Breast reduction surgery can be a big help to patients who are seeking relief from physical symptoms caused by the excessive weight of large breasts, such as neck, shoulder, and back pain. Breast reduction usually can improve these symptoms significantly as well as improve the size and shape of the breasts. Following breast reduction, the breasts are usually more proportional to the rest of the body, and most patients report a significant improvement in their ability to be active. Dr. Hsu incorporates a breast lift into all of his breast reduction procedures.
Good candidates for this procedure:
Patients with breasts that are too large in proportion to their body frame
Patients with chronic neck, back, shoulder pain.
Patients with shoulder strap grooving from bra straps.
- Patients with heavy, pendulous breasts with nipples and areolas that point downward
Patients with skin irritation beneath their breasts
Patients that are restricted from certain physical activity due to the size and weight of their breasts
Patients that are dissatisfaction or self-consciousness about the largeness of their breasts
What to expect: Consultation
All cosmetic consultations are complimentary and serve as a great opportunity to gain further insight by voicing your concerns and having questions answered. During the initial consultation, Dr. Hsu will ask some questions to get to know you and determine if you are a good candidate for breast reduction.
During the consultation, Dr. Hsu will first ask about the area in question, and determine what kind of goals you have for your breasts after surgery. He will then make some careful measurements of your breasts, using multiple measures in order to plan the surgery and individualize it for you. The measurements during the consultation, before surgery, are a key part of the surgical planning. He will also ask about your medical history, including existing medical conditions, past surgeries, tobacco usage, daily medications, supplements, and allergies. For patients over 40, Dr. Hsu will need your recent mammogram results. After giving a thorough examination, Dr. Hsu will go over choosing the location of incision and how much breast tissue you want taken out that will fit your body based on measurements made during the examination.
There are generally two different incision methods. Dr. Hsu will go over each of them during the consultation and determine which method is best tailored for every patient.
The first is the inverted T or “Wise-pattern” reduction (commonly known as the anchor reduction) and is used for patients who have a very large degree of skin excess. The idea is to remove excess breast tissue and skin in all dimensions and reshape the breasts in a way that still looks aesthetic. He will place the nipple higher up to lift the breast, and also pull the skin from the sides and below so that the incisions are well-concealed around the areola, down the middle of the breast and along the inframammary fold under the breast. Most patients are worried about the vertical scar line, but it fades nicely over time.
The second method is the vertical reduction or colloquially known as the lollipop incision which can be done for patients who have less breast tissue to reduce. The horizontal under-the-breast incision is not needed for the vertical reduction. The nipple will be moved up in an elevated position and the skin will be sutured together like cinching a corset.
In either method, Dr. Hsu will also lift the breast in addition to reducing it, so that the overall appearance is more rejuvenated.
Breast reduction is best for patients that want to retain their shape and not completely remove their breasts. Even a small reduction can alleviate some of the pain symptoms you might be experiencing. It is mostly done for functional reasons since there is a possibility that women will be less able to breastfeed after the surgery. If you are looking to get your breast reduction procedure covered by insurance, the insurance companies will usually provide some reimbursement to you for the procedure if they decide that it is justified for functional reasons. If a certain amount of tissue is removed, they will most often require the specimen to be weighed. We can send this information to your insurance to maximize the chance that insurance will reimburse you for some of the costs.
On the day of surgery, come in early to fill out paperwork, meet the anesthesiologist, and the staff will prep you for surgery. Dr. Hsu will meet you in the pre-operative area before surgery to make markings on the areas planned for surgery and answer any last questions you may have.
Breast reduction is a medium-length cosmetic procedure that takes about three and a half to four hours. You will still be able to go home after the operation. During surgery, he will make the agreed upon incision, remove the breast tissue, raise the breast and nipple, and suture everything into place. Dr. Hsu uses a special skin closure technique that involves multiple layers of stitches (all dissolvable) to help achieve the thinnest, most inconspicuous scar.
Recovery & Post-operative Instructions:
After the surgery, Dr. Hsu will wrap dressings around the surgical area which will remain there for the first week during healing. You will also need to wear a surgical bra for about a week to aid the healing process. It is not recommended to lift elbows above your shoulders, but you can still use your arms for different things. During the recovery period, walking is encouraged to help quicken the healing process and minimize clots. Dr. Hsu will be available 24 hours afterward for any immediate concerns.
It is crucial to keep the surgical area dry until Dr. Hsu gives his approval to shower. To clean the rest of your body, you can bathe from the chest down. Swelling & bruising will peak about 48 hours after surgery but will then decrease significantly in the first two weeks. Most patients can return to work after two weeks, but many patients return even sooner. The biggest limitation for post-operative patients is driving, which should be avoided while taking pain medication. Patients usually stop taking pain medication after five to seven days and plan their work schedules accordingly. Six weeks is usually an appropriate time to return to most types of exercise and activity.
Any pain symptoms like neck, back, or shoulder pain should go away pretty soon after the surgery is completed. Many patients notice improvement in their symptoms almost immediately after surgery. Dr. Hsu likes to follow patients after surgery for an extended period of time to make sure the patient is healing well. Most follow up appointments are scheduled immediately after surgery and for up to a year afterward.
Dr. Hsu's view on Breast Reduction.
I personally find breast reduction surgery very satisfying because it can dramatically improve a patient’s quality of life. Most patients, by the time they come to see me for breast reduction surgery, have had years of chronic neck pain, back pain, and shoulder pain caused by excessive weight from very heavy breasts. In some severe cases, patients can have shoulder strap grooving and even nerve problems in their hands and arms related to this!
I like to include a significant breast lift when I perform this breast reduction procedure. There is almost always an excess of both skin as well as breast tissue, and so during the procedure I will almost always elect to place the nipple and areola in a higher position on the new breast to maximize its aesthetic appearance.