Women with very large, pendulous breasts may experience a variety of medical problems caused by the excessive weight (from back and neck pain and skin irritation to skeletal deformities and breathing problems). Bra straps may leave indentations in their shoulders. And unusually large breasts can make a woman or a teenage girl feel extremely selfconscious.
Breast reduction is designed for such women. The procedure removes fat, glandular tissue, and skin from the breasts, making them smaller, lighter, and firmer. It can also reduce the size of the areola, the darker skin surrounding the nipple. The goal is to give the woman smaller, better-shaped breasts in proportion with the rest of her body. The final size depends on the expectations of the patient, and the surgeon´ advice.
If you’re considering breast reduction, this information will help provide a basic understanding of what a reduction mammoplasty can and cannot achieve. Because each individual patient is different no amount of written information can replace a personal consultation with Dr. Gomez-Mendoza and his team.
The following information is strictly the opinion of Dr. Gomez-Mendoza and his associates and pertains to reduction mammoplasty procedures as performed by him.
Candidates for Reduction Mammoplasty
Most women who have the surgery are troubled by very large, sagging breasts that restricts their activities and cause them physical discomfort. In most cases, breast reduction is not performed until a woman’s breasts are fully developed; however, it can be done earlier if large breasts are causing serious physical discomfort. Reduction Mammoplasty can impair the breast-feeding function in some cases.
Planning your surgery
In your initial consultation, Dr. Gomez-Mendoza and his team will evaluate your health and examine your breasts and measure them while you’re sitting or standing, then we will discuss the variables that may affect the procedure ( such as your age, the size and shape of your breasts, and the condition of your skin and explain which surgical techniques are most appropriate for you, based on the condition of your breast and your aesthetic goals.
Preparing for your surgery
Depending on your age and family history, your surgeon may require you to have a mammogram (breast x-ray) before surgery. You will also get specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking and taking or avoiding certain vitamins and medications.
Breast reduction is usually done on an outpatient basis, for convenience and cost containment. If you are admitted to the hospital as an inpatient, you can expect to stay one day.
If you smoke, plan to quit at least two Weeks before your surgery and not to resume for at least four weeks after your surgery.
What type of anesthesia is used?
Dr. Gomez-Mendoza performs most breast reductions, under sedation (gentle, short-acting medication administered by a board certified anesthesiologist to insure comfort and security for our patients) and local anesthesia. Patients are under monitored anesthesia care since they arrive to the operating room till they leave the recovery area. You will receive the safest care possible. The expert care you deserve. Our patients recover more quickly and with less discomfort than when general anesthesia is used.
Where will your breast reduction be performed?
Dr. Gomez-Mendoza performs most breast reductions at the modern Puerta de Hierro Medical Center. Whether you choose to have your procedure done in the peaceful seclusion of our state-of-the-art Medical Center or at one of the many Guadalajara or Puerto Vallarta-area hospitals where we currently enjoy operating privileges; rest assured that you will receive the finest care available.
The surgery itself usually takes two to four hours. Techniques vary, but the most common procedures involves: 1) The doughnut (concentric or periareolar) technique, in which circular incisions are made around the areola, and a doughnut-shaped area of skin is removed from the upper pole of the breast and glandular tissue is removed from the lower pole of the breast to get the volume and shape desired and 2) an anchor-shaped incision following the natural contour of the breast. The incision outlines the area from which breast skin will be removed and defines the new location for the nipple. When the excess of glandular tissue, fat and skin has been removed, the nipple and areola are moved to their new position. The skin is then brought down and around the areola, shaping the new contour of the breast. Liposuction may be used to remove excess fat from the armpit area. Stitches are usually located around the areola, in a vertical line extending downwards from the nipple area, and along the lower crease of the breast. Some patients, especially those with not too large breasts and mild to moderate sagging, may be candidates for modified procedures requiring less extensive incisions. One such procedure is the doughnut (or concentric) breast reduction. Finally, the incisions will be stitched (we only use absorbable sutures placed in an intradermal running fashion so you will not see them and they do not need to be removed). This technique obviates the need for external skin sutures and circumvents the possibility of suture marks.
After your surgery...
You will wear a support bra over your gauze dressings. Your breasts will be bruised, swollen and uncomfortable for a day or two, but the pain should be mild. Any discomfort you do feel can be relieved with your medications. You will wear the bra around the clock for four weeks.
If your breast skin is dry following surgery, you can apply a moisturizer several times a day. Be careful not to tug at your skin in the process, and keep the moisturizer away from the suture areas.
You can expect some loss of feeling in your nipples and breast skin, caused by the swelling. This numbness usually fades as the swelling subsides over the next two to six weeks.
Healing is a gradual process. Although you may be up and about in a day or two, do not plan on returning to work for a week. And avoid lifting anything over your head for three to four weeks.
You will be instructed to avoid sex for two weeks or more, and to avoid strenuous sports for about a month.
If you become pregnant, the operation may affect your ability to breast-feed.
Your new look
Although much of the swelling and bruising will disappear in the first few weeks, it may be six months to a year before your breasts settle into their new shape. Even then, their shape may fluctuate in response to your hormonal shifts, weight changes, and pregnancy. We will make every effort to make your scars as inconspicuous as possible, it is important to remember that breast reduction scars are permanent and your scars may actually appear to worsen during the first two to three months as they heal, but this is normal. Expect it to take six to nine months before your scars flatten out and lighten in color.
Are there any risks?
When a reduction mammoplasty is performed by a qualified plastic surgeon certified by the Board of Plastic Surgery, complications are infrequent and usually minor.
While Dr. Gomez-Mendoza and his team make every effort to minimize risk, individuals vary greatly in their anatomy, their healing ability as well as in their reactions to surgery and anesthesia. Complications that may occur include minor haematoma (a small collection of blood beneath the skin), infection, poor healing and reactions to medications. You can reduce your risks by closely following the advice of your surgeon concerning your pre-operative and post-operative care. There are not risk free surgical procedures.
To contact plastic surgeon Dr. Carlos Gomez-Mendoza about any cosmetic surgery procedures, please fill out our contact form or call us at (33) 3848-5477 in Mexico.