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Mastopexy
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  Breast Reduction Surgery

The procedure reduces, elevates, and reshapes the breasts. Mammoplasty can also reduce the size of the areola (the dark skin surrounding the nipple). Very large breasts can be associated with neck, back, and shoulder pain and pressure, shoulder-grooving (where the bra-straps dig in), postural problems, rashes under the breasts, difficulty to find clothing that fits, interference with exercise and self-image problems.

Breast reduction alleviates painful discomfort and other conditions while improving the appearance of the breasts. We perform the surgery as an outpatient procedure totally under local tumescent anesthesia. If the patient requires general anesthesia or breast reduction under sedation anesthesia, the procedure is done at Bayonne Medical Center, same day surgery cosmetic suite.

The actual procedure takes 2-3 hours, but you will stay in the operating room a little longer. In most cases, you will be allowed to go home 2-3 hours following surgery.

We may choose from a variety of surgical procedures depending upon what changes are desired or feasible to correct. During the procedure the excess breast tissue and skin are removed, creating more aesthetically appealing, lifted, smaller breasts.

An Alternative to standard breast reduction surgical techniques is breast liposuction.

During the surgery the nipples will be moved to a higher position on the breasts. Typically, we make a keyhole incision (a circle around the areola and two incisions down the breast which will be closed to form a line. In some cases, the nipple and areola are transferred as a skin graft to their new position. This is only done when absolutely necessary. Drains may be placed on the sides of the breast to drain blood and excess fluid. The incisions are then sutured, closed, and taped.

The procedure necessarily causes scars. The scars may fade after surgery, but it can take years for them to do so. Usually the scars are acceptable and are hidden when you are wearing a bra. If you are going to have breast reduction surgery, you simply must accept the fact that you are exchanging very large breasts for scars.

Frequently Asked Questions

View Breast Reduction Surgery Photos

Q. What are the instructions after breast reduction surgery?

A.
Anesthetic:
General, twilight sedation, local tumescent anesthetic
Location of operation: Hospital or Surgery Center
Length of surgery: 2-3 hours
Length of stay: outpatient
Discomfort: Moderate. Anticipate 3-7 days of prescription pain medication.
Swelling and bruising: Improve in 2-4 weeks
Bandages: Will be removed in 1-7 days
Stitches: Will be removed in 5-7 days or will be absorbable
Support: You will wear a sports bra or ace wrap for 1-4 weeks. Avoid an under wire bra until your surgeon approves it.
Back to work: 1-3 weeks
Exercise: may be resumed in 2-4 weeks
Final result: Will be seen after the scars have matured, which will be about 1-3 years
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Q. What are the risks and complications of breast reduction surgery?

Scarring: If you are unwilling to accept scars, you should not have mammoplasty, as no surgeon can predict how the scars will heal on you.

Breast size: No one can guarantee your final breast size. You must discuss with us your desired size prior to surgery. You might want to e somewhere between one third and one half of your current size.

Possible risks and complications: Anesthesia reaction, asymmetry, bleeding, breastfeeding problems, boxy or flat breast (normally occurs post-operatively as a temporary condition), change in nipple color, dissatisfaction with breast size (too small or too large), fat necrosis, hematoma (pooling of clotted blood, risk is 3-4%), infection (signs of infection, warmth, redness, soreness, swelling), Irregularities in position of nipples and areola, keloid (heavy scar), nerve damage, nipple loss (1%), nipple numbness, pain, permanent numbness, reactions to medications, sensory change (4-7%), seroma (pooling of watery blood), skin irregularities, skin necrosis, slow healing, swelling, visible scar, wound separation. [Return to Top]

Q. Explain breast reduction by liposuction for females

A. Liposuction offers a minimally invasive alternative to the more invasive traditional mammoplasty procedures. The best candidates for breast reduction by liposuction are women with breasts that contain a large proportion of fat. The proportion of fat in the breast can be determined by physical examination of the breasts, mammogram, ultrasound, CAT scan, or MRI.

Mammoplasty is more appropriate when the breasts have more glandular tissue then fat. Liposuction reduces the breasts by removing excess fat. In addition, a visible breast lift may be accomplished if there is enough elasticity in the skin. Following liposuction the overall shape of the breasts will be very similar to their shape before the procedure (smaller version of the breast that the patient had before liposuction). After liposuction there is a gradual decrease in postoperative swelling over the subsequent 2-4 months. There may be temporary lumpiness for several weeks after surgery. This is not visible and is part of the healing process. [Return to Top]

Before   After   Before   After
     
Very large, asymmetrical breasts treated solely by liposuction by Drs. Pelosi

Q. Explain breast reduction by liposuction for males

A. Pseudogynecomastia is an enlarged male breast caused by excessive fat tissue, but which contains a normal amount of glandular breast tissue. The condition is very common as men become older and in younger men who are relatively obese. Men with excessive fat in their breasts are excellent candidates for liposuction.

Gynecomastia is an enlarged male breast caused by excessive glandular tissue. Excess breast glandular tissue occurs in about 75% during puberty. The condition is normally temporary and in the majority of cases, subsides. Gynecomastia can also be caused by other conditions: alcoholism, effect of medications, low levels of testosterone, renal failure, testicular cancer, adrenal tumors, cirrhosis of the liver, severe starvation, lung cancer, tuberculosis, hyperthyroidism, and drugs.

Drugs that can cause gynecomastia include: Amiloride (moduretic), amiodarone (cordarone), amphetamines, anabolic steroids, antiandrogens (cyproterone), anticancer drugs (cytotoxic), androgens, busulfan (myleran), captopril (capoten), cimetidine (tagamet), clomiphene (clomid), diazepam (valium), diethylpropion (tenuate), digitalis, domperidone, estrogens, ketoconazole (nizoral), marijuana, methyldopa, metoclopramide, nifedipine (procardia), nitrosourea, penicillamine, phenothiazines, phenytoin (dilantin), reserpine, spironolactone (aldactone), tricyclic antidepressants, and vincristine

If a man has a single enlarged breast, this may represent a breast tumor and a mammogram should be performed to rule out the possibility of cancer.

Gynecomastia can be treated by eliminating the cause or by surgical excision.

The normal male breast contains both fat tissue and glandular tissue. The breast tissue is usually small in volume and localized immediately under the nipple, is firmer then the surrounding fatty tissue and feels like a small lump. Mammography is performed prior to breast reduction to determine the amount of glandular tissue located within the surrounding fatty tissue.

Men with excessive fat in their breasts are excellent candidates for liposuction. It is relatively easy to remove fatty breast tissue by liposuction, but more difficult to remove the glandular tissue. Excessive glandular tissue is removed at the time of liposuction using small morcellation instruments through a small areolar incision. [Return to Top]

Q. What are the advantages of breast reduction by liposuction over mammoplasty?

  • Less expensive
  • Minimally invasive with less trauma to the breast
  • No visible scars
  • Can be done as an office procedure totally under local anesthesia
  • The procedure removes primarily the fatty tissue from the breast and mostly spares the glandular breast tissue that is needed for milk production (breastfeeding is normally not affected)
  • Mammograms usually appear normal after breast liposuction because the procedure creates little trauma to the breast tissue
  • Fewer post operative complications
  • Touch-up procedures are easily performed
  • Liposuction does not make the performance of a future traditional mammoplasty procedure more difficult [Return to Top]
Q. Who are the best candidates for breast liposuction?

A. Women with breasts that contain more fat than glandular tissue are the best candidates. These include:

  • Women who do not have pendulous breasts (indicates more glandular tissue then fat)
  • Women who are not thin (thin women tend to have more glandular tissue then fat)
  • Women who do not have excessively large breasts (liposuction usually achieves a 30-50% reduction in size)
  • Women who do not have excessively dense breast tissue
  • Women after menopause (fat replaces glandular tissue)
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