next 2 to 3 weeks. Normal physical activity resumes in 3 to 4 weeks.

Insurance Coverage

Most major health insurance carriers cover breast reduction surgery for medical reasons. Patients must have the symptoms listed above. Furthermore, the amount of tissue removed must meet certain criteria for each insurance carrier. Dr. Zemmel will assist you in obtaining insurance pre-authorization if you are a good candidate for a medically necessary breast reduction.

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