Considering a Breast Reduction?

Have you been considering a breast reduction? I had one in 2004 as a birthday gift to myself (courtesy of my health insurance), and I'm SO glad I did. I'm only 5'2" and I went from a lugging around DDD/F's to a perky C/D cup. My back, neck and shoulders were always sore, and I was so front-heavy that even my bras would give up and the straps would snap after a short while. Not to mention, I couldn't get all those cheap, cute little sexy bras. And forget Victoria's Secret, she doesn't even carry that size. I was restricted to some grandma big-as-a-hang-glider bra with 3 - 5 hooks in the back made by Olga and paying through the nose for it. Or if I was daring to be cute, I'd get something from Frederick's of Hollywood, but it'd fall apart after a few washes (their stuff is made to be taken off as soon as it's put on - not for lugging boulders around everyday).

Anyway, here's some information that might help you in making your decision.

Physical relief is usually the main reason for getting a breast reduction. As shallow and vain as we can be, most insurance companies will not pay for the surgery if it's being done for strictly cosmetic purposes. Most women who opt for the surgery have poor posture, very large, droopy breasts that restrict their activities (ever have to move them 'out of the way' so you can see your zipper or button your pants, put on your belt, etc???), their bra straps might leave indentations on their shoulders from the weight, and just plain ole' cause them physical discomfort. And if all that isn't bad enough, what about being totally self-conscious and not being able to fit any decent clothes without it looking like hooker-wear or wearing a moo-moo? I used to refer to mine as my 'shelf' because they would catch everything, especially if I dropped or spilled food while I was eating.

The best candidates for the surgery are women who are mature enough to fully understand the procedure and have realistic expectations about the results. Just because you get the surgery, you're not going to all-of-the-sudden have this miraculously diva-ish body. You also might want to reconsider if you're planning to have children and want to breast feed. Even though surgeons are more careful these days, in some cases some, all, or most connective tissue and ducts have to be cut, such as in my case, and you may not be able to or may have trouble breastfeeding. I actually had trouble breast feeding before the surgery (though with their size, you'd have thought I could feed a small African nation), and though I did get some milk production after the surgery with my second child, it wasn't nearly enough to sustain my baby.

The actual procedure is technically known as reduction mammaplasty. The procedure removes fat, glandular tissue, and skin from the breasts, making them smaller, lighter, and firmer. It can also reduce the size of the areola, the darker skin surrounding the nipple. The goal is to give the woman smaller, better-shaped breasts in proportion with the rest of her body, while relieving the physical discomfort that breast that large can cause. My breasts were actually asymmetrical, meaning, they weren't the same size - the left was 25% bigger than the right one (it sounds funny, but take a close look in the mirror. Usually one is bigger than the other). I had a total of 3lbs removed, but a friend of mine had a whopping 12lbs removed! Geesh!

Now, breast reduction is an elective surgery - meaning you can LIVE without it; it's not life or death. The operation itself is fairly involved, but it's normally safe when performed by a qualified plastic surgeon. Of course any surgery raises the possibility of complications, including bleeding, infection, or reaction to the anesthesia.

For you totally vain folks, the procedure does leave noticeable, permanent scars, They're on the underside of your breast, and extend out to the sides (I'll explain in a bit). The procedure can also leave you with slightly mismatched breasts or unevenly positioned nipples. And don't forget the problem you may experience with breast feeding. Some women may experience permanent loss or reduced sensitivity in the nipples or breasts. Not to scare you, but it must be said, that in rare cases, the nipple and areola (dark circular part of your nipple) may lose their blood supply and the tissue will die. (The nipple and areola can usually be rebuilt, however, using skin grafts from elsewhere on the body.)

The consultation with your plastic surgeon will go over your expectations as well as his realistic, medical version. You will discuss the size breasts you want to have and any concerns. The surgeon will measure, poke, prod and take notes and pictures (not to broadcast over the internet, but for your insurance company). He or she may also draw on you, to show you where the incisions will be, and quite possibly where you're nipple will be placed. The surgeon will also explain any anesthesia that will be used during the procedure, recovery time, limitations, pre-operative procedures, etc.

Now, here's the skinny on the procedure itself. I had the most common of the techniques for my surgery. My incision, and ultimately the scar, looks like an anchor. The incision circles the areola, extends downward, and follows the natural curve of the crease beneath the breast. Excess glandular tissue, fat, and skin is removed and the nipple and areola are relocated to their new position. Then the skin from both sides of the breast is brought down and around the areola, shaping the new contour of the breast. Liposuction may be used to remove excess fat from the armpit area.

After the surgery, you'll be wrapped in an elastic bandage or a surgical bra over gauze dressings. You may look like and feel Frankenstein for the first day or two if drainage tubes need to be used to drain off excess fluid, and your stitches will follow the anchor-shaped incision, around the areola, extending downward, and along the lower crease of the breast.

I got some 'good drugs' for pain after the surgery. Oxycodone. You'll feel some pain for the first couple of days, especially when you move around, try to sit up or cough. I actually stopped taking the pain medication two days after the surgery, but it all depends on your body's tolerance for pain and healing ability.

The bandages came off a day or so after surgery, but you'll have to wear a really snug sports bra around the clock for several weeks, until the doctor tells you otherwise. The surgeon usually removes your stitches in about two to three weeks.

Although you may be up and about in a day or two, your are still going to be achy occasionally for a few of weeks. Avoid lifting or pushing anything heavy for three or four weeks. Now heed this warning, because it snowed a few days after I had the surgery, and I wound up shoveling my mom's sidewalk. Bad move. It felt as if something 'popped.' After hightailing it to the doctor, a surface stitch had come loose, but thank goodness, the internal ones had remained intact.

One weird thing I remember after the surgery is that my breasts and chest seemed very 'boxy' - by this I mean: have you ever seen professional women swimmers or gymnasts, and it looks as though their chest is box-shaped, and shoulders look really wide? I asked my surgeon about this, and he said it would take a few weeks or months for gravity to do its thing and for my breasts to a settle and get that 'normal' breast shape.

Even though my scarring is permanent, and they're a little darker than I would have hoped, I feel SO much better without all of that top-heavy weight. Each person's skin reacts differently, and you may not be able to see your scars so well. But if you can, when the doctor says it's alright, you may want to try Mederma. It's available almost everywhere and comes in a small tube. It's pretty expensive, like $16 or so, but it works wonders. Besides, your scars will also be hidden by your bra and its straps, and are primarily under your breasts, so you can wear low-cut tops and show off your new 'set.'

This is one of the best things I could have ever done for myself. And I'd do it all again if I had to. Just make sure that your surgeon is board certified and you can also ask for references. To find a plastic surgeon that performs breast reductions, check out the American Society of Plastic Surgeons (ASPS) at www.plasticsurgery.org. If you happen to be in Connecticut or Southern Massachusetts, I used Dr. Alex C. Cech in Hartford, CT. He was awesome!