Breast Reduction

WHAT YOU SHOULD KNOW:

• Breast reduction, also called reduction mammaplasty, is surgery women have to make one or both breasts smaller. It may be done to relieve symptoms or problems caused by large breasts. These problems may include back pain, skin rash under the breasts, and pressure marks caused by large bra straps. Having large breasts may also limit a woman's ability to do some activities and decrease her self-confidence. With breast reduction, some of your breast tissue, fat, and skin may be removed. This may be done with open surgery alone or combined with liposuction. The type of breast reduction to be done depends on how much breast tissue will be removed, how your breasts look, and other factors.
  
  
• Breast reduction may be done for any woman who wants to have smaller breasts. Women should consider having this surgery after their breasts are already fully developed. After surgery, the size and shape of your breasts may be affected by pregnancy, lactation (breast milk production), or changes in your body weight. You and your caregiver will decide if breast reduction surgery is right for you.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

• During or after surgery, you may bleed more than usual or have trouble breathing. You may get an infection. You may have scars, and your breasts may look unequal. You may lose feeling in your breasts, and you may not be able to breast feed. Skin death may occur if you have a problem with healing, and you may need another surgery. Women who smoke are at a higher risk for problems. Even after breast reduction, your breast may continue to change shape.
  
  
• You may get a blood clot in your leg or arm. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs or brain. A blood clot in your lungs can cause chest pain and trouble breathing. A blood clot in your brain can cause a stroke. These problems can be life-threatening. Call your caregiver if you are worried or have questions about your surgery, medicine, or care.

WHILE YOU ARE HERE:

Before your surgery:

• Informed consent: A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.
  
  
• IV: An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.
  
  
• Pre-op care: You may be given medicine right before your procedure or surgery. This medicine may make you feel relaxed and sleepy. You are taken on a stretcher to the room where your procedure or surgery will be done, and then you are moved to a table or bed.
  
  
• Monitoring:
  
  
  • Heart monitor: This is also called an ECG or EKG. Sticky pads placed on your skin record your heart's electrical activity.
    
    
  • Pulse oximeter: A pulse oximeter is a device that measures the amount of oxygen in your blood. A cord with a clip or sticky strip is placed on your finger, ear, or toe. The other end of the cord is hooked to a machine. Never turn the pulse oximeter or alarm off. An alarm will sound if your oxygen level is low or cannot be read.
  
  
• Anesthesia: This is medicine to make you comfortable during the surgery. Caregivers work with you to decide which anesthesia is best for you.
  
  
  • General anesthesia: Caregivers use this medicine to keep you asleep and free from pain during surgery. They give you anesthesia through your IV or as a gas. You may breathe in the gas through a mask or through a breathing tube placed down your throat. The tube may cause you to have a sore throat when you wake up.
    
    
  • Local anesthesia: Medicine is used to numb the area of your body where the surgery or procedure will be done. It is usually injected into the skin. It also may be given as a gel or jelly applied to your gums for dental procedures or as a patch. For such areas as the genitals, medicine may be given as a cream on the skin or mucus membranes.

During your surgery:

• Caregivers will clean your chest area and put sheets over you to keep the surgery area clean. Incisions will be made around the areola and down to the fold of your breast. The fold is the place under the breast where it joins to the chest. More cuts will be made depending on the type of breast reduction to be done. Excess breast tissue, fat, and skin will then be removed and the nipple and areola will be moved up. Your areola may also be cut to make it smaller. If your breasts are very large, your caregiver may completely separate the areola with the nipple from the breast and then position it up higher on your breast.
  
  
• Liposuction may be used to remove excess fat from under your arm and improve the shape of your breast. Your skin will be brought together and sewed with sutures (threads) to close the incision and shape the breast. A piece of mesh may also be placed inside the incision for support before closing it. Thin rubber tubes (drains) may be put into your skin to drain blood or fluid from your incisions. The wound will then be covered with bandages to help shape and support your breasts.

After surgery:

You are taken to a room where your heart and breathing will be monitored. Do not get out of bed until your caregiver says it is okay. A bandage may cover wounds to help prevent infection. You may be able to go home after some time passes. If you had general anesthetic, an adult will need to drive you home. Your driver or someone else should stay with you for 24 hours. If you cannot go home, you will be taken to a hospital room.

• Activity: Call your caregiver for help before getting out of bed. Caregivers may help you get out of bed to walk on the same day of surgery, or the day after. Ask caregivers if there are exercises that you may do while in bed. Exercise helps blood move through your body and may help prevent blood clots from forming.
  
  
• Deep breathing and coughing: This is an exercise to help decrease your risk for a lung infection after surgery. Do the following:
  
  
  • Hold a pillow tightly against your incision (cut) when you cough to help decrease pain. Take a deep breath and hold it for as long as you can. Deep breathes help open the airways that lead to your lungs. Let the air out and follow with a strong cough. Spit out any mucus you cough up. Repeat the steps 10 times every hour.
    
    
  • You may be given an incentive spirometer to help you take deeper breaths. Put the plastic piece into your mouth and take a very deep breath. Hold your breath as long as you can. Let out your breath and cough. Repeat the steps 10 times every hour.
  
  
• Food and drink after surgery: You will able to drink liquids and eat certain foods once your stomach function returns after surgery. You may be given ice chips at first. Then you will get liquids such as water, broth, juice, and clear soft drinks. If your stomach does not become upset, you may then be given soft foods, such as ice cream and applesauce. Once you can eat soft food easily, you may slowly begin to eat solid foods.
  
  
• Intake and output: Caregivers will keep track of the amount of liquid you are getting. They also may need to know how much you are urinating. Ask how much liquid you should drink each day. Ask caregivers if they need to measure or collect your urine.
  
  
• Medicines: You may be given the following medicines:
  
  
  • Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.
    
    
  • Antinausea medicine: This medicine may be given to calm your stomach and to help prevent vomiting.
    
    
  • Pain medicine: Caregivers may give you medicine to take away or decrease your pain.
    
    
    • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.
      
      
    • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.
  
  
• Pneumatic boots: Inflatable boots are put on your legs. The boots are connected to an air pump. The pump tightens and loosens different areas of the boots. This helps improve blood flow to prevent clots.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.