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Breast Reduction Palo Alto

View Before and After PhotosFor many years, breast reduction goals were primarily focused on relieving physical disabilities created by large, pendulous, ptotic (drooping) breasts. Mammoth pendulous breasts can be both physically and emotionally disturbing. Very large breasts (macromastia) upset the harmony of body contour and can detract from an otherwise pleasing figure. Even though a person may be quite slender, large breasts often imply a weight challenge. The fact is, only 10% of the women with macromastia have a true weight problem.

Medical problems associated with large pendulous breasts include: breast, back, neck, muscle, shoulder and joint pain, shoulder notching, irritation from bra straps, arthritic problems with the neck and back, and skin irritation under the breasts (inframammary intertrigo). There is also difficulty with mobility, participation in athletics and challenges in shopping for clothes.

Candidates for breast reduction procedures vary in age from the mid-teen years to the eighties. Many physicians feel that this is one operation that is not done frequently enough. Breast reduction is one of the oldest and most established plastic surgery procedures. Although an aesthetically pleasing contour is one of the goals, it is not categorized as a cosmetic procedure. It can be a cosmetic reconstructive, medically indicated procedure that insurance companies usually consider favorably.

Older surgical techniques sometimes resulted in a flattened breast contour with objectionable long scars, particularly along the inframammary fold below the nipple and along the lateral breast area. In recent years, breast shape and symmetry with finer shorter scars have been made possible. Some liposuction has been introduced recently to facilitate in shaping as well. Some fat is suctioned avoiding glandular breast tissue. It is achieved by using blunt, not sharp, cannulae that do not penetrate the glandular tissue. Axillary (under the armpit) extensions of the lateral subaxillary fat can be sculpted, which gives the breast better definition laterally without a long incision. There are, however, individuals who are not candidates for the liposuction combination technique. If the fat is mixed with the gland, it may be impossible to penetrate with a blunt cannula. Unfortunately, preoperative selection for these patients is often impossible. Approximately 60%-70% of the patients with large breasts will be a candidate for liposuction combined with the surgical resection of the breast. In most patients, the conventional anchor incision can be avoided, but in an extremely large breasted patient, a horizontal incision component may be necessary. This, however, can be minimized with the Vaser® system application. All incisions are kept to the minimal length necessary to accomplish the reduction and to restore the normal contour.

Incision scars in the first six to twelve months following surgery will gradually fade and improve with time. Occasionally, we will see someone that is prone to hypertrophic scarring. This predisposition to unnatural scarring cannot be diagnosed prior to surgery unless the patient shows evidence of it somewhere else on her body. Today, there are products on the market such as silicone sheeting, gel or liquid that is applied to the scar to stop the over production of collagen responsible for it. It is important that all post-operative visits are kept for the surgeon to evaluate and treat if necessary.

Reduction mammaplasty is about a 5 to 6 hour operation. Sutures are removed in stages over the next 7-10 days. For the first 2 weeks restricted arm motion is ideal. The nature of the business will determine when one returns to work.

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