Breast Reduction (Reduction Mammoplasty) and Breast Lift (Mastopexy)
Breast reductions are very popular surgical procedures. Women seeking this procedure perceive themselves as having large breasts. Reasons for desiring a breast reduction are personal and various, but here are some of the more common reasons for desiring the procedure:
It is important to realize that all women have some degree of asymmetry with respect to:
Some degree of breast asymmetry will persist after your surgery no matter how carefully the surgery is done as precise measurements and excision of the redundant tissue is possible.
Breast reductions are performed in a local hospital setting for insurance covered procedures, and in private surgical facilities for uninsured procedures. Breast lift procedures are generally performed in private surgical facilities, as they are rarely insurance covered procedures. In all cases, the patient should be accompanied home following surgery, and monitored for a night following surgery.
CONTRAINDICATIONS (some may be relative)
Prior to any body contouring procedure, it is important to take appropriate preparations to increase safety, and maximize the benefits of the procedure. Patients should not take anti-inflammatory drugs such as Aspirin®, Motrin®, Ibuprophen, or Advil®, due to their effects on the body's blood clotting, for at least two weeks prior to surgery. Tylenol ES®, is a painkiller that can be used for those who suffer from chronic pain. Any use of herbal supplements or other alternative medicine should be discussed with your surgeon. Finally, alcohol should be avoided for at least a week prior to the surgery date.
There has been much debate over the ideal method of reducing unwanted breast tissue and providing a predictable and sustainable shape with the least conspicuous scars. Even today, many debates persist over whether reductions using the most commonly performed Wise-pattern (anchor) incisions are to be eventually replaced in favour by vertical reduction patterns. Other still have designs on eliminating the vertical scar portion on the breast, leaving only the scar in the breast fold. These debates exist because there is no perfect solution.
There are several methods of accomplishing the latter, which include:
A variety of factors related to you the patient (i.e. age, degree of ptosis, size of breasts, etc.) determine which method will be implemented. As there are proponents of each technique, I think it is fair to say that they all produce comparable results. Although many skin patterns have been described, most surgeons prefer to use one pattern in the majority of cases. The most commonly used Wise or "keyhole" pattern of skin incision allows surgeons to adequately remove the redundant skin in both the vertical and horizontal dimensions (which may be less reliably done through the use of short scar techniques). This leaves a resulting anchor type scar with the lower scar often hidden in the fold below the breast.
The typical recovery time following breast augmentation is 3 to 4 weeks. During this period, a contouring garment or bra is often used. Pain is controlled with prescription medication for the first days, up to a week. Generally, over the counter pain medications should suffice. In some cases, stool softeners may be helpful if a prescription narcotic is required. Bruising and swelling can become noticeable 3 or 4 days after the procedure. This is a normal part of the recovery process, and will subside within 2 to 3 weeks following the procedure.
If a breast reduction is performed, there are many unavoidable consequences of this surgery. These aspects are so common and expected that they should not be confused with unexpected complications. These include:
If a mastopexy (breast lift) procedure is done instead of a formal reduction, the same consequences are incurred with the possible exception of the patient's inability to breastfeed.
It is important to understand that any list of potential complications is incomplete, as it is impossible to list all possible outcomes. The following list are the most commonly seen complications of this procedure:
It is important to understand that surgical complications can be life threatening, and result in death, however slight the possibility. In most healthy patients, however, the results are satisfactory without any complications. On occasion, complications of surgery can cause aesthetic problems, and a secondary surgical procedure can be required to correct this. For more detailed discussion on expected results, recovery, and specific complications, please see your individual surgeon.
WHAT TO EXPECT
Pain perception varies widely from individual to individual, but in most cases, the post-operative pain is underestimated. New techniques have been developed to help with this problem. Also, early in the post-operative period, the implants may sit high on the chest wall, usually for 4 to 8 weeks, but this will settle over time. Many women comment that initially, the breasts feel very firm, but will begin to soften over time, although they will never be the same consistency as natural breast tissue. Finally, bruising in the arm pit or abdominal region can occur, and in some cases, can be significant with the trans-axillary or TUBA procedures.
Breast reduction surgery is commonly covered under the Canadian Medical Plan. Breast lifts with or without augmentation are generally considered elective, and are not covered. The final cost for such a procedure is at the discretion of the performing surgeon. The costs generally range from $6000 to $12,000, as published by the Canadian Society of Aesthetic Plastic Surgery. Costs will vary based on the required augmentation and type of implant.
This website does not cover all of the medical knowledge related to breast augmentation nor does it deal with all possible risks and complications of surgery on the breasts. Although it is designed to provide the patient with greater depth of information in some areas, it is not intended to substitute for the in depth discussion between patient and surgeon that must occur prior to any surgical procedure.
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