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.

Getting Ready

The week before your surgery:

• Ask a family member or friend to drive you home after your surgery. Do not drive yourself home.
  
  
• Ask your caregiver if you need to stop using any of your current medicine. These may include aspirin, ibuprofen, or blood thinners.
  
  
• Ask your caregiver before using any over-the-counter medicine, herbs or supplements. Tell your caregiver if you are using any of these.
  
  
• Tell your caregiver if you know or think you might be pregnant.
  
  
• You may need a blood transfusion if you lose a large amount of blood during surgery. Some people are worried about getting AIDS, hepatitis, or the West Nile virus from a blood transfusion. The risk of this happening is very low. Blood banks test all donated blood for AIDS, hepatitis, and the West Nile virus. You may be able to donate your own blood before surgery. This is called autologous blood donation. This must be done no later than three days before surgery. You may also ask a family member or friend with the same blood type to donate blood for you. This is called directed blood donation.
  
  
• You may need to have blood and urine tests, a mammogram, chest x-ray, and other tests. Ask your caregiver for more information about these and other tests that you may need. Write down the date, time, and location of each test.

The night before your surgery:

• Remove any nail polish.
  
  
• You may be given a pill to help you sleep.
  
  
• Ask caregivers about directions for eating and drinking.

The day of your surgery:

• Write down the correct date, time, and location of your surgery.
  
  
• What to bring: You may want to bring items such as a toothbrush and bathrobe.
  
  
• Ask your caregiver before taking any medicine on the day of your surgery. These medicines include insulin, diabetic pills, high blood pressure pills, or heart pills. Bring all the medicines you are taking, including the pill bottles, with you to the hospital.
  
  
• If you wear contact lenses, do not wear them on the day of your procedure or surgery. Glasses may be worn.
  
  
• Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.
  
  
• An anesthesiologist may talk to you before your surgery. This caregiver may give you medicine to make you sleepy before your surgery. Tell your caregiver if you or any member of your family has had a problem with anesthesia in the past.
  
  
• While you are sitting or standing, caregivers will measure and make marks on your breasts as guides during surgery. These marks show where incisions (cuts) will be made. If your nipple and areola (the colored circle around the nipple) are to be moved, this will also be marked.
  
  
• You will be asked to sign a legal piece of paper (consent form). It gives your caregiver permission to do the surgery. It also explains the problems that may happen and your treatment choices. If you are unable to give your consent, someone who has permission can sign this form for you. Before giving your consent, make sure all your questions have been answered so that you understand what may happen.

Treatment

What will happen:

• You will be asked to change into a hospital gown. You may be given medicine to help you relax or make you drowsy. You will be taken on a stretcher to the operating room. You will get medicine called general anesthesia to keep you completely asleep during surgery. Caregivers will clean your chest area, and sheets will be put over you.
  
  
• Caregivers will make incisions 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 the breasts are very large, your caregiver may completely separate the areola with the nipple from the breast and then position it up higher on the 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. An adult will need to drive you home and should stay with you for 24 hours. If you cannot go home, you will be taken to a hospital room.

Waiting area:

This is an area where your family and friends can wait until you are able to have visitors. Ask your visitors to provide a way to reach them if they leave the waiting area.

Contact a caregiver if

• You cannot make it to your appointment on time.
  
  
• You have a fever.
  
  
• You have a skin infection or an infected wound near the area where surgery will be done.
  
  
• You have questions or concerns about your surgery.

Seek Care Immediately if

• You feel a lump in your breast or axilla (underarm), or see or feel other changes.
  
  
• You have fluid coming out from your nipple.
  
  
• You have redness, swelling, or severe pain in the breast.

Copyright © 2012. Thomson Reuters. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

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.