"Beauty comes as much from the mind as from the eye."
- Grey Livingston
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Breast Reduction
Breast reduction surgery (reduction mammoplasty) is a common plastic surgery procedure that was performed about 115,000 times in 2005, according to the American Society of Plastic Surgeons.

Occurrence of Over Sized Breasts

The oversized-breast condition (breast hypertrophy) typically occurs in both breasts at puberty or soon afterward. Sometimes pregnancy-related breast enlargement persists indefinitely. Although rare, sudden onset of breast enlargement may also occur. No medical therapy exists for breast reduction. Specially designed bras can help relieve some of the discomfort, but they may also cause irritation to the shoulder area.

The Benefits of Breast Reduction

Breast reduction surgery is typically performed to create a more proportional chest curvature with your overall body shape, and to alleviate problems with activities, health, and clothing. The procedure can also help achieve symmetry where breasts are not equal in size. The plastic surgeon can change the shape and firmness of the breasts to create a more aesthetic appeal. Nipple surgery may also be performed to reduce areola size. In fact, the breast reduction candidate may require a breast lift to achieve a fully satisfactory outcome.

The Initial Consultation

At your initial consultation, Dr. Harry Marshak will take measurements and photos of your breasts to document your pre-surgical condition and for comparison after surgery. A breast X-ray (mammogram) may also be taken to check for cancer or other abnormalities before surgery.

How Breast Reduction Surgery Is Performed

Breast reduction plastic surgery is usually performed under general anesthesia, so you will sleep through the procedure. The breast comprises glandular tissues, fatty tissues, and skin: all three areas are surgically reduced as needed.

Before entering the operating room, the surgeon will ask you to sit upright. While sitting, surgical markings will be drawn on your breasts. The markings outline the "sitting-up" position of your breasts, to make the correct incisions later during surgery when you are lying down. The drawings will typically take the form of an anchor — encircling the areola and extending above the areola to the new location of the nipple. The markings also extend down vertically below the nipple and horizontally following the natural curve of the crease beneath your breast.

The incision is made along the surgical markings. Flaps are created on both sides of the breast and the excess skin, fat, and glandular tissues are extracted. In most cases the nipples are moved to a higher position on the breast, but remain attached to the nerves and blood vessels. For very large breasts, however, the nipples may need to be moved and grafted to a completely new location. In these cases, the nipples are removed from the underlying connecting tissues and you will lose sensation in the nipple and areola.

The nipple and areola are usually moved to a new position. The position of the nipple is usually vertically level with the crease on the underside of the breast. After surgery, the flaps of skin (that were once above the nipple) are refolded around and beneath the breast, pulled to the front of the breast around the nipple, and sutured in place. The reduction of breast tissue and skin reduces the weight of the breast and reshapes it into proportion.

Upon completion of the procedure, stitches remain around the areola and nipple area, in a vertical line beneath the nipple and horizontally under the breast. If the breasts were not too overly large, then some surgical techniques can avoid the horizontal scar altogether.

After Breast Reduction Surgery

The incisions and tissue movement will cause your breasts to be sore, swollen, and bruised. Pain can be treated by a prescription from your plastic surgeon. You can expect to wear bandages for about two days after surgery. Activity should be kept to a minimum for a week or two. There should be no heavy lifting or pushing for three or four weeks. Caring for young children immediately after surgery is not recommended.

Complications and Risks

As with any breast surgery or other surgery, there is risk of complications related to infection or reaction to anesthesia. With proper precautions by the surgical team, complications are typically minimized or prevented.

Contact Dr. Harry Marshak for a consultation.
Dr. Harry Marshak, F.A.C.S.
421 North Rodeo Drive | Beverly Hills, CA 90210
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