Breast Reduction

Reduction mammoplasty, also known as breast reduction, is the surgical procedure to reduce the size of large breasts. Women that have developed extremely large breasts generally experience back and neck pain, skin irritations, and shoulder indentations due to the weight placed on their bra straps. Breast reduction surgery can relieve these symptoms. Even following surgery the breast can still increase in size due to weight gain, pregnancy, and birth control pills. If you are considering breast-feeding, it is recommended that you postpone the procedure until after nursing. This surgery may impair your ability to breast-feed.

This procedure is a covered surgery by some insurance companies. After consultation a pre-determination letter will be sent to your insurance company requesting approval in writing. Your insurance company will determine if this procedure is medically necessary and respond through a letter to our office. A breast lift without a reduction is considered a cosmetic procedure not covered by insurance.

With every surgery there are possible risks and complications:

Dr. Yaker performs many breast reduction surgeries successfully each year. However; there are risks associated with this surgery. Possible complications following surgery include infection, bleeding, poor healing, and reaction to anesthesia. Smokers must stop smoking 6 weeks before surgery and continue not smoking until approximately 6 weeks after surgery. Smoking greatly increases the risk of complications during the healing process. Even second hand smoke can affect the healing process, it is best to ask those smoking to leave the room or smoke outside if possible.

About the surgery:

The surgery will be performed at the hospital or our on-site AAAASF certified ambulatory surgery center under general anesthesia. Dr. Yaker will reshape the breast by removing excess skin and tissue. Generally there is an anchor shape scar, which runs horizontally and vertically in the crease of the breast. There is an incision around the areola, and most likely the areola will be reduced in size during the surgery. Sometimes, although extremely rare, it is necessary to remove the nipple/areola completely to relocate it higher on the breast to achieve optimum results. Patients having tissue under their armpits may need liposuction for removal of the excess fat. The surgery will take approximately two to three and a half hours. After surgery you will have bandages, and a surgical bra will be fitted for support. You will have drains to collect excess fluids, and these will be removed one to two days following surgery. Some sutures will be removed at one week, and the rest taken out at two weeks. You will need to wear the surgical bra for several weeks, and depending on your individual recovery you will be directed by Dr. Yaker when you may wear a different bra. Patients are encouraged to massage lotions containing Aloe Vera and Vitamin E on the scars to help during the healing process, once all of the sutures have been removed.

Post-Operative Instructions for Breast Reduction

6 Weeks Before Surgery:
NO SMOKING

2 Weeks Before Surgery:

• Do not take aspirin or ibuprofen products (You may take Tylenol)
• Do not take any diet pills or similar appetite suppressant medications, (i.e. Metabolife)
• Do not take any herbal preparations, (i.e. St. Johns Wart)
• Do not take vitamin E.

Products Needed at Home:

Fill your prescriptions given to you during your pre-op visit:

• Percocet, Lortab, Dilaudid, or Darvocet is for pain.
• Keflex is an antibiotic (You will need to take all of these as directed).
• Extra-strength Tylenol
• Benadryl 25mg- For Occasional Itching

Two bags of frozen vegetables (i.e. corn or peas), to be used as ice packs following surgery.

The Night Prior to Surgery:

• Eat a bland meal - Nothing Spicy.
• Take a Pepcid AC.

The Day of the Surgery:

**Eating or Drinking Prior to Surgery Will Result in Cancellation of the Surgery**

• Wear loose clothing, something very easy to put on after surgery. Wear a top that buttons or zips in the front. Do not wear jeans or tight clothing.
• Do not wear make-up.
• Leave all jewelry and valuables at home.
• The person caring for you after surgery will need to stay with you for at least 48 hours.

Post-Operative Instructions For Breast Reduction

Medications:

• Take your pain medications for the pain. Take one every 4-6 hours for pain if needed. Do not take it on an empty stomach. Most patients take their pain medication for 2-4 days after surgery, and if needed longer.
• Take the antibiotics as directed until they are all gone.
• Sometimes patients will develop a yeast infection from the antibiotics, if this occurs call the office.
• Should you become constipated, you may use an over the counter stool softener. If you do not have relief from your stool softener, call the office.
• Should you have nausea, a prescribed Phenergan suppository should help.
• The pain medications can cause nausea, itching, and constipation. When possible taking Tylenol is preferable.
• If you have itching, take Benadryl 25mg one tablet every 4-6 hours as needed.
• Remember no aspirin products until 2 weeks after surgery.

Other Things to Remember:

• If you feel you are in an emergency situation, please call the office at any time. Our phones are answered 24 hours a day. The calls include: abnormal bleeding, abnormal swelling, or a temperature over 101 degrees. Other call should be made during business hours Monday - Friday 9:00a.m. - 5:00p.m.
• Keep the gauze or bandage areas dry.
• You may use your arms at a moderate level as tolerated. Do not raise your arms over your head for one week.
• Most patients take one to two weeks off work, depending on their job responsibilities.
• It is normal to experience numbness and tingling of the breast, this may take up to eight weeks to disappear.
• Do not drive for seven to ten days following surgery.
• Place a baggie of ice, or a bag of frozen vegetables on the breast to reduce pain and swelling.
• Rest or sleep on your back with 2 pillows behind your back for the first 2-3 days to help with the pain and swelling.
• Occasionally patients will notice a nipple discharge after surgery, which is normal and should discontinue within a couple of weeks. If the breast begin to lactate or fill with breast milk, call the office.
• Patients are encouraged to massage lotions containing Aloe Vera and Vitamin E on the scars to help during the healing process, once all of the sutures have been removed.
• Keep activities moderate for the first 4 weeks. After 3 weeks you may ride a life cycle, and take walks. After 4 weeks you may resume normal activities as tolerated.

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Heavy breasts can lead to physical discomfort, a variety of medical problems, shoulder indentations due to tight bra straps, and extreme self-consciousness.

Incisions outline the area of skin, breast tissue, and fat to be removed and the new position for the nipple.

Skin formerly located above the nipple is brought down and together to reshape the breast. Sutures close the incisions, giving the breast its new contour.

Scars around the areola, below it, and in the crease under the breast are permanent, but can be easily concealed by clothing.

Illustrations courtesy of plasticsurgery.org