Discomfort and pain when combined with a poor self image can mean overly large breasts seriously impact some women's quality of life.

The weight of excess breast tissue can prevent you from leading an active life 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.

If you're considering a breast reduction, this outline will give you a basic understanding of the procedure when it can help, how it's performed, and what results you can expect.  It can't answer all of your questions, since a lot depends on the individual patient and the surgeon.  Dr. Walker is more than happy to clarify any misunderstandings, please contact her office with any questions or concerns you may have.

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.

Step 1 - Anesthesia
Medications are administered for your comfort during breast reduction surgery.

Step 2 - The incision
Incision options include a circular pattern around the areola, a keyhole or racquet-shaped pattern with an incision around the areola and vertically down to the breast crease or an inverted T or anchor-shaped incision pattern.  The incision lines that remain are visible and permanent scars, although usually well concealed beneath a swimsuit or bra.

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.

The best candidates for breast reduction are in relatively good health and you must have realistic expectations of the outcome of surgery.

Breast reduction surgery may also make sense for you if you suffer from:

• backaches or neckaches
• stasis ulcers (skin irritation or death of skin tissue due to pressure)
• difficulty breathing
• grooves in your shoulders from your bra straps
• numbness of any portion of the breasts and upper chest from the excessive weight
• displeasure based on the aesthetic or dislike the general size of your breasts for any reason.

Additionally your skin must have good elasticity so that it can bounce back to its former tightness postsurgery.