A reduction mammoplasty, or breast reduction, involves reducing the overall volume by removing breast tissue, and reshaping the breast skin and nipple position to provide a smaller and more youthful appearance to your breasts. Typically patients with larger breasts have back/neck pain, shoulder discomfort, bra strap grooving, and may also experience rashes in the breast creases as well as posture problems. Patients may also feel self-conscious or embarrassed about their large breasts, and their breasts may also interfere with the ability to exercise or lose weight. Bras and certain clothing may be difficult to find in the correct size, and many patients will opt to wear one or more sports bras to help support the extra weight on the chest. Frequently, the breasts also tend to droop because of their heaviness, and there can be asymmetries. The excess weight is made up of both glandular (breast) tissue and adipose (fatty) tissue.
Dr. Sharma’s Goals for your Breast Reduction:
- reduce the breast volume by removing excess breast tissue
- raise the nipple into a better more elevated youthful position on the breast mound
- maintain stable blood supply to the nipple
- improve symmetry of the two breasts
- improve the overall breast shape and lifted appearance
- reduce the excess skin and re-drape it to provide a more well-defined skin envelope to support the breast
- provide a long-lasting result
- improve the symptoms of pain in the back, neck, and/or shoulders
There are a variety of different breast reduction surgical techniques. Dr. Sharma will go over your options during the consultation and determine what will work best for you. Incisions may be placed around the the areola and vertically below the areola (lollipop scar) for a vertical breast reduction technique. This procedure works well for mild to moderate reduction volumes without significant droopiness (ptosis) of the nipples. Another common technique involves placing the scar around the areola, vertically below the areola, and horizontally along the breast crease (anchor scar). Dr. Sharma will discuss the pros and cons of each of the scar patterns with you to determine what is best for your individual needs. In order to minimize the length of scars, and provide the best appearance of your breasts, Dr. Sharma may also discuss the use of liposuction to the sides of the breasts to reduce the excess volume and get you the look you deserve.
Frequently Asked Questions
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Am I a Good Candidate?
Healthy, non-smoking patients who have these features of their breasts typically make good candidates for a breast reduction procedure:
- excess breast volume
- low-lying nipple position
- sagging (ptotic) breasts
- breast asymmetry – one breast larger than the other
- stretch marks (striae) on the breast skin
- a desire to improve the shape of the breasts and feel more confident with smaller breasts
- back, neck, or shoulder pain due to large breasts
- difficulty with physical exercise, sports, or other activities due to the large size of the breasts
- realistic goals and expectations
It is important to have some idea as to how small you would like your breasts to be. While breast cup sizes can be quite variable depending on the bra manufacturer, knowing your current and ideal breast cup sizes will help determine what operation is best for you. Dr. Sharma will review the pros and cons of the various types of breast reduction techniques with you during your consultation, and whether or not you are an appropriate candidate for this procedure.
Breast reduction surgery with Dr. Sharma has a very high satisfaction rate, and many patients feel more comfortable and confident with their breasts. Patients often wish that they had done the surgery sooner rather than delaying it for many years.
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Is Breast Reduction covered by OHIP?
With a referral from your family doctor, we can book you for a consultation to discuss your symptoms and examine you to determine if you are a good candidate for surgery. We then apply to the Ministry of Health to request coverage for your surgery. There may be some parts of the procedure that are not covered by OHIP, and this will be discussed with you at your consultation.
Note that wait times for breast reduction surgery can be lengthy, and some patients may decide that they do not want to wait. If you wish to book a consultation without a referral and without applying for OHIP coverage, this can also be arranged directly through our office.
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What happens on the day of surgery?
Surgery takes place in the operating room with you asleep under a general anesthetic, and can take 2.5-3 hours. Markings are first made before going into the OR to plan how much breast tissue and skin to remove and to mark out the new position of the lifted nipple. Once you are asleep the incisions are made very carefully and the tissue that is removed from each breast is weighed to give you an objective amount of volume reduction. The blood supply is preserved to the nipple without detaching it and re-positioned into a lifted position. Fluid is typically injected to minimize pain and bleeding and liposuction done to remove the excess fatty tissue from the sides of the breasts and to improve the aesthetic appearance. All of the stitches are dissolving underneath the skin to give you the best possible scars. Generally drainage tubes are NOT required. Paper tapes and gauze dressings are applied. You are placed into a customized post-operative surgical bra that we give you at the end of your surgery to provide support and minimize bruising/swelling. After surgery, you will be in the recovery room for a couple of hours and monitored closely. All post-operative instructions and prescriptions will be given to you before going home. Generally, no overnight stay is required and you will be able to go home the same day of surgery with a responsible adult.
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What happens after surgery?
Recovery is a gradual process. You are encouraged to take it easy but still get up frequently for short walks to reduce the risk of blood clots in the legs from immobility. The first 3-4 days you may need some of the prescribed pain medications, and will be recovering from the anesthetic and medications you were given. Most patients are needing only Tylenol or Advil after that. You will be able to shower directly over the paper tapes after 2 days. Generally it is a good idea to take 1-2 weeks off work, depending on what type of work you do. At 4 weeks from surgery you will typically feel fully recovered. You will have to avoid heavy lifting and vigorous exercise up until about 6 weeks from surgery. The final breast shape can take up to 3 months before all residual swelling has completely subsided.
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