WHAT IS BREAST AUGMENTATION?

Also known as augmentation mammaplasty, breast augmentation surgery involves using implants to fulfill your desire for fuller breasts or to restore breast volume lost after weight reduction or pregnancy.

BREAST AUGMENTATION BEFORE AND AFTER

If you are dissatisfied with your breast size, breast augmentation surgery (either breast enhancement or breast enlargement) is a choice to consider. Breast augmentation can:
Increase fullness and projection of your breasts
Improve the balance of your figure
Enhance your self-image and self-confidence
Also known as augmentation mammaplasty, the procedure involves using implants to fulfill your desire for fuller breasts or to restore breast volume lost after weight reduction or pregnancy.
Implants also may be used to reconstruct a breast after mastectomy or injury.
Many patients find it helpful to review breast augmentation before and after photos.
What it won't do
Breast augmentation does not correct severely drooping breasts. If you want your breasts to look fuller and to be lifted due to sagging, a breast lift may be required in conjunction with breast augmentation.
Breast lifting can often be done at the same time as your augmentation or may require a separate operation. Your plastic surgeon will assist you in making this decision.
Is it right for me?
Breast augmentation is a highly individualized procedure and you should do it for yourself, not to fulfill someone else's desires or to try to fit any sort of ideal image. Pictures of breast augmentation procedures performed by ASPS Member Surgeons may help you in the decision-making process.
Breast augmentation may be a good option for you if:
You are physically healthy
You have realistic expectations
Your breasts are fully developed
You are bothered by the feeling that your breasts are too small
You are dissatisfied with your breasts losing shape and volume after pregnancy, weight loss, or with aging
Your breasts vary in size or shape
One or both breasts failed to develop normally

PREPARING FOR BREAST AUGMENTATION SURGERY

After researching the basics about breast enhancement or breast enlargement, many patients want to know what to expect before breast augmentation surgery.

Prior to breast surgery, your ASPS Member Surgeon may ask you to:
Get lab testing or a medical evaluation
Take certain medications or adjust your current medications
Get a baseline mammogram before surgery and another one after surgery to help detect any future changes in your breast tissue
Stop smoking well in advance of your breast augmentation surgery
Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding
Special instructions you receive will cover:
What to do on the day of surgery
Post-operative care and follow-up
Breast implant registry documents (when necessary)
Your plastic surgeon will also discuss where your procedure will be performed. Breast augmentation surgery may be performed in an accredited office-based surgical center, outpatient ambulatory surgical center or a hospital.
You'll need help
If your breast augmentation is performed on an outpatient basis, be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery.

Breast implant risks and safety information

The success and safety of your breast augmentation procedure depends very much on your being completely candid during your consultation. By being actively involved your consultation about breast augmentation, problems, concerns and questions you may have can be addressed by your ASPS Member Surgeon. You'll be asked a number of questions about your health, desires and lifestyle.
Be prepared to discuss:
Why you want breast augmentation surgery, your expectations and desired outcome
Medical conditions, drug allergies and medical treatments
Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs
Previous surgeries
Family history of breast cancer and results of any mammograms or previous biopsies
Your surgeon may also:
Evaluate your general health status and any pre-existing health conditions or risk factors
Examine your breasts, and may take detailed measurements of their size and shape, skin quality, placement of your nipples
Take photographs for your medical record
Discuss your options and recommend a course of treatment
Discuss likely outcomes of breast augmentation surgery and any risks or potential complications
Discuss the use of anesthesia during your breast augmentation procedure

IMPORTANT FACTS ABOUT BREAST AUGMENTATION RISKS AND COMPLICATIONS

The decision to have breast augmentation surgery is extremely personal and you’ll have to decide if the benefits will achieve your goals and if the risks of breast implant safety and potential complications are acceptable.
Your plastic surgeon and/or staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks or potential complications.
The risks of breast implants and complications after breast augmentation include:
Unfavorable scarring
Bleeding (hematoma)
Infection
Poor healing of incisions
Changes in nipple or breast sensation, may be temporary or permanent
Capsular contracture, which is the formation of firm scar tissue around the implant
Implant leakage or rupture
Wrinkling of the skin over the implant
Anesthesia risks
Fluid accumulation
Blood clots
Pain, which may persist
Deep vein thrombosis, cardiac and pulmonary complications
Possibility of revisional surgery
Although there potentially may be complications with breast implants, they do not impair breast health. Careful review of scientific research conducted by independent groups such as the Institute of Medicine has found no proven link between breast implants and autoimmune or other systemic diseases.
Other important considerations:
Breast implants are not guaranteed to last a lifetime and future surgery may be required to replace one or both implants.
Pregnancy, weight loss and menopause may influence the appearance of augmented breasts over the course of your lifetime.
Visit our partner website to learn more about the risks of breast implant surgery.

BREAST AUGMENTATION PROCEDURE STEPS

What happens during breast augmentation surgery?
Step 1 - Anesthesia
Medications are administered for your comfort during breast augmentation surgery. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.
Step 2 - The incision
Incisions are made in inconspicuous areas to minimize visible scarring. You and your plastic surgeon will discuss which incision options are appropriate for your desired outcome. Incision options include:
Inframammary incision, Transaxillary incision, Periareolar incision

Incisions vary based on the type of implant, degree of enlargement desired, your particular anatomy, and patient-surgeon preference.

Step 3 - Implant choice: Silicone breast implants or saline breast implants?
Breast size and shape are important, so be honest and open about your expectations when talking with your surgeon.
Implant type and size will be determined not just on your desired increase in size but more importantly on your breast anatomy, skin elasticity and body type.
Options for Breast Implants
Saline breast implants are filled with sterile salt water. They can be filled with varying amounts of saline which can affect the shape, firmness and feel of the breast. Should the implant shell leak, a saline breast implant will collapse and the saline will be absorbed and naturally expelled by the body.
Silicone breast implants are filled with an elastic gel. The gel feels and moves much like natural breast tissue. If the implant leaks, the gel may remain within the implant shell, or may escape into the breast implant pocket.
A leaking implant filled with silicone gel may not collapse. If you choose these implants, you may need to visit your plastic surgeon regularly to make sure the implants are functioning properly. An ultrasound or MRI screening can assess the condition of breast implants.
Implant manufacturers occasionally introduce new styles and types of implants, so there may be additional options available.
Currently Saline breast implants are FDA-approved for augmentation in women 18 years of age and older.
Currently Silicone breast implants are FDA-approved for augmentation in women 22 years of age and older.
Saline or silicone implants may be recommended at a younger age if used for reconstruction purposes.
See http://www.breastimplantsafety.org/ for current information.

Step 4 - Inserting and placing the breast implant
After the incision is made, a breast implant is inserted into a pocket either:
Under the pectoral muscle (a submuscular placement), or
Directly behind the breast tissue, over the pectoral muscle (a submammary/ subglandular placement)
The method for inserting and positioning implants depends on the type of implant, degree of enlargement desired, your body type, and your surgeon’s recommendations.

Step 5 - Closing the incisions
Incisions are closed with layered sutures in the breast tissue and with sutures, skin adhesive or surgical tape to close the skin. Over time the incision lines will fade.

Step 6 - See the results
The results of breast augmentation surgery are immediately visible. Over time, post-surgical swelling will resolve and incision lines will fade. Satisfaction with your new image should continue to grow as you recover and realize the fulfillment of your goal for fuller breasts.

BREAST AUGMENTATION RECOVERY

Many patients have questions about breast augmentation and recovery.
Although many factors are involved with determining your actual recovery time for breast augmentation, you will likely experience a post-surgical recovery period of 24 to 48 hours and an additional reduced-activity period of a few days, you will likely experience soreness and swelling for a few weeks.
Exercise and normal activity can resume at the direction of your plastic surgeon. Over time, post-surgical swelling will decrease and incision lines will fade.
You will be given specific instructions that may include: How to care for your breasts following breast augmentation surgery, medications to apply or take orally to aid healing and reduce the risk of infection, and when to follow-up with your plastic surgeon.
Be sure to ask your plastic surgeon specific questions about what you can expect during your individual recovery period.
Where will I be taken after my surgery is complete?
What medication will I be given or prescribed after surgery?
Will I have dressings/bandages after surgery? When will they be removed?
Are stitches removed? When?
When can I resume normal activity and exercise?
When do I return for follow-up care?
When you go home
If you experience shortness of breath, chest pains, or unusual heart beats, seek medical attention immediately. Should any of these complications occur after breast augmentation, you may require hospitalization and additional treatment.
The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure and another surgery may be necessary.
Be careful
Following your physician’s instructions is key to the success of your surgery. It is important that the surgical incisions are not subjected to excessive force, abrasion, or motion during the time of healing. Your doctor will give you specific instructions on how to care for yourself.

WHAT IS BREAST LIFT SURGERY?

Commonly referred to as a breast lift or boob lift, mastopexy surgery raises and firms the breasts by removing excess skin and tightening the surrounding tissue to reshape and support the new breast contour.
Enhancing your appearance with a breast lift
A woman's breasts often change over time, losing their youthful shape and firmness. These changes and loss of skin elasticity can result from:
Pregnancy
Breastfeeding
Weight fluctuations
Aging
Gravity
Heredity
Sometimes the areola becomes enlarged over time, and a breast lift will reduce this as well. A breast lift can rejuvenate your figure with a breast profile that is youthful and uplifted.
What breast lifts don't do
Breast lift surgery does not significantly change the size of your breasts or round out the upper part of your breast. If you want your breasts to look fuller, consider breast lift and augmentation surgery. If you want smaller breasts, consider combining breast lift and reduction surgery.
Is it right for me?
Breast lift surgery is a highly individualized procedure and you should do it for yourself, not to fulfill someone else's desires or to try to fit any sort of ideal image.
A breast lift is a good option for you if:
You are physically healthy and maintain a stable weight
You do not smoke
You have realistic expectations
You are bothered by the feeling that your breasts sag, have lost shape and volume
Your breasts have a flatter, elongated shape or are pendulous
When unsupported, your nipples fall below the breast crease
Your nipples and areolas point downward
You have stretched skin and enlarged areolas
One breast is lower than the other

WHAT TO EXPECT DURING YOUR BREAST LIFT CONSULTATION

The success and safety of your breast lift procedure depends very much on your complete candidness during your consultation. You’ll be asked a number of questions about your health, desires and lifestyle.
Be prepared to discuss:
Why you want the surgery, your expectations and desired outcome
Medical conditions, drug allergies and medical treatments
Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs
Previous surgeries
Family history of breast cancer and results of any mammograms or previous biopsies
Your mastopexy surgeon may also:
Evaluate your general health status and any pre-existing health conditions or risk factors
Examine your breasts, and may take detailed measurements of their size and shape, skin quality, placement of your nipples and areolas
Take photographs for your medical record
Discuss your options and recommend a course of treatment
Discuss likely outcomes of breast lift surgery and any risks or potential complications
Discuss the use of anesthesia during your breast lift

PREPARING FOR BREAST LIFT SURGERY

Before mastopexy surgery, you may be asked to:
Get lab testing or a medical evaluation
Take certain medications or adjust your current medications
Get a baseline mammogram before surgery and another one after surgery to help detect any future changes in your breast tissue
Stop smoking well in advance of surgery
Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding
Special instructions you receive will cover:
What to do on the day of surgery
Post-operative care and follow-up
Your plastic surgeon will also discuss where your procedure will be performed. Breast lift surgery may be performed in an accredited office-based surgical center, outpatient / ambulatory surgical center, or a hospital.
You’ll need help
If your breast lift is performed on an outpatient basis, be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery.

BREAST LIFT RISKS AND SAFETY INFORMATION

The decision to have surgery is extremely personal and you'll have to decide if the benefits will achieve your goals and if breast lift risks and potential complications are acceptable.
Your plastic surgeon and/or staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks or potential complications.
The risks include:
An unfavorable breast lift scar
Bleeding (hematoma)
Infection
Poor healing of incisions
Changes in nipple or breast sensation, which may be temporary or permanent
Anesthesia risks
Breast contour and shape irregularities
Skin discoloration, permanent pigmentation changes, swelling and bruising
Damage to deeper structures - such as nerves, blood vessels, muscles, and lungs - can occur and may be temporary or permanent
Allergies to tape, suture materials and glues, blood products, topical preparations or injected agents
Breast asymmetry
Fatty tissue deep in the skin could die (fat necrosis)
Fluid accumulation
Excessive firmness of the breast
Potential partial or total loss of nipple and areola
Deep vein thrombosis, cardiac and pulmonary complications
Blood clots
Pain, which may persist
Possibility of revisional surgery
You should know that:
Breast lift surgery can interfere with diagnostic procedures
Breast and nipple piercing can cause an infection
Breast lift surgery does not normally interfere with pregnancy, but if you are planning to have a baby, your breast skin may stretch and offset the results of mastopexy and you may have more difficulty breastfeeding after this operation
Where will my surgery be performed?
A breast lift procedure may be performed in your plastic surgeon's accredited office-based surgical facility, an ambulatory surgical facility or a hospital. Your plastic surgeon and the assisting staff will fully attend to your comfort and safety.
When you go home
If you experience shortness of breath, chest pains, or unusual heart beats, seek medical attention immediately. Should any of these complications occur, you may require hospitalization and additional treatment.
The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure and another surgery may be necessary.
Be careful
Following your physician's instructions is key to the success of your surgery. It is important that the surgical incisions are not subjected to excessive force, abrasion, or motion during the time of healing to minimize the chances of breast lift scarring. Your doctor will give you specific instructions on how to care for yourself.
Be sure to ask questions: It's very important to ask your plastic surgeon questions about your breast lift procedure. It's natural to feel some anxiety, whether it's excitement for your anticipated new look or a bit of preoperative stress. Don't be shy about discussing these feelings with your plastic surgeon.

BREAST LIFT PROCEDURE STEPS

What happens during breast lift surgery? Your mastopexy surgery can be achieved through a variety of incision patterns and techniques. The appropriate technique for you will be determined based on:
Breast size and shape
The size and position of your areolas
The degree of breast sagging
Skin quality and elasticity as well as the amount of extra skin
Step 1 - Anesthesia
Medications are administered for your comfort during breast lift surgery. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.
Step 2 - The incision
There are three common incision patterns:
Around the areola
A1
Around the areola and vertically down from the areola to the breast crease
A2
Around the areola, vertically down from the breast crease and horizontally along the breast crease
A1
Step 3 - Reshaping your breasts
After your doctor makes the incisions:
The underlying breast tissue is lifted and reshaped to improve breast contour and firmness.
The nipple and areola are repositioned to a natural, more youthful height.
If necessary, enlarged areolas are reduced by excising skin at the perimeter.
Excess breast skin is removed to compensate for a loss of elasticity.
Step 4 - Closing the incisions
After your breasts are reshaped and excess skin is removed, the remaining skin is tightened as the incisions are closed.
Some incision lines resulting from breast lifts are concealed in the natural breast contours; however, others are visible on the breast surface. Incision lines are permanent, but in most cases will fade and significantly improve over time.
Sutures are layered deep within the breast tissue to create and support the newly shaped breasts. Sutures, skin adhesives and/or surgical tape may be used to close the skin.
Step 5 - See the results
The results of your breast lift surgery are immediately visible. Over time, post-surgical swelling will resolve and incision lines will fade.
Satisfaction with your new image should continue to grow as you recover and realize the fulfillment of your goal for breasts which have been restored to a more youthful and uplifted position.

BREAST LIFT RECOVERY

After your breast lift procedure is completed, dressings or bandages will be applied to the incisions. You’ll need to wear an elastic bandage or support bra to minimize swelling and support your breasts as they heal.
A small, thin tube may be temporarily placed under the skin to drain any excess blood or fluid that may collect after breast lift surgery.
You will be given specific instructions that may include: How to care for your breasts following surgery, medications to apply or take orally to aid healing and reduce the risk of infection, and when to follow-up with your plastic surgeon.
Be sure to ask your plastic surgeon specific questions about what you can expect during your individual mastopexy recovery period.
Where will I be taken after my surgery is complete?
What medication will I be given or prescribed after surgery?
Will I have dressings/bandages after surgery? When will they be removed?
Are stitches removed? When?
When can I resume normal activity and exercise?
When do I return for follow-up care?

BREAST LIFT RESULTS WILL BE LONG-LASTING

The final results of your breast lift will appear over the next few months as breast shape and position continue to settle. Incision lines are permanent, but will continue to fade over time.
Your mastopexy results will be long-lasting. Over time, your breasts can continue to change due to aging and gravity. But, you’ll be able to retain your new look longer if you:
Maintain your weight
Keep a healthy lifestyle
Special note: While a breast lift does not usually affect breast function, if you are planning to become pregnant, discuss this with your plastic surgeon. Changes that occur in the breasts during pregnancy can minimize or reverse the improvement a breast lift provides. Likewise, plans for significant weight loss should also be discussed.

WHAT IS BREAST RECONSTRUCTION?

Breast reconstruction is achieved through several plastic surgery techniques that attempt to restore a breast to near normal shape, appearance and size following mastectomy.
Although breast reconstruction can rebuild your breast, the results are highly variable:
A reconstructed breast will not have the same sensation and feel as the breast it replaces.
Visible incision lines will always be present on the breast, whether from reconstruction or mastectomy.
Certain surgical techniques will leave incision lines at the donor site, commonly located in less exposed areas of the body such as the back, abdomen or buttocks.
A note about symmetry: If only one breast is affected, it alone may be reconstructed. In addition, a breast lift, breast reduction or breast augmentation may be recommended for the opposite breast to improve symmetry of the size and position of both breasts.

BEAUTY FOR LIFE

Enhancing your appearance with breast reconstruction
Breast reconstruction is a physically and emotionally rewarding procedure for a woman who has lost a breast due to cancer or other condition.
The creation of a new breast can dramatically improve your self-image, self-confidence and quality of life. Although surgery can give you a relatively natural-looking breast, a reconstructed breast will never look or feel exactly the same as the breast that was removed.
Is it right for me?
Breast reconstruction is a highly individualized procedure. You should do it for yourself, not to fulfill someone else’s desires or to try to fit any sort of ideal image.
Breast reconstruction is a good option for you if:
You are able to cope well with your diagnosis and treatment
You do not have additional medical conditions or other illnesses that may impair healing
You have a positive outlook and realistic goals for restoring your breast and body image
Breast reconstruction typically involves several procedures performed in multiple stages. It can:
Begin at the same time as mastectomy, or
Be delayed until you heal from mastectomy and recover from any additional cancer treatments
It’s important that you feel ready for the emotional adjustment involved in breast reconstruction. It may take some time to accept the results of breast reconstruction.

WHAT TO EXPECT DURING YOUR CONSULTATION

The success and safety of your breast reconstruction procedure depends very much on your complete candidness during your consultation. You’ll be asked a number of questions about your health, desires and lifestyle.
Be prepared to discuss:
Why you want the surgery, your expectations and desired outcome
Medical conditions, drug allergies and medical treatments
Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs
Previous surgeries
The options available in breast reconstruction surgery
The likely outcomes of breast reconstruction and any risks or potential complications
The course of treatment recommended by your plastic surgeon, including procedures to achieve breast symmetry
Your surgeon may also:
Evaluate your general health status and any pre-existing health conditions or risk factors
Examine your breasts, and take detailed measurements of their size and shape, skin quality, and placement of nipples and areolae
Take photographs for your medical record
Discuss your options and recommend a course of treatment
Discuss likely outcomes of breast reconstruction and any risks or potential complications

BREAST RECONSTRUCTION RISKS AND SAFTEY INFORMATION

The decision to have breast reconstruction surgery is extremely personal. You’ll have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable.
Your plastic surgeon and/or staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedures you will undergo and any risks or potential complications.
The possible risks of breast reconstruction include, but are not limited to, bleeding, infection, poor healing of incisions, and anesthesia risks. You should also know that:
Flap surgery includes the risk of partial or complete loss of the flap and a loss of sensation at both the donor and reconstruction site.
The use of implants carries the risk of breast firmness (capsular contracture) and implant rupture.
Breast implants do not impair breast health. Careful review of scientific research conducted by independent groups such as the Institute of Medicine has found no proven link between breast implants and autoimmune or other systemic diseases. Visit www.breastimplantsafety.org for current information.
Where will my surgery be performed?
Surgery for your breast reconstruction is most often performed in a hospital setting, possibly including a short hospital stay, and your doctor will likely use general anesthesia.
Some follow-up procedures may be performed on an outpatient basis, and local anesthesia with sedation may be used.
These decisions will be based on the requirements of your specific procedure and in consideration of your preferences and your doctor’s best judgment.

PREPARING FOR SURGERY

Prior to surgery, you may be asked to:
Get lab testing or a medical evaluation
Take certain medications or adjust your current medications
Stop smoking well in advance of surgery
Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding
Special instructions you receive will cover:
What to do on the day of surgery
The use of anesthesia during your breast reconstruction
Post-operative care and follow-up
Breast implant registry documents (when necessary)
Your plastic surgeon will also discuss where your procedure will be performed. Breast reconstruction surgery may be performed in an accredited office-based surgical center, outpatient/ambulatory surgical center, or a hospital.
You’ll need help
If your breast reconstruction is performed on an outpatient basis, be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery.

BREAST RECONSTRUCTION PROCEDURAL STEPS

What happens during breast reconstruction surgery?
Step 1 - Anesthesia
Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.
Step 2 - Flap techniques reposition a woman’s own muscle, fat and skin to create or cover the breast mound.
Sometimes a mastectomy or radiation therapy will leave insufficient tissue on the chest wall to cover and support a breast implant. The use of a breast implant for reconstruction almost always requires either a flap technique or tissue expansion.
A TRAM flap uses donor muscle, fat and skin from a woman’s abdomen to reconstruct the breast. The flap may either remain attached to the original blood supply and be tunneled up through the chest wall, or be completely detached, and formed into a breast mound.
Alternatively, your surgeon may choose the DIEP or SGAP flap techniques which do not use muscle but transport tissue to the chest from the abdomen or buttock.

A latissimus dorsi flap uses muscle, fat and skin from the back tunneled to the mastectomy site and remains attached to its donor site, leaving blood supply intact.

Occasionally, the flap can reconstruct a complete breast mound, but often provides the muscle and tissue necessary to cover and support a breast implant.

Step 3 - Tissue expansion stretches healthy skin to provide coverage for a breast implant.
Reconstruction with tissue expansion allows an easier recovery than flap procedures, but it is a more lengthy reconstruction process.
It requires many office visits over 4-6 months after placement of the expander to slowly fill the device through an internal valve to expand the skin.
A second surgical procedure will be needed to replace the expander if it is not designed to serve as a permanent implant.
Step 4 - Surgical placement of a breast implant creates a breast mound.
A breast implant can be an addition or alternative to flap techniques. Saline and silicone implants are available for reconstruction.
Your surgeon will help you decide what is best for you. Reconstruction with an implant alone usually requires tissue expansion.
Step 5 - Grafting and other specialized techniques create a nipple and areola.
Breast reconstruction is completed through a variety of techniques that reconstruct the nipple and areola

BREAST RECONSTRUCTION RECOVERY

Following your surgery for flap techniques and/or the insertion of an implant, gauze or bandages will be applied to your incisions.
An elastic bandage or support bra will minimize swelling and support the reconstructed breast. A small, thin tube may be temporarily placed under the skin to drain any excess blood or fluid.
A pain pump may also be used to reduce the need for narcotics.

You will be given specific instructions that may include: How to care for your surgical site(s) following surgery, medications to apply or take orally to aid healing and reduce the risk of infection, specific concerns to look for at the surgical site or in your general health, and when to follow up with your plastic surgeon.

Be sure to ask your plastic surgeon specific questions about what you can expect during your individual recovery period.
Where will I be taken after my surgery is complete?
What medication will I be given or prescribed after surgery?
Will I have dressings/bandages after surgery?
When will they be removed?
Will there be drains? For how long?
When can I bathe or shower?
When can I resume normal activity and exercise?
When do I return for follow-up care?
Healing will continue for several weeks as swelling decreases and breast shape and position improve. Continue to follow your plastic surgeon’s instructions and attend follow-up visits as scheduled.
Results and outlook
The final results of breast reconstruction following mastectomy can help lessen the physical and emotional impact of mastectomy.
Over time, some breast sensation may return, and scar lines will improve, although they’ll never disappear completely.
There are trade-offs, but most women feel these are small compared to the large improvement in their quality of life and the ability to look and feel whole.
Careful monitoring of breast health through self-exam, mammography and other diagnostic techniques is essential to your long-term health.
When you go home
If you experience shortness of breath, chest pains, or unusual heart beats, seek medical attention immediately. Should any of these complications occur, you may require hospitalization and additional treatment.
The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure and another surgery may be necessary.
Be careful
Following your physician’s instructions is key to the success of your surgery. It is important that the surgical incisions are not subjected to excessive force, abrasion, or motion during the time of healing. Your doctor will give you specific instructions on how to care for yourself.

WHAT IS BREAST REDUCTION SURGERY?

Also known as reduction mammaplasty, breast reduction surgery removes excess breast fat, glandular tissue and skin to achieve a breast size in proportion with your body and to alleviate the discomfort associated with overly large breasts.

BREAST REDUCTION SURGERY: HEALTH AND BEAUTY FOR LIFE

Enhancing your appearance with breast reduction surgery
Overly large breasts can cause some women to have both health and emotional problems. In addition to self image issues, you may also experience physical pain and discomfort.
The weight of excess breast tissue can impair your ability to lead an active life. The emotional discomfort and self-consciousness often associated with having large pendulous breasts is as important an issue to many women as the physical discomfort and pain.
Also known as reduction mammaplasty, breast reduction surgery removes excess breast fat, glandular tissue and skin to achieve a breast size in proportion with your body and to alleviate the discomfort associated with overly large breasts.
Is it right for me?
Breast reduction surgery is a highly individualized procedure and you should do it for yourself, not to fulfill someone else’s desires or to try to fit any sort of ideal image.
Breast reduction is a good option for you if:
You are physically healthy
You have realistic expectations
You don’t smoke
You are bothered by the feeling that your breasts are too large
Your breasts limit your physical activity
You experience back, neck and shoulder pain caused by the weight of your breasts
You have regular indentations from bra straps that support heavy, pendulous breasts
You have skin irritation beneath the breast crease
Your breasts hang low and have stretched skin
Your nipples rest below the breast crease when your breasts are unsupported
You have enlarged areolas caused by stretched skin

WHAT YOU SHOULD KNOW BEFORE YOUR BREAST REDUCTION SURGERY

The success and safety of your breast reduction procedure highly depends on your complete candidness during your consultation. You’ll be asked a number of questions about your health, desires and lifestyle.
Be prepared to discuss:
Why you want the surgery, your expectations and desired outcome
Medical conditions, drug allergies and medical treatments
Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs
Previous surgeries
Family history of breast cancer and results of any mammograms or previous biopsies
Your surgeon may also:
Evaluate your general health status and any pre-existing health conditions or risk factors
Examine your breasts, and may take detailed measurements of their size and shape, skin quality, placement of your nipples and areolas
Take photographs for your medical record
Discuss your options and recommend a course of treatment
Discuss likely outcomes of your breast reduction procedure and any risks or potential complications
Discuss the use of anesthesia during your procedure for breast reduction

BREAST REDUCTION RISKS AND SAFETY INFORMATION

The decision to have breast reduction surgery is extremely personal. You will have to decide if the benefits will achieve your goals and if the risks of breast reduction surgery and potential complications are acceptable.
Your plastic surgeon and/or plastic surgery staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks or potential complications.
The risks of breast reduction and breast reduction complications include:
Unfavorable scarring
Infection
Changes in nipple or breast sensation, which may be temporary or permanent
Anesthesia risks
Bleeding (hematoma)
Blood clots
Poor wound healing
Breast contour and shape irregularities
Skin discoloration, permanent pigmentation changes, swelling and bruising
Damage to deeper structures - such as nerves, blood vessels, muscles, and lungs - can occur and may be temporary or permanent
Breast asymmetry
Fluid accumulation
Excessive firmness of the breast
Potential inability to breastfeed
Potential loss of skin/tissue of breast where incisions meet each other
Potential, partial or total loss of nipple and areola
Deep vein thrombosis, cardiac and pulmonary complications
Pain, which may persist
Allergies to tape, suture materials and glues, blood products, topical preparations or injectable agents
Fatty tissue deep in the skin could die (fat necrosis)
Possibility of revisional surgery
You should know that:
Breast reduction surgery can interfere with certain diagnostic procedures
Breast and nipple piercing can cause an infection
Your ability to breastfeed following reduction mammaplasty may be limited; talk to your doctor if you are planning to nurse a baby
The breast reduction procedure can be performed at any age, but is best done when your breasts are fully developed
Changes in the breasts during pregnancy can alter the outcomes of previous breast reduction surgery, as can significant weight fluctuations
The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single breast reduction procedure and another surgery may be necessary.
Where will my surgery be performed?
Breast reduction procedures may be performed in your plastic surgeon’s accredited office-based surgical facility, an ambulatory surgical facility or a hospital. Your plastic surgeon and the assisting staff will fully attend to your comfort and safety.
When you go home
If you experience shortness of breath, chest pains, or unusual heart beats, seek medical attention immediately. Should any of these breast reduction complications occur, you may require hospitalization and additional treatment.
The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure and another surgery may be necessary.
Be careful
Following your physician’s instructions is key to the success of your surgery. It is important that the surgical incisions are not subjected to excessive force, abrasion, or motion during the time of healing. Your doctor will give you specific instructions on how to care for yourself and minimize breast reduction surgery risks.
Be sure to ask questions: It’s very important to address all your questions directly with your plastic surgeon. It is natural to feel some anxiety, whether excitement for the anticipated outcome or preoperative stress. Discuss these feelings with your plastic surgeon.

PREPARING FOR BREAST REDUCTION SURGERY

After researching the basics about breast reduction, many patients want to know what to expect before breast reduction surgery.
Prior to surgery, you may be asked to:
Get lab testing or a medical evaluation
Take certain medications or adjust your current medications
Get a baseline mammogram before surgery and another one after surgery to help detect any future changes in your breast tissue
Stop smoking well in advance of breast reduction surgery
Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding
Special instructions you receive will cover:
What to do on the day of surgery
Post-operative care and follow-up
Your plastic surgeon will also discuss where your procedure will be performed. Breast reduction surgery may be performed in an accredited office-based surgical center, outpatient/ambulatory surgical center, or a hospital.
You’ll need help
If your breast reduction procedure is performed on an outpatient basis, be sure to arrange for someone to drive you to and from surgery, and to stay with you the following night.

BREAST REDUCTION PROCEDURAL STEPS

What happens during breast reduction surgery?
Breast reduction surgery is usually performed through incisions on your breasts with surgical removal of the excess fat, glandular tissue and skin.
In some cases, excess fat may be removed through liposuction in conjunction with the excision techniques described below. If breast size is largely due to fatty tissue and excess skin is not a factor, liposuction alone may be used in the procedure for breast reduction.
The technique used to reduce the size of your breasts will be determined by your individual condition, breast composition, amount of reduction desired, your personal preferences and the surgeon’s advice.
Step 1 - Anesthesia
Medications are administered for your comfort during breast reduction surgery. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.
Step 2 - The incision
Incision options include:
A circular pattern around the areola

The incision lines that remain are visible and permanent scars, although usually well concealed beneath a swimsuit or bra.
A keyhole or racquet-shaped pattern with an incision around the areola and vertically down to the breast crease

An inverted T or anchor-shaped incision pattern

Step 3 - Removing tissue and repositioning
After the incision is made, the nipple (which remains tethered to its original blood and nerve supply) is then repositioned. The areola is reduced by excising skin at the perimeter, if necessary.
Underlying breast tissue is reduced, lifted and shaped. Occasionally, for extremely large pendulous breasts, the nipple and areola may need to be removed and transplanted to a higher position on the breast (free nipple graft).
Step 4 - Closing the incisions
The incisions are brought together to reshape the now smaller breast. Sutures are layered deep within the breast tissue to create and support the newly shaped breasts; sutures, skin adhesives and/or surgical tape close the skin. Incision lines are permanent, but in most cases will fade and significantly improve over time.
Step 5 - See the results
The results of your breast reduction surgery are immediately visible. Over time, post-surgical swelling will resolve and incision lines will fade. Satisfaction with your new image should continue to grow as you recover.

RECOVERY TIME FOR BREAST REDUCTION

Many patients have questions about recovery from breast surgery.
When your breast reduction procedure is complete, dressings or bandages will be applied to the incisions. An elastic bandage or support bra may be worn to minimize swelling and support the breasts as they heal.
A small, thin tube may be temporarily placed under the skin to drain any excess blood or fluid that may collect.
You will be given specific instructions for breast reduction recovery that may include: how to care for your breasts following breast reduction surgery, medications to apply or take orally to aid healing and reduce the risk of infection, specific concerns to look for at the surgical site or in your general health, and when to follow up with your plastic surgeon. Be sure to ask your plastic surgeon specific questions about what you can expect during your individual recovery period.
Where will I be taken after my surgery is complete?
What medication will I be given or prescribed after surgery?
Will I have dressings/bandages after surgery? When will they be removed?
Are stitches removed? When?
When can I resume normal activity and exercise?
When do I return for follow-up care?

BREAST REDUCTION RESULTS

The results of breast reduction surgery will be long-lasting. Your new breast size should help relieve you from the pain and physical limitations experienced prior to breast reduction.
Your better proportioned figure will likely enhance your self image and boost your self-confidence.
However, over time your breasts can change due to aging, weight fluctuations, hormonal factors and gravity.