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This is by far one of the most rewarding surgical procedures in Plastic Surgery. It has one of the highest percentages of highly satisfied patients. In fact, it solves so many functional problems for the patients that it is sometimes considered reconstructive in nature and covered by some health insurance carriers. Excessively large breasts (“breast hypertrophy”, “gigantomastia”) can cause a host of severe problems for patients, including: painful shoulder grooves from the bra straps, chronic upper back and neck pain, skin rashes under the breasts, difficulty fitting bras, clothes and bathing suits, difficulty with exercise, etc. A Reduction Mammoplasty usually relieves all of these symptoms and results in a very happy patient. There are many different techniques for reducing the size of the breasts. However, they are usually variations of two basic themes: 1) Removing the nipple and areola completely and replacing them as a “free graft” of thin patch or, 2) Keeping the nipple and areola attached to the breast tissue and moving the entire block or “pedicle” superiorly. The first technique is easier, quicker, has less blood loss and fewer chances of complications, but results in flattened nipples that usually do not become erect with cold exposure, loss of nipple sensation and no ability to breast feed. It is usually performed only on older patients or those with significant health problems. The second technique is the most popular and the one most often performed. It usually preserves some (variable) nipple sensation, full ability to become erect and theoretically at least, the ability to breast feed. All breast reductions involve removal of excess skin and breast tissue and therefore there are resulting scars. The extent and location of the scars vary with the technique used by the surgeon. |