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Women with very large, pendulous breasts experience a variety of medical problems caused by the breasts' excessive weight. These symptoms may range from back or neck pain to skin irritation, skeletal deformities and breathing problems. Bra-straps may leave indentations in shoulders and occasionally, neuralgia (traction on the nerves) within the armpit region may result. Unusually large breasts can make a woman or teen-age girl extremely self-conscious and impede their ability to exercise. Breast reduction is designed for such women. The breast reduction procedure removes various amounts of fat, glandular tissue, and skin from the breasts making them smaller, lighter, and firmer. It also will raise the nipple areola complex, as well as reducing the size of the areola. The best candidates for breast reduction are those patients who desire the procedure for physical relief, rather than simple cosmetic improvement. Breast reduction is not recommended for women who intend to breastfeed. Planning your SurgeryDuring his initial consultation with you, Dr. Burt Greenberg will examine, measure, as well as photograph your breasts through slide and digital photography. Dr. Greenberg may use computer imaging to provide an opportunity for you to see how your breasts will look afterwards. The nipple/ areola position, and the incisions around the areola (in the vertical line between the 6 o'clock position of the areola and the transverse crease underneath the breasts) will be discussed. Dr. Burt Greenberg performs this procedure at North Shore University Hospital. or at Dr. Burt Greenberg's Great Neck Cosmetic Surgery and Laser Facility which is accredited at the highest level ("C" level) by the American Association of Ambulatory Surgical Facilities (AAAASF). Dr. Burt Greenberg asks that a mammogram be obtained prior to surgery. The SurgeryDependent upon the size and shape of the breasts, the nipples either remain attached to their blood vessels and nerves (pedicle technique) or, less commonly, the nipple areolas are completely removed and relocated into the higher position. In some highly selected patients, a vertical reduction mammoplasty is used which results in significantly smaller, lower inframammary scars and is combined with liposuction of the breasts. Drainage tubes are used for one to two days following the procedure and the hospital nursing unit, or Dr. Burt Greenberg's nurses, will instruct you on drain management. After your SurgeryJobst breast garment is used for the first week. You may feel some pain, especially when you move around or cough, and some discomfort for a week or more. Medications, such as Tylenol #3 or Vicodin, are prescribed to lessen the pain and discomfort. After the first week, a sports bra with a front located clip is used. Your first menstruation following surgery may cause your breast to swell and hurt. You may also experience random "shooting" pains for a few months and can expect some loss of feeling in the nipples and breast skin caused by the swelling after surgery. This usually, though not always, fades over the next twelve weeks or so. In some patients, however, it may last a year or more and, occasionally, nipple numbness may be permanent. Dr. Burt Greenberg will change the steri-strips (paper tapes) on the incisions after the first two to three days. All sutures are absorbable, eliminating the need for later removal. Most women return to non-strenuous activities in approximately one week. You will have much less stamina for several weeks and should limit your exercises to stretching and lower body light exercise until your energy level returns. For the first several days, it is normal for a small amount of fluid to drain from your surgical wound. Although most of the swelling and bruising will disappear in the first few weeks, it may be up to six months to one year before your breasts settle into their new shape. Even then, their shape may fluctuate in response to hormonal shifts, weight changes, and pregnancy. Dr. Greenberg makes every effort to locate scars as inconspicuously as possible. However, it is important to remember the breast reduction scars are extensive and permanent. They often remain lumpy and red for months, gradually become less obvious, and sometimes eventually fading to thin white lines. The "T' (intersection of the vertical and horizontal lines) causes the greatest difficulties for incisional healing. Occasionally, scar revision, the removal of "dog ears' or excess skin on the side most portion of the incision, is required. |
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BURT GREENBERG,
MD. FACS
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