Breast Reduction in Jupiter and Palm Beach County
Women with large, heavy, pendulous breasts often complain of associated neck and back pain, postural changes, grooves in the shoulders from the bra straps and frequent rashes beneath the breasts. In addition, very large breasts can make a woman feel “out of proportion” and can make clothing more difficult to properly fit. The breasts may interfere with normal activities such as exercise and sports.
Breast reduction surgery reduces the size and the weight of the breasts and attempts to improve breast shape by elevating the nipple position and reducing redundant skin and underlying tissue of the breasts. While an incision is made around the nipple, it is not “removed” but rather left attached to the underlying breast and re-positioned to a higher location. The reduction in breast weight previously supported by the upper and lower back, neck and shoulders frequently improves symptoms and allows resumption of normal activities with greater comfort.
Breast reduction is usually performed in women in whom breast development is complete. Ideally, it is done following completion of breast-feeding and child-bearing. However, symptoms and psychosocial issues may not allow for delay until that time.
- The Consultation
- The Surgery
- The Recovery
- What are some of the particular concerns regarding breast reduction?
- Making the Decision
The Consultation
A breast reduction can enhance your appearance and your self-confidence, but it won’t necessarily change your looks to match your ideal, or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them with Dr.Koger.
Dr. Koger will typically spend at least an hour discussing your medical history and goals. Examination will evaluate current breast size, shape, skin tone and degree of ptosis (droop). Scars, sensation and breast-feeding issues, as appropriate, will be discussed. Issues of proportion and appropriate degree of reduction will be discussed. Every individual has specific goals and unique anatomical considerations. The detailed consultation will address these important issues. Back to Top
All surgery carries some uncertainty and risk
A breast lift is not a simple operation, but it’s normally safe when performed by a qualified plastic surgeon, such as Dr. Koger. Nevertheless, as with any surgery, there is always a possibility of complications. Bleeding and infection following a breast lift are uncommon. You can reduce your risks by closely following Dr. Kogers’s advice both before and after surgery. Back to Top
Planning your surgery
In your initial consultation, it’s important to discuss your expectations frankly with Dr. Koger, and to listen to his opinion. Every patient (and every physician, as well) has a different view of what is a desirable size and shape for breasts.
Dr. Koger will examine your breasts and measure them while you’re standing. He will discuss the variables that may affect the procedure (such as your age, the size and shape of your breasts, and the condition of your skin) and whether an implant is advisable. You should also discuss where the nipple and areola will be positioned; they’ll be moved higher during the procedure, and should be approximately even with the crease beneath your breast.
Dr. Koger will describe the procedure in detail, explaining its risks and limitations and making sure you understand the incision marks that will result. He will also explain the anesthesia to be used and the type of facility where the surgery will be performed.
Don’t hesitate to ask Dr. Koger any questions you may have, especially those regarding your expectations and concerns about the results.
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Preparing for your surgery
Depending on your age and family history, Dr. Koger may require you to have a mammogram (breast x-ray) before surgery. You’ll also get specific instructions on how to prepare for surgery, including guidelines on eating and drinking, not smoking, and taking or avoiding certain vitamins and medications.
While you’re making preparations, be sure to arrange for someone to drive you home after your surgery and to help you out for a few days if needed.
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Where your surgery will be performed
Your breast lift may be performed in a hospital or an outpatient surgery center. It’s usually done on an outpatient basis, for cost containment and convenience. If you’re admitted to the hospital as an inpatient, you can expect to stay overnight.
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Types of anesthesia
Breast lifts are usually performed under general anesthesia, which means you’ll sleep through the operation. However, there are other possible anesthesia options and Dr. Koger will discuss them with you during your consultation. Back to Top
The surgery
Mastopexy usually takes two to four hours. Techniques vary, but the most common procedure involves an anchor-shaped incision following the natural contour of the breast.
The incision outlines the area from which breast skin will be removed and defines the new location for the nipple. When the excess skin has been removed, the nipple and areola (still attached to the underlying tissue) are moved to the higher position. The skin surrounding the areola is then brought down and together to uplift and reshape the breast. Incisions are usually located around the areola, in a vertical line extending downwards from the nipple area, and along the lower crease of the breast.
Some patients, especially those with relatively small breasts and minimal sagging, may be candidates for modified procedures requiring less extensive incisions. One such procedure is the “doughnut (or Benelli) mastopexy,” in which circular incisions are made around the areola, and a doughnut-shaped area of skin is removed.
If you’re having an implant inserted along with your breast lift, it will be placed in a pocket directly under the breast tissue, or deeper, under the muscle of the chest wall.
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After your surgery
After surgery, you’ll be wearing gauze dressings. Your breasts will be bruised, swollen, and uncomfortable for a day or two, but the soreness shouldn’t be severe. Any discomfort you do feel can be relieved with medications prescribed by Dr. Koger.
After 24 hours, the bandages can be removed be replaced by a soft stretchy camisole or tank bra. You’ll need to wear this around the clock for three to four weeks. The stitches are internal and absorbable, therefore there are no sutures to be removed.
If your breast skin is very dry following surgery, you can apply a moisturizer several times a day. Be careful not to tug at your skin in the process, and keep the moisturizer away from the suture areas.
You can expect some loss of feeling in your nipples and breast skin, caused by the swelling after surgery. This numbness usually fades as the swelling subsides over the next six weeks or so. In some patients, however, it may last a year or more, and occasionally it may be permanent.
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Getting back to normal
Healing is a gradual process. Although you may be up and about in a day or two, don’t plan on returning to work for a week, depending on how you feel. If you have any unusual symptoms, don’t hesitate to call Dr. Koger.
Dr. Koger will give you detailed instructions for resuming your normal activities. You may be instructed to avoid strenuous sports for about a month. After that, you can resume these activities slowly. If you become pregnant, the operation should not affect your ability to breast-feed, since your milk ducts and nipples will be left intact.
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Your new look
Dr. Koger will make every effort to make your incision marks as inconspicuous as possible. Still, it’s important to remember that mastopexy incisions are permanent. They often remain lumpy and red for months, then gradually become less obvious, sometimes eventually fading to thin white lines. Fortunately, the incision marks can usually be placed so that you can wear even low-cut tops.
You should also keep in mind that a breast lift won’t keep you firm forever. The effects of gravity, pregnancy, aging, and weight fluctuations will eventually take their toll again. Women who have implants along with their breast lift may find the results last longer.
Your satisfaction with a breast lift is likely to be greater if you understand the procedure thoroughly and if your expectations are realistic.
Serving South Florida, including Martin, St. Lucie, and Palm Beach County.
The Surgery
The surgery is usually performed at an Out Patient Surgery Center or Hospital, depending upon the extent of tissue removal. Anesthesia is administered by Board-Certified anesthesiologists. Prior to surgery, Dr. Koger will plan with you the new nipple position, skin and underlying tissue removal. Incisions and resulting scars will vary according to the degree of breast “droop” and the amount of skin and tissue to be removed. The simplest incision involves a “lollipop” like scar, while more extensive reductions involve an “anchor” type scar which adds a scar in the fold to the “lollipop.” At the completion of the surgery, light tapes are placed over the incisions and gauze gressings are applied. The patient usually goes home, or potentially can stay overnight in the hospital if preferred.
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The Recovery
Patients usually can shower in 2 days. Arm use and motion is not restricted although lifting associated with straining is not advised for at least 2 weeks. The post-operative pain is usually the most severe during the first three days. It is usually well controlled with oral pain medications. By the end of the first week, much of the pain has subsided and many normal activities resumed. Driving should not be done until oral narcotics are no longer required for pain control. Generally, full exercise activity is not recommended for about 3-4 weeks post-operative. It is recommended that a support bra be worn, at all times, except when showering for the first post-operative month.
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What are some of the Particular Concerns regarding Breast Reduction surgery?
Breast reduction patients tend to be very happy patients. However, there are some very important considerations that must be taken into account prior to proceeding. Breast reduction surgery results in permanent visible scars. While they fade over the first 1-2 years following surgery, they never disappear. In addition, there is a risk of loss of sensation to the nipple and to other areas of breast skin. Because this cannot be predicted, if this is an unacceptable risk, the surgery should not be done. In this procedure, while the nipple position is elevated and the amount of excess skin hanging below the breast fold reduced, there is not typically a long term increase in upper breast volume, as is desired by many patients. Although the breasts are smaller, recurrent ptosis (drooping) of the breasts will occur due to stretching of the skin and the effects of gravity. The degree of breast reduction should take into account the contour of the abdomen. While some patients wish to be “as small as they can be,” reduction to that degree tends to make a protruding abdomen look still larger. So, body proportions must be taken into account.
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Making the decision
Every surgical procedure has inherent benefits, risks and limitations. Dr. Koger wants you to feel comfortable asking any and every question that you may have at your initial consultation, pre-operative visit or at any time to assist you in determining whether breast reduction is right for you. He believes that taking sufficient time needed to discuss, plan, individualize and perform your procedure is necessary time that is well spent.
Serving South Florida, including Martin, St. Lucie, and Palm Beach County.
