Breast Reduction

Many women with very large breasts find navigating everyday life uncomfortable. It is often challenging to find clothing that fits properly. Many women with large, heavy breasts find it difficult to engage in physical activity or suffer from back, neck and shoulder pain. They can also suffer from skin irritation beneath their breasts and indentations in their shoulders from overly tight bra straps. Often, women and teenagers with unusually large breasts feel self-conscious and unhappy with their disproportionate shape. Breast reduction can help a woman feel more proportionate. Dr. Motakis views breast reduction surgery as a balancing procedure. With any breast procedure, his goal is to offer his patients symmetric, proportionate, lifted breasts that look natural. Upon a thorough discussion, Dr. Motakis will determine the type of breast reduction procedure, which is most appropriate for you.

What is a breast reduction?

A breast reduction— also known as reduction mammoplasty — is a surgical procedure performed in order to decrease the size and improve the shape of your breasts and make them appear smaller and more lifted. During breast reduction, excess breast tissue and skin are removed, and the nipple and areola are lifted at the same time. Dr. Motakis has expertly performed breast reductions surgeries to give women natural looking proportionate breasts, which allow them to live a comfortable, confident, active lifestyle. Breast reduction is a procedure that is often very similar to a breast lift, the main difference being that in a breast reduction the breast is made smaller. Both procedures result in a lifted breast and frequently have similar incisions.

Who is a good candidate for breast reduction?

Most adult women in good health who have large breasts are good candidates for this procedure. Women who feel that their breasts appear elongated and heavy with the nipples pointing somewhat downwards and who’s areolas appear excessively large or who have one breast sitting lower than the other are likely good candidates for a breast reduction lift. Smoking can interfere with healing, so it is important to stop smoking 4 weeks before this procedure and only resume 3-4 weeks after. Lastly, if you are planning to lose a significant amount of weight, it is best to have your breasts reduced once you have reached your goal weight and your weight has stabilized. Ideal candidates are women with large breasts that are in good physical health and have realistic expectations about the surgical results.

Certain healthcare plans, including the Ontario Health Insurance Plan, may pay for breast reduction to relieve medical symptoms. Coverage may depend on a significant amount of breast tissue being removed. To determine your eligibility, you will require a letter of predetermination from your family physician prior to surgery. At his private clinic, Dr. Motakis can only assist you if you are seeking a purely cosmetic breast reduction.

The procedure

Breast reduction surgery is usually performed through incisions on your breasts with surgical removal of the excess fat, glandular tissue and skin. In some cases, excess fat may be removed through liposuction in conjunction with the excision techniques described below. Depending on how large the breasts are different techniques may be used to optimize the shape of your breasts. These include:

  • Using incisions around the areola and down the middle of the lower breast (lollipop or vertical breast reduction).
  • Using an anchor scar with looks like the lollipop but has an additional horizontal incision along the lower crease of the breast (wise pattern or anchor breast reduction). This technique is necessary in cases of very large breasts with severe droop where the vertical skin excess is too extensive.

During the consultation, Dr. Motakis will discuss with you which procedure is best suited for you based on your breast size.

The procedure takes 2-3 hours to perform. During the procedure the breast tissue is exposed, the excess removed from the lower and lateral aspect of the breast and the remaining tissue is lifted and reshaped to create a lifted and smaller looking breast. The nipple is repositioned to its ideal higher position and when necessary the areola is decreased to its ideal diameter. Lastly, the excess skin is removed in order to create a tighter and firmer looking breast. All sutures used during the procedure are internal and usually, there are no drains used. Surgical tape is then applied over all incisions and bandages are applied. This makes recovery easier and scarring optimal. The bandages stay intact over the first postoperative week. A supportive compressive bra is applied after the procedure to minimize swelling.

What is the recovery period for a breast reduction?

Recovery after surgery takes 1-2 weeks during which a supportive compression bra is worn. Specific dressings will be applied after your surgery and they will stay intact until your follow up visit one week after surgery. You will be able to shower the next day after the procedure as Dr. Motakis does not usually use drains with this procedure. Your breasts will be slightly swollen and may feel slightly sore, but when needed, you will feel comfortable with the use of mild analgesics. After one week, you should be able to return to work, but you will need to limit intense physical activity such as going to the gym for 3-4 weeks. At your one week follow up appointment your bandages will be changed, the incisions inspected, and a special tape applied to expedite healing and reduce scarring. There are no sutures that need to be removed with breast lift surgery, as Dr. Motakis uses only internal dissolving sutures in order to minimize scarring and decrease patient discomfort.

What are the risk factors of a breast reduction?

Complications of breast reduction include unfavorable healing or scarring, change in skin or nipple sensation, infection and asymmetry, among others. However, these seldom occur. Dr. Motakis will discuss all risks in detail during your consultation and pre-operative appointments. Correcting these complications may also require additional surgery.

Are there any alternatives to a breast reduction?

Currently, breast reduction is the only procedure available to decrease breast size.

Can breast reduction be combined with other procedures?

A breast reduction can be combined with various other procedures such as liposuction of the axillae and the arms or any other areas or a tummy tuck (see mommy makeover surgery) among others.

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