Breast Reduction

Sometimes large breasts can affect a woman's self esteem greatly.

Moreover, it can cause tension and pain in the chest, neck and back. If you suffer and feel inhibited in your body and sexual activities, perhaps you should consider a breast reduction ( breast reduction surgery) with Dr. Dirk Kremer.

This operation removes the bottom of the breast tissue and excess breast skin. A new breast if formed from the remaining breast tissue. During the surgery, nerves and blood vessels are added to the nipples and areola, so that afterwards you retain sensitivity and in most cases your ability to breastfeed.

With surgery (breast reduction) the size and shape of your chest is permanently altered, but in the course of years of natural aging, weight gain and gravity can change the shape of your chest again.

You have scars around the areola and a vertical one from the bottom edge of the areola.
extending into the inframammary fold and a transverse scar in the inframammary fold.

With the help of a new surgical technique, and suitable conditions the transverse scar can be reduced.

This operation can in principle be carried out at any age, however, you should be fully grown, and your breasts be fully developed.

Interested in a breast reduction?
Please find out more in our comprehensive information about breast reduction below

References

• Areola - In anatomy, an areola, plural areolae is any circular area such as the colored skin surrounding the nipple.
• Inframammary fold - Inframammary fold (IMF), inframammary crease or inframammary line is the feature of human anatomy which is a natural boundary of a breast from below, the place where the breast and the chest meet.

Exciting new developments in the field of breast reduction surgery have been incorporated into our practice. Liposculpture reduces the amount of incisions needed so minimal incisions are now possible. On select cases, a laser can be used.

GENERAL INFORMATION

Reduction mammaplasty is designed to improve the appearance of overly large breasts by reducing their size and reshaping them. The surgery is also designed to relieve symptoms of pain and discomfort in the breasts, shoulders, neck and upper back.
Breast reduction surgery is usually performed in our outpatient surgical facility or in a hospital, which would require a two to three day stay. The procedure takes approximately 3 to 5 hours, depending on the complexity of the surgery.

Photographs are as important to the plastic surgeon in the proper care of his patients as X-rays are to physicians in other medical specialties. Therefore, photographs are taken before and after surgery. These photographs become a part of the patient's confidential medical record. Mammograms (a type of X-ray) of the breasts are sometimes included in the pre-operative assessment of the patient. These studies are done to insure that there is no breast disease present before surgery.

THE ANESTHESIA

Breast reduction surgery is performed under a "light" general anesthetic (patient is asleep). This technique provides excellent operating conditions while affording maximal patient comfort and safety. A board-certified doctor anesthesiologist who remains in attendance throughout the operation administers the anesthetic. All of the required monitoring, anesthetic delivery and emergency equipment are present at all times. Further information, including any questions you may have, will be explained and discussed fully by our anesthesiologist prior to your surgery.

PRE-OPERATIVE PREPARATIONS

You must be in good health to undergo any elective cosmetic surgery. A physical examination and routine lab work will need to be performed by your own primary physician. If you do not have a primary doctor, we can refer you to local doc-tors in our area. We do not provide these services. It will be required that all this pre-op paperwork is in our office 1-2 weeks prior to surgery.It is a required that someone drive you home upon your discharge. Also arrange for transportation to and from our office for your post-operative appointments until your doctor gives you permission to drive.

DO NOT take aspirin or aspirin-containing products for 2 weeks prior to surgery and for 2 weeks after surgery. An adequate diet with vitamin supplements, especially Vitamin C, is recommended. You should be in the best nutritional state possible prior to surgery. If you will be preparing your own meals at home after surgery, have on hand easy-to-prepare foods. Bring loose-fitting, front-opening clothing with you the morning of surgery to wear home.

THE SURGICAL PROCEDURE

Marking and measuring of the breasts is an important part of the preparation for surgery. These markings are made before the anesthesia is given and with the patient sitting fully upright. They are used as guidelines for the incisions during surgery when the patient is in a reclining position.
The surgical procedure consists of removing part of the skin and the underlying tissue of the breasts, moving the nipple upward and reshaping the remaining tissues into a smaller, higher configuration. Scars left by this procedure are generally predictable and although they tend to fade with time, they are permanent. There is a circular scar around the nipple, a scar in the fold under the breast, and a vertical scar connecting them. No scars are present above the nipple.
Occasionally, revision of the scars is necessary to obtain the optimum cosmetic result. These revisions are minor and can be carried out in the office under local anesthesia.

POSSIBLE COMPLICATIONS

Complications are rare and usually respond promptly to proper treatment without affecting the final result.
BLEEDING: If bleeding occurs after the operation, it may accumulate in the breast and require opening the wound to remove the blood and prevent further bleeding.
INFECTION: This occurs rarely and usually responds to antibiotics.

NUMBNESS OF THE NIPPLE: This is almost always temporary and sensation can be expected to return. On rare occasions, however, it may be permanent.

LOSS OF A NIPPLE: Complete or partial, this is extremely rare, but has been reported on occasion. Should this happen, a reconstructive operation can be performed with satisfactory results at a later date.

WHAT TO EXPECT AFTER SURGERY

Pain is rarely strong, more commonly being a degree of discomfort. Pain medication is prescribed by the doctor for the patient to use during hospitalisation and at home. Many patients like to spend a night in a medical after care, where nurses tend to their needs, although it is not required.

Some swelling will occur but usually begins to subside by the third or fourth day. Some degree of swelling may persist for weeks or even months.

Bruising may appear extensive for the first week, but will subside over the next several weeks.

SURGICAL BRA: This is applied at the time of surgery and is worn for about a week after the operation. Steri-strips covering all incisions are removed and replaced by the nurse in 5-6 days. After two weeks, a comfortable sports bra can be purchased. Avoid purchasing underwire bras that would create too much pressure on incisions.

Social and work activities should be quite limited for two to three weeks after surgery. If your job requires lifting, pushing, etc., a longer recuperation period may be necessary. Driving should be avoided for one week after surgery.

In general, it is recommended that a patient undergoing this operation not attempt to nurse following surgery. Nursing may cause the breasts to enlarge again, thus eliminating the effects of surgery. Of those who try to nurse, some find they are unable to do so because enough glandular tissue has been removed to prevent adequate milk production.

POST-OPERATIVE CARE

Avoid raising your arms over your head for 2 weeks. Avoid any strenuous exercising or lifting for 6 weeks.

Avoid lying on your abdomen for 2 weeks. Optimal sleep position is elevated on your back with 2 pillows. Keep a pillow under each arm, and a pillow under your knees.
Showering is usually permitted after 72 hours. Do not attempt to peel off the steri-strips (if applicable), the nurse will change them. Soaking in the bathtub is not recommended for two weeks.

The surgical bra is worn day and night for two weeks. Then a comfortable yet supportive sports bra can be worn.

Arnica gel can be applied to bruised areas (avoiding any incisions) soon after surgery.

RESUMPTION OF PHYSICAL ACTIVITIES -GENERAL RULES OF THUMB TWO, FOUR, SIX RULE FIRST WEEK- TAKE IT EASY!!! PATIENTS WHO ARE TOO VIGOROUS FREQUENTLY DEVELOP COMPLICATIONS!
At two weeks- take long walks on a flat surface. No other kind of workouts. Any activity that would raise your blood pressure would compromise the healing incisions and newly developing blood supply.

At four weeks- light exercise such as aerobics, but no weight training. Start light. For example, if you normally do 30 minutes on a treadmill, begin with 15 minutes, then increase as your body gets used to things. Use of vitamin C and E concentrate and scar-fade gel should begin as soon as the incisions are completely healed, usually 3-4 weeks.

At six weeks- resume all previous activities with clearance from Dr Kremer. Avoid sun exposure to incision site for months following surgery, as this may result in a hyperpigmented scar.