Big, heavy and pendulous breasts may cause pain in the back, neck, and shoulders, as well as skin irritation and important discomfort. If you have these symptoms, breast reduction may help you. This surgery involves getting rid of the fat, gland and skin in the breast area in order to make them smaller, firmer, higher and to reposition your nipple in the center of the breast. It is also possible to reduce the diameter of the nipple during this surgery. This surgery will fix your symptoms and improve your silhouette by giving you more harmonious proportions. By removing at least 250 grams of tissue, the surgery will be reimbursed by the RAMQ.
Getting ready for a breast reduction
Two kinds of incisions can be performed in order to reduce the size of the breasts. Normally, the lower the breast, the more incisions are performed. Vertical: periareolar (around the nipple) and vertical incision. To correct a moderate fall of the breasts. ”T” shape: periareolar, vertical and an incision under the breast. To correct an important fall of the breasts. We will discuss the ideal size of your breasts in order to reduce your symptoms and to respect the balance of your breasts with the rest of your body: It is essential to stop smoking six weeks before and after the surgery. This measure reduces chances of delayed healing. Delayed healing is also more frequent in patients with diabetes or who are overweight.
Breast reduction: surgery
This day surgery lasts between one hour and a half and two hours and is performed under general anesthesia. After the surgery, a dressing will cover and support your breasts. If your work does not require any physical activity you will be able to return after one week.
Recovery after breast reduction
This surgery causes moderate pain which is easily controlled with the prescribed medication. Your breasts will be swollen and you will experience a light pain during the first few days. The dressing must be kept dry and intact for the first post operatory consultation five days after the surgery, after which it will be removed and replaced by a support bra that you will have to wear for six weeks. The rest of the postoperative consultations are generally scheduled three weeks, three months and one year after the surgery. During the consultation three weeks after the surgery, the steri strips will be removed and you must start massaging the scars. Intense physical activity must be avoided for six weeks. If your work does not require any physical activity you will be able to return after one week. It is possible for the swelling to linger some time after the surgery. The final result is normally achieved two to three months after the surgery, but it is possible for the scars to display some redness for six to twelve months
- Infection: Very rare, usually successfully treated with antibiotics.
- Bleeding: Very rare, can sometimes require surgery to remove the blood that accumulates in the breast. This complication can sometimes be due to a strenuous exercise short time after surgery.
- Healing problems: Some patients may develop hypertrophic scars or keloids following this surgery. These scars are treated with massage, silicone dressings or injections. The scars can also widen after surgery or present white or dark discoloration. These imperfections can be corrected if necessary 1 year after surgery.
- Asymmetry: Some asymmetries can be noted in the position and shape of the areola or the volume or shape of the breast. If I deem relevant, these imperfections can be corrected under local anesthesia one year after surgery.
- Sensitivity: Some women report that their nipples become oversensitive, less sensitive or insensitive after surgery. You may also notice small areas of numbness around the scars. These symptoms usually disappear gradually but can be permanent in rare patients.
- Delayed healing: Some patients may have an opening of some wounds or skin necrosis. These situations occur primarily in patients with diabetes or smokers. These wounds are usually treat by dressing changes and heal alone but will often leave a larger scar.
- What can happen if I gain weight? If you gain weight your breasts will grow again and compromise the surgical result. Conversely, your breasts will decrease if you lose weight. It is better to have a stable and ideal weight before surgery.
- When can I start physical exercise? You must wait six weeks before starting any intense physical activity. It is recommended to start with exercises progressively after the surgery.
- How long does pain last after surgery? Tolerance to pain is different in every patient. After approximately five days pain stops, but discomfort or a nagging sensation may remain when in movement. These sensations may linger for a few weeks, especially when doing physical activity.
- When will I be able to drive again? You can drive once you stop taking the prescription drugs and when movement no longer causes any pain.
- When will I be able to have sexual intercourse after surgery? You can restart sexual activity as soon as you feel comfortable. It is recommended to wait for at least two weeks to allow for the healing of the incisions and to avoid the risk of opening the wounds.
- When will I be able to take a shower? Unless otherwise indicated, you will be able to take a shower after the removal of the dressings 1 week after surgery.
- When will I be able to take a bath, go to a spa or swim? With the physician’s authorization, immersion in water is possible three weeks after the surgery.
- What is the recovery time for these surgeries? The pain usually disappear in a week. The swelling lingers more and could take up to two months to disappear.
- What happens if I have an emergency outside office hours? After the surgery we will provide you with emergency numbers.
- When will the stitches be removed? The sutures are melting stitches, so there is no need to have them removed. The small knots on the sides of the scars may take longer to fall. If that is the case, they will be removed in the post operatory consultation 3 weeks after the surgery.
- When will I be able to use underwire bras? You can use them two months after the surgery.
- Are the results of this procedure are sustainable? This procedure produces quite durable but not permanent effects. The effects of gravity, aging or significant changes in weight could possibly be noticeable.
- Is it possible to breastfeed after the procedure? Yes. Breastfeeding is possible in half the patients after a breast reduction. It should be note that a large variation in breast size during pregnancy can stretch the skin and make the results of a reduction less durable.
- Can RAMQ cover a breast reduction? The surgery can be covered if more than 250 grams of tissue is removed in each breast. If you want to have the surgery in a private setting you will have to pay the surgery room fees (around 2500$)
Before & After
Those pictures will highlight the differences before and after the procedure.