Breast Reduction
Artwork by Dr. BYUN
Breast Reduction Information
Disproportionately large breasts can limit a woman’s freedom, making some physical activities impractical or uncomfortable. Bra straps may chafe against the skin and put a strain on shoulders, potentially impacting circulation. The added weight of heavy breasts pulls the shoulders forward, often leading to chronic back pain and a slouch when walking or standing.
For patients with small frames, a breast reduction can be a welcome solution to neck and back pain, poor posture, and even social awkwardness. Trusted Chicago plastic surgeon Dr. Michael BYUN is skilled in reshaping the size and proportion of breasts to dramatically improve your quality of life. This can end soreness, inflammation, and pain.
It is pertinent to find out the pros and cons of the different types of breast reduction and breast lift techniques, which include, but are not limited to, Periareolar Lift, Vertical Mammaplasty, Wise Patterns, etc. Many patients do not know the risk factors associated with certain procedures; for example, some techniques result in more decreased nipple sensation than other techniques, and some doctors can cause a “boxy breast” appearance. Consultations are a great opportunity for Dr. BYUN to review your history, analyze your goals, and examine your tissues. He will then recommend the best surgical approach to fit your specific goals and anatomy. Dr. BYUN and our team always encourage patients to do their research in order to learn more about the right way, and the best way to do your breast reduction / breast lift and then be able to make an informed decision on the surgeon you choose.
Breast Reduction Procedure
Many reductions result in flat, wide patterns. They are initially happy because the breast bulk is reduced, but they become dissatisfied because the chest becomes flat and deflated. Dr. Michael BYUN, a world renowned plastic surgeon created a new pattern of breast reduction that makes the shape perkier, with the breast diameter becoming smaller as well. He achieves this by taking tissues from the bottom part of each, then the two sides of the breast tissues are moved centrally and superiorly. This makes the breast smaller, perkier, and the entire circle of the breast tissue becomes smaller and lifted.
Breast reduction, or reduction mammoplasty, removes fat, glandular tissue, and skin to make the breasts smaller, lighter and firmer. The size of the areola can be reduced as well. These procedures have the goal of providing smaller, better-shaped breasts that are in proportion with the rest of the body.
The surgery is performed for about two to three hours under general anesthesia. Though incredibly rare, complications may include loss of the nipple, infection, scarring, nipple erectile ability loss or nipple numbness. Numbness could potentially be permanent and affect the ability to breastfeed in the future.
Breast Reduction Recovery
Discomfort after the operation is minimal, as the sutures dissolve internally and dressings can be removed in 10 to 14 days. Driving can be resumed in four to five days, while showering and bathing can begin in five to seven days. Physical activity, which includes lifting objects, must be restricted for two weeks, and active sports should be avoided for two to four weeks. Dr. BYUN will schedule three to four postoperative visits in order to monitor the recovery process.
Facts and Advice from Dr. Michael BYUN
Once you find a surgeon, always look through their before and after photos of breast reduction procedures on their website – it is very important that you do your research. A great, and very important bonus is if the surgeon also has photos showcasing the longevity of their breast reduction procedures.
ALWAYS make sure the surgeon is board certified by the American Board of Plastic Surgery, not certified in Cosmetic Surgery, General Surgery, Gynecology, etc.
Look at the diameter of the breast; it should be reduced after the reduction, while still remaining projected. Avoid surgeons with “after” breast reduction photos that look wide and flat. After surgery the breast should have a smaller diameter and thus appear smaller from the frontal view. Also, the breast should be more projected (perky) from the side view. Many surgeons just remove content of breast tissue to satisfy the insurance requirements, which makes the breast deflated.
Avoid surgeons who do anchor-shape incisions. Dr. BYUN does the straight vertical incision below the areolar. This is called a vertical mammoplasty.
Ask the surgeon if they use inferior pedicle technique or central pedicle technique. Technique is important when it comes to nipple integrity. Blood circulation is often compromised when the inferior pedicle technique is used. Compromised nipple integrity can lead to reduced sensation or nipple necrosis. Dr. BYUN uses a central mound pedicle technique, which does not compromise blood circulation and provides better sensory function to the nipple. In other words, the central pedicle technique is superior.
Breast reduction scars should not go into your lateral chest, near your ribs. The scars should stay under the inframammary fold and up to the nipple. If a larger, more lateral cut is made, the breast shape will most likely become boxy as time goes by. ALSO, Shape can change with age and with pregnancy.
Most surgeons who are within the Insurance network do not perform liposuction to the surrounding tissues since the insurance company does not cover that additional procedure. It is important to do a little bit of liposuction (this is another benefit of meeting with Dr. BYUN – gaining the proper education related to procedures, surgery, and technique).
It is hard to have insurance to pay for breast reduction surgery. The doctors who accept insurance often sign up with the insurance company to gain the volume. Because of this, more careful evaluation is required as indicated above by looking at the surgeon’s before and after photos, credentials, etc.
Breast Reduction FAQs
What Are The Benefits Of Breast Reduction?
In addition to greater comfort and improved confidence, breast reduction surgery has a wide range of benefits. Such benefits include added symmetry to the breasts, and sculpting a more appealing shape. The nipple can also be adjusted. Compressing the size of the areola will create an elegant new profile. If there is sagging, Dr. BYUN can also lift each breast to renew the natural contour.
Is Breast Reduction Similar To Breast Lift?
In some ways, yes. During each procedure, the breast is reshaped, resulting in a perkier appearance. Although a breast lift does involve the removal of some tissue, its emphasis is on reclaiming a youthful profile by elevating the breast.
By contrast, during breast reduction the surgeon makes a vertical incision, removes fat and skin, then tightens and reshapes each breast. The size of the areola may be reduced, and in the case of larger breasts the nipple and areola may also be repositioned.
Will There Be Scarring After The Surgery?
Scarring is one of the trade-offs of a breast reduction procedure. The type of incision that is necessary will depend on the extent of the reduction in breast size. Significant reductions usually require a so-called “anchor shape” or “inverted-T” incision that extends around the circumference of the areola, vertically down and across the base of the breast. Smaller reductions can be performed using a “lollipop” incision that eliminates the necessity of cutting across the bottom of the breast. Although scars will be noticeable in the first months after surgery, they will fade with time.
Are The Results Permanent?
In the absence of future pregnancies or dramatic weight gain, the results of your breast reduction will be long-lasting. The procedure resets the clock on your profile, but cannot freeze time altogether. Some future sagging or loosening will naturally occur with aging. Except in rare cases, breast tissue will not grow back, so your reduction in volume and the many benefits you are enjoying from a more proportionate shape should indeed be permanent.
Will I Be In Pain?
You will not feel anything during the procedure, since anesthesia will be used. However, after the anesthesia wears off, you will feel some pain and discomfort. It is highly recommended that you start off taking Extra Strength Tylenol, every six (6) to eight (8) hours, alternating with Motrin. Please DO NOT MIX pain relief medications together at the same time. If you are experiencing a higher level of pain, please take the prescribed pain medication (Norco, or other prescribed pain medication).
How Long Does The Recovery Take? When Can I Go Back To Work & Exercise?
Depending on both the surgery and your own physiology (your body’s healing), most patients have a downtime of two (2) to three (3) weeks before returning to daily activities such as exercising. During the first ten (10) days, we ask that you do not do any activity that increases your heart rate. This is to help the healing process, since the blood clot that has stopped the bleeding from the surgery dissolves in about seven (7) days. After ten (10) days, increase activity by ten percent (10%) each week as tolerated. Stop activity if you see a dramatic increase in swelling when you wake up the following day. At the one (1) week post-op visit you will be provided with healing instructions and what specific activities are allowed. Patients can usually return to work after one (1) week.
What To Do If I Become Constipated?
Reduce Norco usage, walk around, and take an over-the-counter medication like Colace or MiraLAX. It is recommended that you start using an over-the-counter stool softening medication one (1) day before surgery and continue taking it until you no longer need to be taking Norco for pain.
What Does The Healing Process Look Like?
Bruising, Swelling, and Stitches (which can pucker) are all NORMAL. Tissue firmness is NORMAL. Your body may not heal symmetrically, meaning one side may take longer to heal than the other, this is NORMAL. Any previous asymmetry may remain.
Why Are My Results Uneven?
Post-op asymmetry is NORMAL. Pre-existing asymmetry will continue since the human anatomy of left vs. right does not always match. Human tissue is naturally asymmetric. This applies to Breasts, Face, Eyes, and even the Nose.
Why Is My Swelling Lasting Longer On One Side?
This is very common. The function of your Lymphatic System (which acts as a highway of Arteries, Veins, and Lymphatic Channels) is to filter out fluid from particular areas of the body. Lymph Nodes, Bone Structure & Tissue Shape are different from right to left, so when it comes to draining, the “clearance rate” of the swelling is also entirely different on each side. The heart is located on the left side of the body and distributes blood throughout the body using different paths & pressures. The drainage of the heart is not completely linear; thus, another reason why Lymphatic Clearance is different on each side.
How Soon Can I Take A Shower?
We recommend waiting forty-eight (48) hours to shower. Make sure you are steady on your feet. Do not soak the incisions and pat them dry when done.
Can I Get My Sutures Wet?
After forty-eight (48) hours, stitches can get wet. It is highly recommended, however, that only normal saline (over-the-counter medical cleaning solution) is used to clean the stitches. DO NOT use any cleansers or alcohol products on the suture site. Picking or pulling at the sutures is not approved and can cause damage. Pat the sutures dry if need be.
How Often Can I Apply Heat And Cold Packs?
Hot packs are NOT recommended due to a side effect of increased inflammation which can further delay the healing process. However, cold packs are recommended with frequent usage in fifteen (15) minute intervals.
How Soon Can I Get On A Plane?
Every case is unique. Typically, short distances (short domestic flights) are okay. However, we recommend that you wait until you see Dr. BYUN’s team at the one (1) week follow-up appointment for final approval. Please keep in mind that extra swelling can occur due to pressure changes in the plane.
BYUN Post Operative Information & Care Instructions for Breast Reduction
MEDICATIONS TO HELP WITH NAUSEA
ZOFRAN (or OTHER ANTI-NAUSEA MEDICATION): Take one (1) Zofran tablet (or other anti-nausea medication) as prescribed on your way home from surgery.
MEDICATIONS TO HELP WITH INFECTION
KEFLEX (or OTHER ANTIBIOTIC MEDICATION): Start the antibiotics as prescribed (make sure to consume food when taking any antibiotics as it can cause nausea). It is crucial to complete the ENTIRE course of antibiotics.
MEDICATIONS TO HELP WITH PAIN
TYLENOL & MOTRIN: Start with two (2) extra strength Tylenol (take every 6-8 hours). You may take Motrin instead of Tylenol if preferred. Do not take Tylenol and Norco within the same 6-8 hour window. Taper off medications as tolerated.
NORCO (or OTHER PRESCRIBED PAIN MEDICATION: If pain is not controlled with extra strength Tylenol or Motrin, take one-two (1-2) tablets of Norco instead (take every 6-8 hours). DO NOT DRIVE if you’re taking Norco as it can cause drowsiness and other side effects. Norco has Tylenol in its composition – AVOID TAKING NORCO WITH TYLENOL and/or MOTRIN in the same 6-8 hour window.
METHODS & MEDICATIONS TO MINIMIZE BRUISING AND SWELLING
ARNICA TABLETS & BROMELAIN (over the counter): Take one (1) week before and continue for one (1) week after surgery.
ICE THERAPY: Fifteen (15) minutes on, fifteen (15) minutes off. Icing is most important in the first forty-eight (48) hours post-surgery. Icing will still be effective after that forty-eight (48) hour period and is still recommended.
COMPRESSION: Firm but gentle wrapping with ace bandages.
METHODS TO ENHANCE RECOVERY
PROTEIN INTAKE: Protein can be ingested in any form; powder, shakes, bars or foods high in protein.
HYDRATION: Increase water intake (i.e., Pedialyte hydration packets to put in water) & Electrolyte drinks (i.e., Vitamin Water).
CLEANING WOUNDS TWO (2) to THREE (3) TIMES A DAY: Not cleaning enough can cause infection while cleaning too much can take away good, healing tissue and prolong recovery.
MINIMIZE STRESS: Stress leads to inflammation and can delay healing.
METHODS TO DECREASE NAUSEA
HYDRATION: Hydrate the day before with clear fluids. NO FOOD or WATER 8 hours prior to surgery, but you may hydrate before the 8 hours.
MEDICATIONS, CHEWS & FOODS
Take anti-nausea medications (Zofran, or other prescribed anti-nausea medication).
Try ginger candy or a flat ginger ale drink.
Avoid strong scents and smells, or food odors.
Eat slowly and in small portions.
Do not lie down flat after your meal for two (2) hours.
Return to normal foods slowly (please refer to the steps below):
- Start with CLEAR LIQUIDS (water)
- Move into a SOFT DIET (applesauce, pudding, etc.)
- Return to a REGULAR DIET
IMPORTANT: A full diet can be introduced ONLY when the others are successfully tolerated.
IMPORTANT: Start with room temp food – the hot temperature of the food may cause nausea.
ACTIONS TO AVOID AFTER SURGERY
AVOID HEAT THERAPY: Heat expands the tissue and can ruin the surgical work.
AVOID TOO MUCH ACTIVITY: Increasing heart rate and blood pressure can worsen swelling and fluid build-up.
AVOID MASSAGING THE SURGICAL SITE unless told to do so by our medical team.
AVOID TAKING BANDAGES / ACE WRAP(S) OFF: DO NOT remove bandages until after forty-eight (48) hours, or as instructed by our medical team. If ACE wraps are not worn correctly, original surgical results may not be maintained.
AVOID LAYING ON ONE SIDE: Laying on one particular side can cause an increase in swelling on one side of the body, can worsen asymmetrical appearances, and delay the healing process.
THE SPECIFICS
ON THE WAY HOME: Take anti-nausea medication.
UNTIL ONE (1) WEEK FOLLOW UP: Start antibiotics (take with food like yogurt, applesauce, or crackers) and start pain management.
PAIN MANAGEMENT OPTIONS:
Tylenol Extra-Strength & Motrin: one (1) to two (2) tablets / capsules, alternating every six (6) to eight (8) hours.
For Intolerable Pain: Norco, or other prescribed pain medication (take with food and as directed).
DO NOT drive and DO NOT mix Norco with Tylenol and Motrin.
If taking Norco, take with stool softener, as Norco can slow down digestion.
AFTER SURGERY: Start stool softener as directed: Colace, Miralax, or fiber supplements. Apply Ice to and around the surgical area.
MONITOR SWELLING: The first three (3) days are the worst, the majority of swelling subsides in three (3) weeks.
Elevate legs above heart level.
Start foot exercises – ten (10) times every hour (60 min), this helps to prevent clots.
Start breathing exercises – ten (10) times every hour (60 min), take a deep breath in, hold for ten (10) seconds and exhale.
Perform these exercises at your own pace, helps prevent lung collapse and pneumonia from general anesthesia.
WOUND CARE: To be done two (2) days after surgery – at your forty-eight (48) hour postoperative visit.
BANDAGES & DRESSING
- Remove gauze and ACE band – DO NOT remove anything directly on the skin.
- Apply Bacitracin / Neosporin to incisions three (3) to (4) times daily to prevent infection and scar depression.
- Once bleeding or oozing has stopped, stop application of ointment.
- Keep the incision clean and dry – use saline and gauze to clean, NO RUBBING.
It is OK to touch the dressing and adjust if it causes any discomfort.
If the dressing is soiled before the two (2) day mark, replace it with a new, clean gauze / ACE bandage.
IMPORTANT: If you have the urge to vomit, sneeze, or cough let it out.
IMPORTANT: If you’re continuously vomiting, call the office.
WHAT TO AVOID AFTER SURGERY
AVOID Lifting Arms Above Head or Behind Back
AVOID Sleeping on your Stomach
AVOID Chest or Arm Exercises
AVOID Strenuous Activity for at least two (2) weeks
DO NOT Lift Objects over 10lbs
EXTRA CREDIT
Be Kind to Yourself and Trust the Healing Process
BE PATIENT – swelling can take a few weeks to months to decrease.
SORE THROAT feeling from the Endotracheal Tube placed by the Anesthesiologist, resolves within in one (1) to two (2) days, using ice chips or hot tea will help to soothe sore throat.
PLEASE NOTE – If surgery is more than five (5) hours, the anesthesia team may insert a catheter to monitor your body fluid during surgery, the catheter is removed at the end of surgery, discomfort is normal and present for twenty-four (24) hours.
SENSATION, NUMBNESS and TINGLING is NORMAL – new nerves awaken and grow after muscle repair, it may take up to six (6) months to one (1) full year for normal sensation to return.
BLEEDING within the first twenty-four (24) to forty-eight (48) hours is NORMAL.
BRUISING can appear away from the incision, this is NORMAL – bruising will change colors as it heals.
PUCKERING after surgery is NORMAL and a great sign – this shows that your muscles are adhering to the tissues, do NOT massage the puckered areas.
In The Media
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Dr. Michael BYUN is a serious doctor with seriously comprehensive experience unlike many of his peers, setting him heads and shoulders above the rest.
