Breast reduction

sculpturing the big breast...
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Photos before & after
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Breast reduction
Introduction
Breasts that are excessively large in proportion to body size are a frequent cause of back and neck pain as well as grooves or irritation on the shoulders from bra straps. Additionally, sleep and participation in certain activities may be affected, and the likelihood of rashes and infections in the folds underneath the breasts increases. Fortunately, an operation known as reduction mammaplasty or simply, breast reduction, achieves good results in alleviating these problems. This procedure is sometimes considered a necessary reconstructive process and may be covered by health insurance plans when a minimum amount of tissue is removed. A reduction removes extra breast tissue to achieve a healthier, more comfortable size and reshapes the breasts, making them firmer and lifting them to a more youthful position. An additional benefit is that uneven breasts can be made more even.

Surgical Technique Variations
Reduction techniques vary depending on breast size and shape, the amount of tissue to remove, and other factors such as scarring or the need for future breast-feeding ability. Common procedures include an inverted T-shaped incision, a vertical incision, a free nipple graft, and liposuction. The inverted T, or anchor technique, extends around the top of the areola, downward and then towards the side and center along a natural curve that will become the breast crease. The vertical incision technique extends around the top of the areola with a v-shaped incision down the midline. The free nipple graft technique removes the nipple and areola and replaces it higher on the breast after removing tissue. Liposuction can also be used alone or in combination with another technique to remove excess fat from the breasts in certain candidates. This animation will show the common, inverted-T technique, in which the nipple and areola remain attached and are moved upwards to a new position after underlying breast tissue is removed. Your surgeon may use other techniques depending on your specific conditions.

Incisions and Tissue Removal
During an initial consultation, your physician will take size and shape measurements and mark your breasts to evaluate surgical options, determine your desired nipple placement, and preplan the procedure. Photographs may also be taken and sent to insurance companies as part of obtaining approval for the operation. The day of your procedure, you will be placed under anesthesia, meaning you will sleep through the procedure. Incisions are made along pre-marked lines and the excess skin is removed. Next portions of underlying fat and glandular tissue are surgically removed and sculpted to reduce size and lift the breasts. Dissolvable internal sutures are often used to help maintain the shape and reduce tension on the skin during healing.

Restructuring the Breasts
The nipples and areolas, which remain attached to their original blood and nerve supply, are raised to their new, more youthful position. Next, the areas beneath the areolas are brought together and closed with sutures to reshape the now smaller, lighter, and firmer breasts. A surgical drain tube may be placed in each breast to allow fluids to escape the bottom of your breasts as you heal. Dressings will be placed on the breasts, and you will typically be wrapped in an elastic bandage or placed in a compression garment or surgical bra, which helps maintain the shape while healing. The breast reduction procedure typically takes from two to five hours.

Recovery and Results
Swelling and discoloration after the procedure are normal and will subside over time. Pain typically fades quickly and can be managed with medications as you heal. Any surgical drains are removed after a day or two, and your bandages may be removed as well. External sutures are removed after one to two weeks, and you may be instructed to wear the compression garment, avoid sleeping on your stomach, and avoid excessive exertion or heavy lifting for a month or more. Scarring along the lower midlines and creases of the breasts is normal, and your physician will have placed the sutures so the resulting scars are as inconspicuous as possible. Although the scars will at first appear red and enlarged, they will eventually fade to thin, slightly discolored lines that are easily concealed below low-cut tops and behind bathing suits. Patients typically experience extremely high satisfaction with reduced upper body pain, an improved ability to engage in physical activities, and a new appearance with smaller, more youthfullooking breasts.