Reduction mammoplasty (breast reduction) is
performed on patients from their early teens through their
later years to alleviate the physical problem as well as the psychological burden of large breasts.
Breast reduction and breast uplift surgery overview by John E. Sherman, MD, FACS New York Plastic Surgeon
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 fold due to the constant pressure on
Age of the Patient: Dr. Sherman has operated on patients from age 12 to age 84 for breast reduction. Among all of our cosmetic and reconstructive patients, they are among the most pleased.
older patient, the large breast exerts a hanging weight 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 to have early difficulty in
social settings, because of the self-image problems that
Operation: Breast reduction
plastic surgery is usually performed in a hospital as an outpatient, or our
fully accredited office-based surgery center. Depending on the amount
of tissue to be removed, the operation may take anywhere from
2 to 4 hours. If performed in the hospital, the patient
has the ability to spend one night as an inpatient. Dr. Sherman
performs this operation at the New York Presbyterian Hospital, Weill Cornell Medical Center, The Lenox Hill Hospital, on in Connecticut at The Greenwich Hospital.
There are various techniques that have been
described to accomplish the breast reduction. Most involve
maintaining the nipple and the areola complex on a pedicle,
and transferring this unit to a new position above the breast
crease (inframammary fold). Dr. Sherman uses several 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 rarely 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. However, this procedure has
the advantage of being shorter in time, and the disadvantage
of producing a nipple that is totally devoid of sensation.
Anesthesia: The breast reduction
operations are usually performed under general anesthesia whether in a hospital, or in our office-based facility. Some exceptions may be made.
Convalescence: Although the
operation is lengthy, the convalescence is quite limited.
Patients are able to return to work in about 5 - 7 days, and
resume normal activities in about three weeks after breast
Blood Transfusion: The most
commonly asked question is whether patients are routinely transfused during surgery.
We have not transfused a patient in over 25 years. Prior to surgery, a complete blood count must be taken on the patient to determine if surgery can be performed without the need for additional blood. It may be judicious to donate your own blood prior to surgery if your blood count is low. More commonly, patients are evaluated and treated for their relative anemia prior to surgery.
Insurance Information: Insurance
criteria for breast reduction changes frequently, and also may vary
from carrier to carrier. In general, if the patient has physical
complaints that are referable to the large breasts, and a
critical amount of breast tissue is removed, your insurance carrier may
reimburse the cost of the procedure. Again, documentation must be made of your physical complaints related to large breasts.
Our office manager will help you petition your
insurance company to help your predetermination of benefits.
are not frequent following breast reduction mammoplasty. Scars may
be minimal or noticeable, but certainly are present. Nipple
sensation may also be diminished or lost, and there may be wound healing
problems. Dr. Sherman will discuss all potential complications
with you concerning breast reduction mammoplasty at the time of consultation.
Cigarette Smoking: Dr. Sherman does not perform this operation
on cigarette smokers. Most of the potential complications
are related to cigarette smoke and nicotine. If you are a smoker, you should
stop for at least one month prior to surgery. Nicotine patches
are not a substitute, and do not significantly diminish the
risk of complication.
To set up a private consultation with Dr. Sherman, contact us today. Call us at (212) 535-2300 or e-mail us.