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Patients who choose breast reduction surgery are often seeking relief from physical symptoms caused by the weight of large breasts. Breast reduction usually can solve these problems as well as improve the size and shape of your breasts. Following breast reduction, your breasts will be more proportionate to the rest of your body, and clothes will fit you better.
You may be a good candidate for breast reduction if your breasts are disproportionately large for your body frame, if you have symptoms related to large breast size (like back pain, neck pain, shoulder pain, and shoulder grooving), if you are unable to exercise effectively due to your breast size, or if you are just self-conscious about your breast size.
After you arrive at our office, you’ll first meet with one of Dr. Kavali’s Physician Assistants, Maggie or Alicia. They will begin the consultation process by reviewing your medical history, establishing your goals for the surgery, and by taking relevant photographs for your medical record.
Dr. Kavali will complete the consultation process by meeting with you to personally hear about your goals for surgery. She will ask about your desired breast size and anything else related to the appearance of your breasts that you feel is important. This conversation will help Dr. Kavali understand your expectations and determine whether they can realistically be met.
Dr. Kavali will examine your breasts. She will be looking at the size and shape of your breasts, the quality of your skin, and the location of your nipples and areolas (the pigmented skin surrounding the nipples).
The consultation time is meant to be comfortable and educational. We want you to feel completely informed, so you can make your own personal best decision. There are some questions that commonly arise during the consultation process, so we’ve included them here:
Breast reduction can be performed at any age, but Dr. Kavali usually recommends waiting until breast development has stopped. Childbirth and breast-feeding may have significant and unpredictable effects on the size and shape of your breasts. Nevertheless, many women decide to undergo breast reduction before having children and feel that they can address any subsequent changes later. If you plan to breast-feed in the future, you should discuss this with Dr. Kavali.
You should tell Dr. Kavali if you plan to lose a significant amount of weight, particularly if you have noticed that your breasts become smaller with weight loss. It is not necessary to starve yourself to lose weight before breast reduction surgery, but you should be as close to your ideal body weight as is reasonably possible for you.
Insurance coverage is sometimes available for breast reduction surgery. Many factors determine your eligibility, including the specific terms of your insurance policy and the amount of breast tissue to be removed. A letter of predetermination will be required by your insurance company prior to surgery. Dr. Kavali or a staff member in her office will discuss these matters with you.
Dr. Kavali uses two primary methods for achieving your short scar breast reduction goals, the SPAIR technique or SBR (“scarless” breast reduction).
SPAIR stands for short-scar peri-areolar inferior pedicle reduction. It involves only two incisions. One incision is made around the areola. Another runs vertically from the bottom edge of the areola to the crease underneath the breast, creating what Dr. Kavali refers to as “lollipop scar”. There is no incision in the crease under the breast. This is a distinct advantage compared with more traditional methods, which leave you with a long scar beneath the entire breast.
The SPAIR technique leaves the nipple attached to its underlying tissue, so as to optimally protect sensation and the possibility of future breastfeeding, although neither outcome can ever be guaranteed by any reputable surgeon. This technique also uses internal stitches (that can’t be seen from the surface) to mold the breast into a more youthful shape. The breast is lifted and shaped with this technique.
Quite simply, SBR is liposuction breast reduction. Just as we can use liposuction to remove unwanted fat from any other area of the body, we can also use it to reduce breast size.
The major benefit of this technique is the virtual absence of scars on the breasts. There is one tiny scar, about 1/4” long, in the crease under each breast. SBR is ideal for reducing breast size to alleviate back pain, neck pain, and shoulder pain. It’s also good for correcting some types of breast asymmetry. It does not reshape the breast, however. It does not “lift” the breast or the nipple; it simply gives you a smaller version of the breast you currently have. SBR is a good option for women who understand the benefits and drawbacks of the procedure.
In some cases, liposuction of the breast can be combined with the SPAIR technique to provide ideal size and shaping for the breast. Liposuction of other body areas can also be done at the same time, if desired.
Fortunately, significant complications from breast reduction are not too common. Every year, many thousands of women undergo successful breast reduction surgery, experience no major problems, and are happy with their results. Anyone considering surgery, however, should be aware of both the benefits and the risks.
The subject of risks and potential complications of surgery is best discussed on a personal basis between you and Dr. Kavali.
Some of the potential complications that may be discussed with you include bleeding, infection and reactions to anesthesia.
Following reduction, sometimes the breasts may not be perfectly symmetrical or the nipple height may vary slightly. If desired, minor adjustments can be made at a later time. Permanent loss of sensation in the nipples or breasts may occur rarely. Revision (secondary) surgery is sometimes helpful in certain instances where incisions may have healed poorly. In the unlikely event of injury to or loss of the nipple and areola, they usually can be satisfactorily reconstructed using skin grafts.
Our goal is to make your surgical experience as easy and comfortable for you as possible.
Depending on your age, or if you have a history of breast cancer in your family, Dr. Kavali may recommend a baseline mammogram before surgery and another mammographic examination some months after surgery. This will help to detect any future changes in your breast tissue. After your breast reduction, you will still be able to perform breast self-exams, which you should do monthly. Breast reduction surgery does not increase your risk of developing breast cancer.
If you are a smoker, you will be asked to stop smoking for at least 3 weeks prior to your surgery date. Smoking dramatically and specifically increases your risk of wound healing complications after surgery, which could give you unsightly scars.
Breast reduction surgery is usually performed on an outpatient basis. Recovery is generally the same, regardless of which technique is chosen. Typically the greatest swelling occurs two days after surgery. You will be asked to wear a bra continuously for the first 3-4 weeks. With SBR, you may be comfortable continuing the bra support for up to 6 weeks. Most swelling will be gone in about 6 weeks, but final settling of the breasts won’t occur for up to 9-12 months, which is when you’ll have your final result.
Be sure to go to the Patient info link on this site. You can find consent forms and instructions for each procedure, and you’ll find information about what to do and what to expect before and after your surgery.
-C.W.