Breast Reduction Procedure

Hi,

I am Dr. Santosh Bhatia. So, today we are going to talk about a common procedure called as breast reduction. We often see women who suffer from a condition known as giganto mastia which is invariably speaking hormonal, sometimes you see it running in families this is nothing else but massive gigantic breast. Often it is seen in younger individuals also. I have recently operated on a 21 year old young female also for the same condition. Commonly, what a person suffers from in such conditions are besides the cosmetic appearance of large breasts, unable to buy relevant clothes, bras and things like that. They also have pain in the neck, shoulder, back, arms. They often complain of itching in the underside of breast because of lack of being able to clean that area well and constant rubbing of the breast against the abdominal wall or chest wall causing a lot of skin inflammatory reactions to that area. So, they often come finally extremely frustrated and tired of the size of the breasts to the extent where sometimes I have had patients who are so unimaginably speaking so frustrated with it that they sometimes they just remove my breast out.

Obviously we don't do that. We kind of counsel them and make them understand how we can reduce the size of the breast to make it more pleasant and more acceptable to themselves and to people around them. So, what is the procedure entail? Again, the most common procedure that we do is known as a breast reduction surgery. This can be done in different methodologies. Very rarely we may use liposuction or we may use liposuction as an adjunct to the conventional breast reduction surgery. Now in breast reduction surgery once obviously the patient comes in, I examine them, I understand what are their goals, what size they are looking at, I try to explain to them what can be achieved and definitely what cannot be achieved. I also try to assess them in terms of whether they have asymmetry in the breast, any nipple sensation problem they are suffering from and things like that. Now, again many women ask me questions like how will I be able to feed my child post surgery, will I have nipple sensation post surgery and various questions like that. Now commonly we see that nipple sensation is invariably speaking our goal is to maintain the nipple sensation, our goal is to maintain post surgical lactation or breast feeding. Very rarely it may happen that you may have decreased in nipple sensation, sometimes you may have difficulty in feeding your child but again it is a rare occurrence and not the normal.

In terms of the breast reduction surgery prior to surgery as any other surgery we call you in for clinical examination, certain blood tests and X-RAY are done. We sometimes do a mammogram if there is a suspicion of any kind of a lump in the breast and once we have your anaesthesia fitness, we go ahead with the surgery. The common types of surgery as I have explained to you earlier is we do a breast reduction with a circum vertical scar at the end of it so that the scar will be around the nipple areola complex and there'll be a vertical scar at six o'clock position down to us something known as the inframammary crease. Sometimes we take an anchor-shaped incision if the breast is very large, then we need to do that and in cases where it is possible, we may just make an incision around the nipple areola complex so that that scar is practically invisible. In terms of what are the results that we achieved so we normally typically depending again on the patient profile, on law of averages about 200-300 grams of breast tissue sometimes even 800 grams of breast tissue we have removed in patients who have extremely large breasts. After we do the surgery, there will be some tapes and bandages which is there on your breast for about 10-15 days. I commonly call you on day 3 wherein you come in and we do your dressing after which you come on day 10 to day 12 to remove the stitches.

During this period for the first three weeks you have to wear a sports bra that possibly has to be worn as much as possible without wearing any underwire bra or without wearing any bra with lot of designs and things on it. After your 15 days, then I call you on 1 month, 3 months, 6 months and after that a yearly follow-up is generally done. This procedure is fairly straightforward. You have to stay in the hospital for one night post the procedure just to keep a watch on you and sometimes in some patients if there is a very large amount of breast reduction we may put a drain inside the breast. This drain is nothing else but to remove any kind of fluid which is in building up into the breast and commonly again it is kept for 2 to 3 days after which we generally remove it. If patients often ask me what are the most common things or complications that we may see in such a surgery, you may get some amount of bruising, some amount of swelling which is common. It's just a sequel of your surgery. I don't call it a complication. It is there for about 15-20 days after which it all resolves. Thank you. For any further information, you can contact me on lybrate.com.

Thank you.