While most women with large breasts simply live with it, if you are suffering from the extreme conditions listed above, are in good general health, and have already breast-fed any children you plan to have, or don't plan to breast feed in the future, you may be a candidate for breast reduction, also known as "reduction mammaplasty."
Preparing for Breast Reduction
Reduction mammaplasty is designed for women with sagging or pendulous breasts who are also suffering from other symptoms, and is not intended solely for cosmetic improvement, but for real physical relief. The surgery itself involves the removal of skin, glandular tissue, and fat from the breasts, making them smaller, lighter, and firmer, and generally in better proportion to the rest of your body. The procedure may also reduce the size of the areola (the darker area surrounding your nipple).
If you decide to pursue breast reduction, you should be aware that while the operation is not simple, it is generally safe, as long as it's performed by a qualified plastic surgeon. As with any surgery, there are risks, including bleeding, possible infection, or adverse reactions to the anesthesia. You may develop small sores around your nipples after this surgery, but antibiotic cream usually takes care of them. Following your doctor's advice will greatly reduce your risks.
Before you actually have your breast reduction surgery, you will have a consultation appointment with your surgeon. He or she will examine your breasts, measure them, and possibly take photographs as a reference (though the photographs may also be used for insurance purposes. While breast enlargement is not covered by insurance, in some cases, breast reduction is.)
You and your surgeon will discuss all the different elements that will affect the outcome of the surgery - things like your age, the size of your breasts, and their existing shape. You'll also talk about the new location of your nipples and areolas, which will be lifted during the surgery, and should end up in a position roughly even with the crease under your breasts.
You may also be required to have a mammogram, both for reference during the surgery and for future mammograms.
The Surgery
The surgery itself may be done either in a hospital or at an out-patient clinic, and, if done at a hospital, should not require more than an overnight stay.
There are many different procedures, but the most common will involve an anchor-shaped incision that circles your areola, and follows the natural curve of the crease beneath your breast in a downward and inside direction. The surgeon will remove excess glandular tissue, fat and skin, possibly using liposuction to remove the fat from your armpits. They will move your nipple and areola to their new positions, and then bring the skin from both sides of the breast down around your areola, to form a new contour.
While the your nipples remain attached to their blood supply and nerves in most cases, if your breasts are pendulous, or extremely large, they may have to be completely removed and grafted into their new position. If this is the case, you will lose sensation in your nipples and areolas.
Stitches will usually be around the areola and in a downward vertical line from there to the breast crease, and then extend along that crease. There are some techniques were the vertical line of stitching can be removed, and in some cases, the entire procedure will only require liposuction, though this is rare.
After Surgery
After your breast reduction surgery, you will be wrapped in either an elastic bandage or a surgical bra over gauze dressings, and you may have a small tube in each breast to drain blood and fluids for the first couple of days. The bandages will be removed a day or two after your surgery, but you'll have to continue wearing the surgical bra twenty-four hours a day until and swelling and bruising subside, generally several weeks.
Your breast skin may become very dry after surgery. You can use moisturizer to help relieve this, as long as you keep your sutures dry. Your stitches will be removed in about three weeks.
Other post-surgery effects will include some pain, especially in the first few days, and more so if you move around, or cough. You will be prescribed medication to relieve the pain, and should fill it before you go home. You will also notice some discomfort during menstruation - especially during your first post-surgery period, and shooting pains at random intervals. There may be a loss of feeling in your nipples and breast skin, but usually fades within six weeks, though it may take more than a year, and can sometimes become permanent.
Please remember that while most of your swelling and bruising will be gone after a few weeks, it can take six months to a year before your breasts have settled into their new shape. As well, it's important to be aware that while your surgeon will do his or her best to make your scars as minimal as possible, there will be extensive, permanent scarring, though the scars will become less obvious over time.
Breast reduction gives women the fastest body-image changes of any plastic surgery procedure, and you may find that you look better proportioned and your clothes fit better, almost immediately. However, do give yourself time to adjust to your new body, and remember that your family and friends may need some adjustment time as well.
If you remember this, and were well-informed and prepared for your surgery and the required after-care, you will soon find yourself facing the world with greater confidence, and that is the best result of all.
