• Breast reduction is usually done to obtain physical relief beyond simple cosmetic improvement. The majority of women who demand this surgery have problems because their excessively large and unoccupied breasts restrict their activity and cause great physical discomfort. In most cases, breast reduction is not performed until the woman is fully developed; however, it may be necessary sooner if large breasts are causing serious problems. The best candidates are those who are mature enough to understand the procedure and have realistic expectations about the results. If breast reduction is your medical necessity, it can be sponsored by insurance companies who pay for breast reduction, however, they may require that a certain amount of breast tissue is removed. Photographs will be taken which will be used for the pre-authorization process with your insurance company. In case you have the support of insurane company, our office will contact your insurance company to obtain pre-authorization

In your first consultation, it is important that you discuss your expectations with us, and listen to our opinions. Each patient has their different points of view about what is the optimal shape and the size of the breast. We will examine and measure your breasts, and you will probably be photographed for references during and after the surgery. We will discuss the variables that may affect the procedure, such as your age, the size and shape of your breasts, and the conditions of your skin. We will also discuss where the nipple and areola should be positioned; These structures will rise during the procedure, and should be placed approximately at the level of the submammary fold.
We will describe the procedure in detail, explaining its risks and limitations and the scars that remain and their location. We will also explain the type of anesthesia used, where the intervention and the costs of the intervention will be carried out. Large breasts can cause physical discomfort, some medical problems, marks on the shoulders by the bra, and a significant loss of self-esteem.

Sometimes we will need a mammography (breast x-ray) prior to surgery. We do have facilities for that. You should also follow our instructions on how to prepare for the intervention, including periods of fasting on the day of surgery, habits such as smoking, the intake of certain medications and vitamins. Breast reduction does not usually require blood transfusion. However, in exceptional cases, we may recommend autotransfusion. In this way, if required, we could use your own blood.
It is important to be accompanied by a responsible adult during the first days, since at the beginning you need someone to help you, until you can make your normal life.

Breast reduction surgery must be performed in a hospital, and generally under general anesthesia. The surgery usually lasts two to three hours.

The techniques for breast reduction vary, but the most common way scar leaves around the areola, which extends downward, and follows the submammary fold. We remove excess fat, glandular tissue and skin, and move the areola and nipple to its new position. Afterwards, the breast is sutured, giving it a new shape. Sometimes we can use liposuction to remove excess fat from some areas. In most cases, the nipple remains with its vessels and nerves. However, if the breasts are very large or pendulous, the nipple and areolae can be lifted and grafted in a new position. (This will lead to loss of sensation in the nipple and areolar tissue.) The sutures are usually located around the areola, in a vertical line from this down, and along the inframammary fold. Sometimes, techniques that eliminate the horizontal part of the scar can be used. And occasionally you can use only liposuction to reduce the size, leaving minimal scars.

• After the surgery, you will wear an elastic bandage. A small tube is placed in each breast to drain blood and fluids for a day or two. Subsequently, the tubes will be removed by our staff in our office during a post-operative visit and the bandage will be replaced by a sports bra. You may feel discomfort during the first few days, especially when moving or coughing, and some discomfort for a week or two. We will give you medication to reduce discomfort.
  The bandages will be removed a day or two after the surgery, although you will continue to wear a sports bra for several weeks, until the swelling goes away. The sutures will be removed in about two weeks.
  If your breast’s skin is very dry after surgery, you can apply a moisturizer several times a day. But be sure to keep the suture area dry. Your first period after surgery can cause your breasts to swell and bother. You may also experience some subjective discomfort during the first few months. Likewise, you can expect some loss of sensitivity in the nipple and in the skin of the breast caused by the edema after surgery. These are attenuated by six months postoperatively, and occasionally it may be permanent. The incisions delimit the area of skin, the breast tissue, and the fat that must be removed and the new position of the nipple. The skin and gland are sutured to give the new shape to the breast. The stitches close the incisions giving the breast its new contour. The scars around the areola, below it, and in the midriff fold are permanent, but can easily be hidden by clothing.

• Although you can live a normal life in a day or two, your breasts will bother you for a week or two. You should avoid lifting or pushing heavy things for three or four weeks. We will give you detailed instructions to resume your normal activities. Most women can return to work and normal social activity in two weeks. But you must be a little careful and limit your physical exercise until you are progressively recovered completely. Mind that the surgery will affect your stamina for several weeks, so you should limit your exercise to stretching, bending, and swimming until your energy level returns. You should also wear a good sports bra to hold the chest. A small amount of exudate from your wound is normal, as well as some scabs. If you have abnormal symptoms, such as bleeding or severe pain, contact us.

• Although most of the inflammation goes away in the first few weeks, it can go from six months to a year until your breasts stabilize in their new form. Even then, your form may fluctuate in response to hormonal stimuli, weight changes, and pregnancy. We will strive to make your scars as inconspicuous as possible. However, it is important to remember that breast reduction scars are permanent. These often remain red and hardened for months, and then fade to eventually reach the state of white lines with a massage of vitamin E into the healed incision lines. Fortunately the scars are placed in areas that are hidden with normal clothes and bathing suits. Of all the procedures in plastic surgery, breast reduction is what allows you to see faster changes in body image. It will be a great physical discomfort for the size of the breasts to make your body look better proportioned, and the clothes feel better.