Breast reduction surgery can improve back pain, neck pain, shoulder strap grooving, and even headaches. Although the breast cannot be completely lifted up off the chest wall, skin rashes are often significantly reduced. Patients report improved exercise tolerance, improved posture and improved self-esteem.
There are two main ways to perform breast reduction. The standard method is called the “anchor” method. The method that I use most frequently is called the “vertical” technique. Vertical technique provides better projection and more stable with time. Also this surgery has less scarring then the standart ‘ anchor’ method. But the disadvantage is that it has a 5% revision rate.The need for revision varies with each technique. We always allow the shape to settle for a full year before deciding whether a revision is indicated. With the vertical technique, patients worry about the pucker that persists just above the fold at the bottom of the vertical scar. This pucker settles with time: 95% of patients worry about it, and only 5% of patients need to have it corrected – and not until a full year has passed. Revisions are less likely with the anchor technique – not so much because they aren’t indicated, but because we have very little to offer to correct the puckers (the technical name for these puckers is actually “dog-ears”).
In order to remove the puckers that develop with the anchor technique under the arm (this is extra skin) the scar would need at times to extend all the way around the back. This is especially true with all techniques in patients who have a significant amount of excess skin (as in patients who have experienced a large weight loss). Sometimes a good correction just cannot be achieved.
Breast reduction surgery is not very painful. The areas where liposuction has been performed can be more of a problem – sore and bruised. These areas become hard and lumpy and can take weeks to settle. Most patients take some pain medication – but only for a few days. Some patients take no medication at all. Patients wake up with a surgical brassiere in place. There is gauze over the incisions and some blood can seep into the gauze. This is removed the next morning and patients may then have a shower and wash directly over the area. The incisions are covered with paper tape – just pat the tape dry and let it take three weeks to peel off. Most patients wear the brassiere for about two weeks night and day.
Patients are encouraged to walk the first week. They can then gradually work up to exercise with something like the stationary bicycle (because there is little upper body movement). Some patients who want more aerobic exercise will walk uphill to avoid bouncing. A sports bra (and even an additional tensor bandage) may be necessary if a patient wants to start jogging at 3 or 4 weeks. Swimming involves a lot of upper body movement and is probably the last activity to consider.
If a patient works at a desk, they can usually return to work in about 2 weeks.