Women with unusually large, sagging or uneven breasts are often dissatisfied with their physical appearance. Some experience pain or discomfort from the sheer weight of their breasts and the pressure of brassiere straps on their shoulders. Premenstrual congestion often adds to the discomfort.

 

Large breasts can hamper a woman's physical activities and make it difficult to find properly fitting clothes, particularly brassieres. Today, because of advances in surgical techniques, thousands of women with these problems are being helped through a surgical procedure called reduction mammaplasty or breast reduction. This surgery is designed to improve the body contour, reduce pain, and make the individual more comfortable when engaging in physical activities.

Before Surgery

Prior to surgery, a complete medical history is taken in order to evaluate the general health of the patient. The breasts are examined thoroughly to determine the most effective surgical approach and to search for abnormal lumps or growths. The physician describes the type of anesthesia to be used, the procedure, what results might realistically be expected and possible risks and complications.

Mammograms or x-rays may be taken as well as photographs. Preoperative instructions often include the elimination of certain drugs (aspirin, garlic, Arthritis medications, etc.) for a week before surgery in order to minimize the possibility of excess bleeding. Patients are advised to refrain from smoking before surgery for at least one week and for two weeks after the procedure. Patients who smoke have a higher risk of poor healing and other problems.

The Procedure

Dr. Galoob commonly performs breast reduction in his AAAHC accredited Office Surgical Facility (www.aaahc.com ). It is also sometimes performed in a local outpatient surgical facility. There are a number of techniques for breast reduction. Dr. Galoob uses techniques that retain nipple sensitivity, a natural appearing nipple/areola area and allows breast-feeding if desired. This procedure leaves an inverted T shaped scar. A breast reduction can take three to five hours or more, depending upon the extent of the surgery.

Following Surgery

Following surgery, the patient wears bandages and a brassiere for support. Dr. Galoob commonly performs these procedures on an outpatient basis and the patient stays in a local hotel for one to two days. Pain connected with the procedure is minimal to moderate and is controlled with oral medication. Antibiotics are given IV at the time of surgery and continued post operatively for several days to prevent infection. Instructions for the day of surgery include bed rest with limited activities. The physician determines when normal activities can be resumed; however, strenuous exercise and overhead lifting must be avoided for several weeks.

Sutures are removed in seven to fourteen days. Numbness around the treated area may occur, but this condition is usually temporary. Swelling and discoloration disappear in a few days, and scars from the incision, although permanent, fade significantly with time.

Complications are rare. However, there are certain inherent risks connected with every surgical procedure that should be thoroughly discussed with the physician. Patients can minimize complications by carefully following directions given by the physician. Some patients who experience poor healing may require additional treatment.

Questions and Answers

Will I be able to Breast Feed?

Dr. Galoob utilizes newer techniques of nipple-areola relocation that preserve the ducts to the nipple along with sensation and blood supply. Women who have had this type of procedure can ofetn breast feed after the surgery.

When Can I go back to work?

Most women can return to restricted activity within 2 weeks, normal activity within 8 weeks. The time of return to work depends on the type of job and whether adequate healing has occurred.

Will this operation help my neck and back pain?

It is common for patients to notice an immediate relief of neck and back discomfort immediately after surgery. The success of the operation in relieving these symptoms varies depending on the individual patient, the amount of breast tissue removed and other factors. A convenient test for the patient to determine if the operation might help is to lift the breasts off of the chest in the standing position. If neck and back discomfort is immediately relieved, there is a good chance the surgery might help.

Thousands of Breast Reductions are successfully performed each year. The amount of improvement is individual and depends upon the extent of surgery, the patient's skin tone, body build and healing process. Complications associated with the procedure are rare. However, there are inherent risks such as infection, bleeding and anesthetic problems connected with every surgical procedure. Possible risks and complications should be discussed thoroughly with the physician prior to surgery. Patients can minimize complications by carefully following directions given by the physician and by avoiding smoking.

Will insurance pay for this Surgery?

Some insurance companies will pay part or all of the costs of this surgery if it is performed as a result of back or neurological problems related to large breasts. Each insurance carrier is different, and it is recommended that individuals check with their own agents to determine if there is coverage.

What are some things my insurance company will require?

The insurance industry has a standardized list of requirements to approve breast reduction as medically necessary so that they will pay. Most require documentation that conservative measures to control the patients symptoms have failed. Many require copies of other doctor's office visits documenting these issues. Some requirements include:
· Pain in the upper back, neck and shoulders which is long-standing in duration and increasing in intensity and is not related to other musculoskeletal causes (e.g. poor posture, acute strains, post traumatic conditions, poor lifting techniques or other evidence of over use)
· Persistent rashes under the breast that are recurrent even after treatment.
· Pain and/or numbness in the arms and/or hands.
· A minimum of six (6) weeks of physical therapy for back, neck and shoulder pain
· A maintenance home exercise program,
· Appropriate support bra with weight distributing straps
· Regular use of Anti-inflammatory agents
· Symptomatic measures to treat the neck and back pain, including application of heat and cold,
· Significant shoulder grooving or ulceration of the skin of the shoulder,
· Obvious breast enlargement with photo documentation
· Documentation that at least a pound of tissue has been removed from each breast at surgery.

If you are interested in learning more about Breast Reduction contact us and we will be happy to answer your questions.