Reduction Mammoplasty (Breast Reduction)
Reduction mammoplasty (breast reduction) is
performed on patients from their early teens through their
later years to alleviate the physical problem of large breasts.
Indications for Breast Reduction:
The patient that seeks breast reduction often complains of
back pain, and shoulder pain, as well as breast pain. There
are often skin changes in the breast due to the pressure on
the skin.
Age of the Patient: In the
older patient, the large breast exerts a pendulum effect,
which may make it difficult to breathe, and causes severe
back problems. In the younger patient, the premature development
of the breasts may cause the child an early difficulty in
peer relationships, because of the self image problems that
are generated.
Dr. Sherman has operated on patients from age
12 through age 84 for breast reduction. Among all of our reconstructive
and cosmetic patients, they are among the most pleased.
Operation: Breast reduction
plastic surgery is usually performed in the hospital, or our
fully accredited out -patient facility. Depending on the amount
of tissue to be removed, the operation may take anywhere from
2 to 4 1/2 hours. If performed in the hospital, the patient
has the ability to spend one night in the hospital. Dr. Sherman
performs this operation at The New York Hospital Cornell University
Medical Center or at Beth Israel North Hospital in New York.
There are various techniques that have been
described to accomplish the breast reduction. Most involve
maintaining the nipple and the areolar complex on a pedicle,
and transferring this unit to a new position above the breast
crease (inframammary fold). Depending on the technique used,
the resultant scars may be positioned around the nipple and
vertically down to the crease, or in addition, along the inframammary
crease. Dr. Sherman uses several different techniques, depending
on the age of the patient, the particular anatomy of the patient,
and the goals of the patient.
A free nipple graft is used when the amount
of breast removed is exceedingly large, and the distance that
the nipple must be repositioned is exceptionally long. This
is usually reserved for older patients. This procedure has
the advantage of being much shorter, and the disadvantage
of producing a nipple that is totally devoid of sensation.
Anesthesia: The breast reduction
operation is almost always performed under general anesthesia.
If the patient must have IV sedation, and avoid the general
anesthesia, it may be performed in smaller reductions.
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