08 Jan Breast Reduction: The Essentials
Dr. Somogyi lays out the essential information you’ll need to know when considering a breast reduction.
What is a breast reduction?
A breast reduction is a surgical procedure designed to remove excess volume from the breast. As part of a breast reduction, the breasts – along with the nipples – are repositioned higher onto the chest. Often, liposuction is also performed at the same time to improve the lateral (outer) part of the breast and help contour the lateral chest “bra roll”.
What are the costs of breast reduction surgery?
In Ontario, a breast reduction can be covered by OHIP if the patient has symptoms related to heavy breasts. An application must be submitted by the surgeon and approved by OHIP before the procedure can be covered. In most cases, liposuction of the lateral breast and chest is recommended. This portion is never covered by OHIP. The costs for contouring liposuction are $4000-$5000, inclusive of the extra fees for additional facility time and anaesthesia.
What types of incisions are used?
There are 2 standard incisions for a breast reduction. The Wise Pattern or “Anchor Shaped” incision and the Circum-vertical or “Lollipop Shaped” incision. Both involve an incision encircling the border of the areola and an incision that extends vertically down from the areola to the lower breast fold. The Wise Pattern uses an additional horizontal incision along the lower breast fold.
The decision of which incision to use is made after examining and measuring the breast and discussing your goals of surgery. Depending on skin quality, size of the breast, degree of droopiness and how much smaller you would like to be, one of the two incision types will be recommended.
How long is the procedure and what do I do right after surgery?
Breast Reduction surgery is performed under a general anaesthetic and takes approximately two hours. At the end of the surgery, you will be wrapped in a supportive tensor bandage that will be removed after 3-4 days. You will spend an additional two hours in the recovery area after surgery until you feel well enough to go home to rest. Once you get home, you should rest and avoid strenuous activities until your first post-operative appointment, which is usually 3-4 days after surgery. Normal, light activities can be performed right after surgery. There are no specific limitations in arm or shoulder movements.
What is recovery like after a breast reduction?
All sutures are dissolving and will be covered with steri-strips that come off on their own after about two weeks. You will then wear a sports bra (ideally one that opens in the front) 24/7 until four weeks after surgery. You can shower and wash normally as soon as the initial bandage comes off 3-4 days after surgery. Most patients return to normal light activities and sedentary work (office work or school) around one week after surgery. Strenuous activity and exercise can begin slowly at four weeks after surgery.
Pain medication is prescribed after breast reduction surgery. This usually includes Tylenol and an anti-inflammatory such as Celebrex. These are usually enough to keep patients very comfortable. A stronger pain medication, such as hydromorphone, is also prescribed and taken when needed.
What are the potential risks of breast reduction surgery?
In general, breast reduction surgery has an exceedingly high satisfaction rate with a very low complication profile. Having said this, all surgical procedures have the risk of bleeding, infection, slow wound healing, poor scarring, blood clots and anesthetic complications. These are all very rare with breast reduction surgery. The additional risks specific to breast reduction surgery can include asymmetries, injury or loss of the nipple, nipple hypersensitivity or numbness, breastfeeding complications and internal scarring or hardening of breast tissue.
Additionally, it is important to note that although the results of breast reduction surgery are excellent, there are many changes in life that will lead to changes in the breasts themselves. As such, patients that gain or lose weight, have a pregnancy, breastfeed or go through significant hormonal changes will note changes in the shape and size of their breast regardless of whether a breast reduction has been performed or not.
What are the next steps in pursuing breast reduction surgery?
While breast reduction surgery is very common, the procedure itself is individualized to each patient’s body and their goals. Going through a comprehensive consultation with Dr. Somogyi will provide you with a plan that will best suite you. If there is potential for the surgery to be covered by OHIP, you will need a referral sent to Dr. Somogyi by your family doctor.