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Exciting new developments in the field of breast reduction surgery have
been incorporated into our practice. Liposculpture reduces the amount
of incisions needed so minimal incisions are now possible. On select cases,
a laser can be used.
GENERAL INFORMATION
Reduction mammaplasty is designed to improve the appearance of overly
large breasts by reducing their size and reshaping them. The surgery is
also designed to relieve symptoms of pain and discomfort in the breasts,
shoulders, neck and upper back.
Breast reduction surgery is usually performed in our outpatient surgical
facility or in a hospital, which would require a two to three day, stay.
The procedure takes approximately 3 to 5 hours, depending on the complexity
of the surgery.
Photographs are as important to the plastic surgeon in the proper care
of his patients as X-rays are to physicians in other medical specialties.
Therefore, photographs are taken before and after surgery. These photographs
become a part of the patient's confidential medical record. Mammograms
(a type of X-ray) of the breasts are sometimes included in the pre-operative
assessment of the patient. These studies are done to insure that there
is no breast disease present before surgery.
THE ANESTHESIA
Breast reduction surgery is performed under a "light" general anesthetic
(patient is asleep). This technique provides excellent operating conditions
while affording maximal patient comfort and safety. A board certified
doctor anesthesiologist who remains in attendance throughout the operation
administers the anesthetic. All of the required monitoring, anesthetic
delivery and emergency equipment are present at all times. Further information,
including any questions you may have, will be explained and discussed
fully by our anesthesiologist prior to your surgery.
PRE-OPERATIVE PREPARATIONS
You must be in good health to undergo any elective cosmetic surgery. A
physical examination and routine lab work will need to be performed by
your own primary physician. If you do not have a primary doctor, we can
refer you to local doctors in our area. We do not provide these services.
It will be required that all this pre-op paperwork is in our office
1-2 weeks prior to surgery.
- It is a required that someone drive you home upon your discharge.
Also arrange for transportation to and from our office for your post-operative
appointments until your doctor gives you permission to drive.
- DO NOT take aspirin or aspirin-containing products for 2 weeks prior
to surgery and for 2 weeks after surgery.
- An adequate diet with vitamin supplements, especially Vitamin C, is
recommended. You should be in the best nutritional state possible prior
to surgery.
- If you will be preparing your own meals at home after surgery, have
on hand easy to prepare foods.
- Bring loose-fitting, front-opening clothing with you the morning
of surgery to wear home.
THE SURGICAL PROCEDURE
Marking and measuring of the breasts is an important part of the preparation
for surgery. These markings are made before the anesthesia is given
and with the patient sitting fully upright. They are used as guidelines
for the incisions during surgery when the patient is in a reclining
position.
The surgical procedure consists of removal of part of the skin and underlying
tissue of the breasts, moving the nipple upward and reshaping the remaining
tissues into a smaller, higher configuration. Scars left by this procedure
are generally predictable and although they tend to fade with time,
they are permanent. There is a circular scar around the nipple, a scar
in the fold under the breast, and a vertical scar connecting them. No
scars are present above the nipple.
Occasionally, revision of the scars is necessary to obtain the optimum cosmetic
result. These revisions are minor and can be carried out in the office under
local anesthesia.
POSSIBLE COMPLICATIONS
Complications are rare and usually respond promptly to proper treatment
without affecting the final result.
BLEEDING: If bleeding occurs after the operation, it
may accumulate in the breast and require opening the wound to remove
the blood and prevent further bleeding.
INFECTION: This occurs rarely and usually responds
to antibiotics.
NUMBNESS OF THE NIPPLE: This is almost always temporary
and sensation can be expected to return. On rare occasions, however,
it may be permanent.
LOSS OF A NIPPLE: Complete or partial, this is extremely
rare, but has been reported on occasion. Should this happen, a reconstructive
operation can be performed with satisfactory results at a later date.
WHAT TO EXPECT AFTER SURGERY
Pain is rarely strong, more commonly being a degree of discomfort. Pain
medication is prescribed by the doctor for the patient to use during
hospitalization and at home. Many patients like to spend a night in
a medical after care, where nurses tend to their needs, although it
is not required.
Some swelling will occur but usually begins to subside by the third
or fourth day. Some degree of swelling may persist for weeks or even
months.
Bruising may appear extensive for the first week, but will subside over
the next several weeks.
SURGICAL BRA: Is applied at the time of surgery and is
worn for about a week after the operation. Steri-strips covering all incisions
are removed and replaced by the nurse in 5-6 days. After two weeks, a comfortable
sports bra can be purchased. Avoid purchasing underwire bras that would
create too much pressure on incisions.
Social and work activities should be quite limited for two to three
weeks after surgery. If your job requires lifting, pushing, etc., a
longer recuperation period may be necessary. Driving should be avoided
for one week after surgery.
In general, it is recommended that a patient undergoing this operation not
attempt to nurse following surgery. Nursing may cause the breasts to enlarge
again, thus eliminating the effects of surgery. Of those who try to nurse,
some find they are unable to do so because enough glandular tissue has been
removed to prevent adequate milk production.
POST-OPERATIVE CARE
Avoid raising your arms over your head for 2 weeks. Avoid any strenuous
exercising or lifting for 6 weeks.
Avoid lying on your abdomen for 2 weeks. Optimal sleep position is elevated
on your back with 2 pillows. Keep a pillow under each arm, and a pillow
under your knees.
Showering is usually permitted after 72 hours. Do not attempt to peel
off the steri-strips (if applicable), the nurse will change them. Soaking
in the bathtub is not recommended for two weeks.
The surgical bra is worn day and night for two weeks. Then a comfortable
yet supportive sports bra can be worn.
Arnica gel can be applied to bruised areas (avoiding any incisions)
soon after surgery.
RESUMPTION OF PHYSICAL ACTIVITIES
GENERAL RULES OF THUMB
TWO, FOUR, SIX RULE
FIRST WEEK: TAKE IT EASY!!! PATIENTS WHO ARE TOO VIGOROUS
FREQUENTLY DEVELOP COMPLICATIONS!
At two weeks: take long walks on a flat surface. No
other kind of workouts. Any activity that would raise your blood pressure
would compromise the healing incisions and newly developing blood supply.
At four weeks: light exercise such as aerobics, but
no weight training. Start light. For example, if you normally do 30
minutes on a treadmill, begin with 15 minutes, then increase as your
body gets used to things. Use of vitamin C and E concentrate and scar-fade
gel should begin as soon as the incisions are completely healed, usually
3-4 weeks.
At six weeks: resume all previous activities with
clearance from Dr. Moelleken. Avoid sun exposure to incision site for
months following surgery, as this may result in a hyperpigmented scar. |
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Breast Reduction with Lift.
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Bilateral Breast Reduction with Breast Lift.
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Bilateral Breast Reduction with Breast Lift.
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Breast Reduction with Lift.
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Breast Reduction with Lift.
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