BREAST REDUCTION (Reduction Mammaplasty)

 Background
 Patient Groups
 Patient Concerns and Planning
 Preparing for Surgery
 The Operation
 Recovery
 At Home
 Office Visits and Follow-up
 Outcome and Complications
 Case Histories (Before and After)

THE OPERATION
Surgery for breast reduction can take 3 to 5 hours. Anesthesia is preferably a general method whereby a tube is either inserted into the back of the throat only or into the airway itself. Intravenous fluids are administered as well as medications for comfort, infection control, and general relaxation. Patients may be operated as an outpatient or for general medical supervision may stay overnight. The breasts are lightly taped on occasion to compress any pleats that are normal right after surgery. Some compression bandages are placed to support the breasts, but bras are not applied right away in order to protect the breasts from too much compression. The cone of the breasts is flattened in some cases and there are moderate pleat ridges around the areolae. This appearance may be disquieting but rapidly improves over days to weeks. These features are natural for this method of purse string repair.

4 key landmarks are joined into a tear configuration so that all surgery is performed within the perimeter of this design to permit closure in a circle by cinching the purse string.
The yellow and violet pattern is the breast tissue that is assembled into a new internal brassiere. The nipple is moved upward with the gland as the internal bra is fashioned so the new breast will be situated higher on the chest.
After the internal bra is fashioned and the breast is suspended to the chest, the skin is closed by cinching the purse string suture to form a circular scar around each areola. The nature of a purse string cinch will be to create some necessary early pleating which subsides over time. The yellow pattern on the right breast is the breast tissue that is closed within a vertical or t scar pattern of skin closure. The white vertical and horizontal lines on the left breast represent the vertical and t scar method of skin closure for extreme forms of enlarged breasts.
The purse string will close each areola into a circle illustrated in blue. The white vertical and horizontal lines represent the closure and eventual scars when the vertical or t scar reduction method of skin closure is performed.