Generally, patients seeking breast reduction have been dealing with neck, back and shoulder pain for years. If physical therapy and anti-inflammatory medications have not been able to help you, breast reduction can be an excellent option. In fact, breast reduction has one of the highest satisfaction rates of any procedure in Plastic Surgery. The surgery removes some breast tissue and skin, to lift, narrow, firm, and reshape the breasts, while also reducing the size of the areola. As with any other breast surgery, it is critical to ensure that the aesthetics of the breasts are respected. The goal is to relieve your symptoms, while simultaneously improving the shape and appearance of the breasts.
During your consultation, you should expect to discuss your medical history, breast health history (e.g., prior mammograms), any surgeries you have undergone, and medications you use. After meeting Dr. Nagarkar and his nurse, you will also have medical photographs taken in the office to assist with the surgical planning.
There are many techniques for breast reduction, and it is important to choose the right one for the right patient. No two breasts are alike – not even in the same patient – so the choice of technique is important. Patients are often focused on their neck pain, but it’s necessary to remember breast aesthetics as well. After a comprehensive examination and discussion, I like to make detailed measurements to help design the best surgery for each patient. Often, a little liposuction may be necessary to improve the chest wall area where the breast tissue blends into the back.
Who is a good candidate for breast reduction:
Most patients without major medical problems or a history of breast cancer can be good candidates for breast reduction. Your surgery may be covered by insurance if you have already tried physical therapy and medications without any relief.
How to prepare for surgery:
Dr. Nagarkar will let you know if any laboratory tests are required prior to your surgery. In most patients, a pre-operative mammogram will be needed. This provides baseline information and helps identify changes in your breast tissue. You must stop smoking or using nicotine-containing patches or gums for 6 weeks before surgery. This is critical as smoking increases the risk of significant complications. Finally, you will discuss with Dr. Nagarkar which medications and supplements you should stop taking before surgery, and which ones you can continue. You will get detailed written instructions for pre- and post-operative care. In addition, you will receive any postoperative prescriptions you might need so that you can have them filled by your pharmacy in advance.
What to expect on the day of surgery:
Breast reduction is generally an outpatient surgery that lasts around three hours, depending on the complexity of the case, and whether you have chosen to have other procedures performed at the same time. You should plan on having nothing to eat or drink after midnight the night before surgery. You will need to have someone drive you to and from the surgery, and to stay with you for 24 hours afterwards. A licensed and certified anesthesiology provider will be present during your procedure to provide anesthesia and monitor you at all times during the surgery.
What to expect after surgery:
Results
Your surgery is designed and performed to achieve the ideal result and as close to 100% symmetry as possible on the operating table. In the first 48 hours after surgery, you will have significant swelling which is often asymmetric in nature. It will take 2 to 3 months for the swelling to resolve and for you to see your final result. Your scars may appear raised, and inflamed at first, but will fade, soften, and flatten, over the course of 6 months to a year after surgery.
The first few days
Recovery after breast reduction is usually quite rapid. You will be able to go home the same day. The evening after surgery, it is critical that you are out of bed and walking. This reduces the risk of forming blood clots in your legs. Dr. Nagarkar will call you the next day to make sure you are doing well, and to answer any questions you might have.
Pain
Narcotic pain medications are usually only needed for a day or two, and often are not required at all. Often, anti-inflammatory over the counter medications like Tylenol and Ibuprofen are adequate.
Incision care
Your incisions will all be closed with internal absorbable sutures, and surgical glue, so you can generally start showering the day after surgery, although bathing, swimming, or getting in a jacuzzi should not be done until at least 3 weeks after surgery. You will also have a surgical bra to support the breasts that you should wear for the first 6 weeks after surgery, whenever you are up and about. You should protect your fresh scars from sun exposure for at least 6 months after surgery, because they are extra sensitive to sunlight during this period. Dr. Nagarkar may discuss special scar care techniques such as silicone sheeting or moisturizers with you. If you are prone to forming keloids, it is very important that you discuss this with him prior to your surgery.
Drains
Most patients do not require surgical drains.
Diet
You can return to your regular diet after surgery, but for the first day or two, stick with lighter meals. Anesthesia can sometimes make your digestive system a bit sensitive, and having a double cheeseburger the evening after surgery is not recommended. You should refrain from high-sodium foods because salt may increase swelling or prolong the time required for your swelling to resolve.
Work
Recovery after breast reduction is usually quite rapid. Most patients only need to take a few days off work.
Activities
You will be able to go back to non-strenuous activities such as walking, using a computer, writing, and so on, immediately after surgery. You should not reduction anything over 10 pounds (or a gallon of milk), for 2-3 weeks after your surgery to allow your tissues to heal.
Driving
You can resume driving once you are no longer taking narcotic medications, and when you feel that you are in full control of your car. This often takes a week or two.
Exercise
Aerobic exercise such as yoga, running, cycling, barre, etc., must be stopped for three weeks to allow the tissues to heal. Strenuous activity too early in the recovery brings a high risk of bleeding, which can cause significant complications.
Follow-up visits
You will see Dr. Nagarkar in the office usually 7 – 10 days after surgery to examine the incisions and ensure that you are healing appropriately. We will see you again at the 4-6 week mark at which time Dr. Nagarkar may clear you from any activity restrictions if you are healing appropriately. Finally you will have appointments around 3 months, 6 months and 1 year after surgery.
To meet Dr. Nagarkar in person, schedule your consultation or call us.