Breast Reduction

If your breasts are not in proportion with your frame, you may well be an appropriate candidate for breast reduction. Patients with significant back, neck, and shoulder pain symptoms or grooving from their bra straps may make you eligible for insurance coverage, depending on the plan’s requirements.

The ideal candidate should otherwise be:

• Healthy
• Have a body mass index (BMI) ideally less than 30
• A non-smoker

Many men suffer from male breast growth or gynecomastia, the abnormal non-cancerous enlargement of one or both breasts. Gynecomastia is often genetic in origin and frequently runs in families. It can be a significant source of embarrassment, limiting wardrobe choices, activities, and time at the beach.

Male breast reduction, or gynecomastia correction, can be an excellent option for men who have tried other approaches, like weight loss, without resolving their gynecomastia. Most insurance policies consider gynecomastia surgery as a cosmetic procedure.

In the week before your surgery

• Complete household chores and prepare all meals for the first few days of post-operative recovery.
• Follow preoperative care instructions when eating, drinking, and taking medications. Do not eat or drink anything after midnight the night before surgery, except for a sip of water with your medications.

After your surgery

• Arrange for someone to drive you home and stay with you for the first 24-48 hours, as you may feel drowsy.
• It is essential to go for a short walk (with assistance, if needed) every few hours after your breast surgery to decrease the chance of post-operative problems such as blood clots.
• Take 15-20 deep breaths every hour to keep your lungs open.
• Eat a healthy, light diet for 2-3 days, being careful to avoid spicy foods. Ease abdominal discomfort or indigestion after surgery by drinking water or warm liquids and prune juice to prevent constipation.

Remember to take your medications as directed by Dr. de la Pedraja to manage discomfort or symptoms. These are likely to include Acetaminophen (Tylenol) and some form of narcotic.

Wound Care

• You may shower or simply sponge bath two days after surgery with assistance and wash your skin with soap and water as you usually would. Avoid soaking the incisions and gently pat dry after washing.
• You may wear a camisole and post-operative bra provided by de la Pedraja after surgery. He will advise you when you may wear an underwire bra again – usually a minimum of four  weeks after surgery.
• Most wounds will be closed with dissolving sutures that are buried as well as skin glue. Do not apply any lotions, ointments, creams, or solutions as these can harm fragile healing tissue.
• Do not smoke or expose yourself to nicotine or other smokers, as this can compromise wound healing.
• Infection is very rare, but please call Dr. de la Pedraja at any sign of infection, indicated by fever, increased pain, spreading redness, or significant swelling.

Activity

For the first few days after your breast surgery, avoid raising your heart rate or blood pressure as this could lead to bleeding. Gentle, full-range of motion exercises with your arms 3-5 times per day are recommended starting on the day of your surgery.

Do not lift anything greater than 10-15 lbs in weight, or perform strenuous exercises for 7-10 days. Chest muscle exercises or strenuous bouncing exercises should be avoided for six – eight weeks.

Massage of the breast and areas that received liposuction can help increase circulation and soften tight areas under the skin. Wait at least 3-4 weeks after surgery before starting massage to avoid increased swelling.

General Outcomes

• Moderate swelling of your breasts after surgery is to be expected. Your breasts may initially appear relatively high and perky after breast reduction but will settle into their natural position over several weeks
• If you chose to have liposuction simultaneously as your breast reduction, swelling and bruising could be expected, and the swelling and sensation of tightness will gradually subside over the months that follow. Bruising may last for a few weeks and, due to gravity, can move down your body.
• Your incisions may appear lumpy and bumpy, but this is normal, and the incisions will flatten over a few weeks.
• Following breast reduction, the nipples may be inverted rather than projecting outward, but this is normal, and the nipples will usually project out again within a few days to weeks.
• The areolas can appear asymmetric or irregularly shaped, which is normal due to the dissolving sutures. The asymmetry will resolve over a few weeks.
• Sensations like shooting pain, numbness, and burning are common during the healing process and can take several weeks to gradually disappearing. If the nipples are sensitive, they can be desensitized with some gentle touching.
• Scars take up to a full year to mature. You may notice that they are red, raised, and firm for weeks to months before becoming soft, flat, and pale. Vitamin E should be avoided since it can irritate the scar. Tanning booths and direct sun should also be avoided. Silicone cream or a skin moisturizer with an SPF 30+ sunscreen and gentle massage may be helpful.

Please call our office at 305-441-9144 if you have:

• Continuous bleeding (a small amount of bleeding from the incision is expected).
• Significantly more puffiness or swelling on one side than the other.

Dr. de la Pedraja encourages gentle activity starting the day after surgery. Avoid heavy lifting or upper body strength training for at least 6 – 8 weeks. When you restart your exercise regimen, favor low-impact activities like a stationary bicycle to allow your breasts to recover. High impact activities are best avoided for the first few weeks after surgery.

Patients who proceed with breast reduction can expect scars, and while these fade with time, there is significant individual variation in the amount of scarring. While scars are unavoidable, they will be positioned in the most cosmetically appropriate locations and kept as short as possible. The scar beneath the breast is hidden in the fold of the breast.

For at least the first 4-6 weeks, the scars may be firm, pink, and slightly raised, but they typically soften and fade, becoming smooth and inconspicuous over time. Many patients either don’t notice or aren’t bothered by their incision lines a year after surgery. It may take up to 1-2 years for the scars to fully mature.

The type of breast reduction procedure determines incisions and scars. The most common types are a Wise pattern (or inverted T or anchor pattern) and circum-vertical (also known as the vertical or lollipop pattern). Dr. de la Pedraja meets with each patient to determine the ideal type of breast reduction.

While most patients do not experience significant changes in nipple sensation, some women may experience increased or decreased nipple sensation following breast reduction. Numbness, shooting pain, and burning are common sensations during the healing process and may last several weeks before they gradually disappear. Some patients initially may find their nipples to be hypersensitive to touch or temperature. If the nipples are sensitive, they may be desensitized with gentle touching. If the nipples have less sensation, you can expect this to improve over time.

Because the nipples’ connection to the breast tissue is preserved, you are encouraged to try breastfeeding if you want. Many women can successfully breastfeed after their breast reduction surgery. Because glandular tissue is removed during breast reduction surgery, the procedure may affect your ability to deliver milk, although this is very rare. Each patient has differing results in this regard, and this topic will be discussed during your consultation.

Dr. de la Pedraja will evaluate your situation to determine if you might qualify for coverage by your insurance company. Factors such as the size of your breasts relative to your body mass index and the amount of breast tissue to be removed are factors taken into consideration. Other factors such as your breasts being disproportionately large relative to your body, and other symptoms, including neck pain, shoulder grooves from bra straps, back pain, or skin irritation, will all be considered by your insurance company.