Breast reduction, also called reduction mammaplasty, is a procedure that removes excess breast tissue and skin, making breasts more proportionate to the rest of the body. The areola may be reduced and repositioned as well.

Breast reduction can:

• Give significant relief from physical and emotional
  discomforts
• Give a new sense of freedom in exercise and
  physical activity
• Give you an ability to wear a greater variety of clothing

Certain feelings or conditions may indicate that you are ready—and have reasonable expectations—for breast reduction:

You are a good candidate if you have:

• Back, neck or shoulder pain caused by the weight of your breasts
• Heavy, sagging breasts with very low nipples and areolas
• Breasts that are too large in proportion to your body frame
• Skin irritation under your breasts
• Indentations in your shoulders caused by tight bra straps
• Restricted your physical activity due to the size and weight of your breasts
• Feelings of self-consciousness about the large size of your breasts
• One breast that is much larger than the other

First you will:

• Discuss your specific goals with Dr. Swier
• Have your physical and emotional health evaluated
• Have your breasts photographed and examined for your medical records
• Learn the likely outcomes and potential risks of the procedure
• Get a course of treatment recommended by Dr. Swier
• Schedule a baseline mammogram
• Share your family’s history of breast cancer
• Ask questions and get answers to help you understand the process

Be sure to:

• Openly share your expectations
• Disclose your complete health history, current medications, and use of vitamins, herbal supplements, alcohol, tobacco and drugs
• Commit to precisely follow all of Dr. Swier’s instructions

The specific method for your breast reduction will be chosen by Dr. Swier. The most common method uses a three-part incision. One part of the incision is made around the areola. Another is made vertically from the bottom edge of the areola to the crease underneath the breast. The third incision is a horizontal one beneath the breast, which follows the natural curve of the breast crease.

Dr. Swier will determine in each case which incision is best. For some patients, a horizontal incision may not be necessary. And men and women whose breasts contain a significant
amount of fatty tissue may be able to have liposuction alone to reduce breast size.

After excess breast tissue, fat and skin are removed, the areola and nipple are shifted to a higher position. The areola, which is usually larger than ideal, is reduced in size. Skin that was formerly located above the nipple is brought down and together to reshape the breast. Liposuction may be used to improve the contour, especially on the sides of the breasts. The nipples and areolas usually remain attached to their underlying tissue, allowing for a preservation of sensation and also preserving the ability to breast-feed (although it is not guaranteed).

You will be asked to:

• Aviod certain medications that may complicate surgery or recovery
• Stop smoking for a period of time before and after surgery
• Arrange for help or special care following surgery

• Your procedure may be performed in a hospital, outpatient surgery center or office-based surgical suite
• If you are admitted to a hospital, your stay will be short, typically one night
• Usually a general anesthesia will be administered to keep you comfortable
• You will emerge from surgery with, in some cases, small drainage tubes placed beneath the breast skin to help prevent fluids from accumulating
• Gauze dressings will be placed on your breasts, covered with an elastic bandage or surgical bra
• You’ll be taken to recovery where you will be closely monitored

Within one week:

• You will begin to move about more comfortably and perhaps return to work
• Surgical drains will be removed and dressings will be changed

After several weeks:

• Most of the swelling and discomfort will diminish
• You may stop wearing the support bra
• Sensation within the nipple and areola will gradually improve
• You may resume mild exercise and arm movements

After a few months:

• Your breasts will start settling into a natural shape
• Incision lines will begin to fade
• You will notice relief from neck, back and shoulder pain