Breast Reduction (Reduction Mammaplasty)
Women who are unhappy about having large breasts and/or want to treat symptoms such as back pain, breathing problems and poor posture, may benefit from reduction mammaplasty (breast reduction), during which fat, glandular tissue and skin are removed from the breasts. The resultant smaller breasts increase patient comfort, and look more in proportion to the rest of the body. Ideal candidates for reduction mammaplasty are women with oversized breasts that are causing medical problems, low self-esteem, and/or physical or social discomfort. Women who are pregnant or breastfeeding cannot undergo reduction mammaplasty.
The Reduction Mammaplasty Procedure
Reduction mammaplasty is performed under general anesthesia. Depending on the technique used and the individual case, it takes from 2 to 5 hours to perform. One of the following incisions is often used:
- Two rings, one larger than the other, around the areola
- A keyhole shape, around the areola and down to the breast crease
- An anchor shape, beginning in the breast crease, and extending up to and around the areola
Liposuction alone is sometimes used to reduce breast size. One advantage is that it leaves little-to-no scarring. However, because liposuction removes only fatty tissue, patients must have more fatty than glandular tissue in their breasts. Liposuction is also often used on men whose breasts are enlarged.
Recovery From Reduction Mammaplasty
After reduction mammaplasty, patients typically experience soreness, swelling and bruising for several days. Bandages are removed after 2 days, and replaced with a surgical bra. Physical activity should be limited for 1 to 2 weeks, while exercise and other strenuous activity should be avoided for at least 4 weeks. Stitches are removed after 2 to 3 weeks, at which point most patients return to work and other regular activities.
The results of reduction mammaplasty are noticeable immediately after surgery. As swelling and bruising subside, the breasts’ appearance improves. Scars fade with time, and usually cannot be seen when a patient wears a bathing suit or low-cut top.
Risks Of Reduction Mammaplasty
In addition to the risks associated with any surgery, risks related to reduction mammaplasty, depending on the technique used, include the following:
- Loss of sensation
- Excessive firmness
- Inability to breast-feed
- Loss of skin/tissue where incisions meet
- Partial or total loss of areola and nipple
Although reduction mammaplasty provides long-lasting results, breasts are still subject to the effects of aging and gravity.
Male Breast Reduction
Gynecomastia, which is the overdevelopment of male breasts, affects an estimated 40 to 60 percent of men. It can be the result of hormonal imbalance, obesity, certain drugs or heredity, and can affect one or both breasts.
Candidates for breast reduction are men who have large or sagging breasts that make them feel physically and/or emotionally uncomfortable. Breast reduction can be performed on men whose breast development is complete; are in good health, both physically and emotionally; do not smoke; and are not overweight. Ideally, candidates have firm, elastic skin that will reshape itself to fit the contours of their breasts postsurgery.
Male Breast Reduction Procedure
Male breast reduction is usually performed under general anesthesia on an outpatient basis, and typically takes 1 to 3 hours. Male breast reduction is performed using liposuction or surgery, or a combination of the two.
If the enlarged breasts are caused primarily by excessive fatty tissue, the tissue is typically removed with liposuction, during which a cannula (a thin, hollow tube) is inserted through extremely small incisions, and then moved back and forth to loosen excess fat, which is suctioned out using a vacuum or a cannula-attached syringe. The incisions are made around the lower halves of the areolas or in the underarms.
If the enlarged breasts are caused primarily by excess glandular tissue, surgery is required. Incisions are made to allow for tissue to be removed. Repositioning the areolas/nipples and excising excess skin also requires incisions. Sutures are used to close the incisions, which are then bandaged, and the area is typically covered by a compression garment.
Recovery From Male Breast Reduction Surgery
Following male breast reduction surgery, there is bruising, swelling and discomfort. Discomfort usually dissipates after a few days, and can be lessened with prescribed pain medication. To help reduce swelling, the compression garment is worn for about 2 weeks, and at night for several additional weeks. Swelling and any skin discoloration partially subside after 1 or 2 weeks, at which time stitches are removed.
Patients typically return to work within a week. Light aerobic exercise can be performed after a week, but strenuous activities should be avoided for 4 to 6 weeks.
Risks Of Male Breast Reduction
In addition to the risks associated with surgery and anesthesia, those related to male breast reduction include the following:
- Skin injury
- Loss of nipple sensation
- Asymmetrical breasts or nipples
The results of gynecomastia surgery are usually permanent, as long as the patient’s weight remains stable. If drugs were the cause of the condition, the patient must permanently stop taking them to maintain results.