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Adam G. Tattlebaum M.D.

A Patient’s Guide To: After A Breast Reduction

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What is a Breast Reduction?

Whether you’re planning to get the surgery or you’re still on the fence, you’ll need to know what to expect after a breast reduction. The procedure involves reducing both the size and the weight of the breasts, by removing excess fat, breast tissue, and skin from the breasts. Depending on breast size and technique, the surgery itself takes about two-and-a-half hours. A Breast Reduction includes a Breast Lift

Benefits of Breast Reduction Surgery

Women undergo a breast reduction procedure for many reasons – addressing both medical and aesthetic concerns. Medical concerns may include chronic back, neck, and shoulder pain, restricted physical activity, and skin irritation. In some cases, breast reduction may improve or alleviate these symptoms. Aesthetic concerns may include the inability to fit into bras and other clothing and in some cases loss of self-confidence. 

Having breast surgery can be a big decision, but here are some of the many reasons for high satisfaction rates after a reduction:

  • Better proportioned breasts, giving you a more balanced look
  • Lifted breasts will give you a more youthful look
  • Strong evidence suggests reducing the weight of the breasts helps alleviate neck, back, and shoulder pain
  • Your bras and other clothing will fit better and may help to boost your self-confidence

What can I expect after Breast Reduction Surgery?

It’s been described as having the weight of the world being lifted – not from the shoulder, but from the chest – both literally and figuratively. 

After they’ve had it done and their breasts have settled nicely into place, most women are pleased that they went forward with the surgery and regret not having done it sooner. In fact, this surgery is consistently cited as one of the highest patient satisfaction in cosmetic procedures. That’s certainly the case among my patients.

Immediately after surgery, you will be wearing either a surgical bra or elastic bandage, which you will need to wear for about a week.

Most patients will then wear a gently compressive sports bra for about six weeks. All sutures are dissolvable. If necessary, you may need to go home with
drainage tubes, though I generally don’t use them.

Breast reduction recovery time will vary, but you will need help for a few days afterwards. You should also avoid any strenuous exercise for at least 21 days. Normal activities can usually resume after this point. 

Your breasts will continue shaping, which you and I will watch together, for six months. And if we’re happy with the results – excellent! Otherwise, we can make adjustments. You can see some of the before and after photos
here.

Post-Surgery Concerns

Many of my patients ask about nipple sensation after breast reduction surgery. If it’s a standard breast reduction in which we leave the nipple attached, then – yes, it’s possible to maintain nipple sensation, though it is not guaranteed. Another common question I get is – will I be able to breastfeed after breast reduction surgery? Again, like the nipple sensation question, with standard surgery, breastfeeding is possible, but not a guarantee. Scarring after breast reduction surgery is another concern. I take great strides to minimize the cosmetic impact of the scars, but they will be present. And genetics play a crucial role in the healing process.

Breast Reduction Scars 

I get a lot of questions about breast reduction surgery and one question in particular that most women ask about is the boob scars after surgery.

In every surgical procedure, there will be scarring. Many patients worry about how visible the scars will be. Your starting size will determine the type of incision that is made. During the discussion with my patients, I explain where the incisions will be so they won’t be surprised at finding a scar they didn’t expect.

The planning of scar placement is important to provide for proper breast shape. There are a few incision methods, the most common is the wise pattern. It is sometimes referred to as the anchor or keyhole pattern because of the type of scar it leaves.

Other scar patterns may only be a vertical or horizontal scar. There is the lollipop procedure which reduces the dimension of the scarring and minimizes healing but it is far less powerful. The wise pattern is the mainstay of most breast reduction surgeries because it removes the most extra skin and allows both a horizontal and vertical tightening of the breast.

Your surgical incisions heal when the body forms new collagen fiber to repair the damage. The new scar tissue is close to but not as strong as your normal skin. Scars become thicker for about six weeks after surgery as the body deposits random collagen to promote quick healing. After that time, for most patients, the scar tissue diminishes but the strength goes up as the fibers align.

Sutures buried within the dermal tissue give additional strength to your external sutures as the incision heals.  Your scars can change in appearance for about a year. Genetics play a crucial role in your healing process. The amount of collagen the body lays down and how it is remodeled as you heal is hugely determined by genetic factors. It is common for ethnic patients to make thicker or darker scars. While keloids can occur, they are far less common than a thick hypertrophic scar.

How to Minimize Scars after Breast Reduction Surgery

The most important thing to keep in mind is you must always make certain you follow all pre-and post-surgical instructions. This way your body will be prepared for proper and speedy healing after breast reduction surgery.   

Topical Products

Many of my patients use topical products such as vitamin E oil or cocoa butter. Some believe silicone sheeting sometimes helps with softening scars and reducing their appearance, but the science is unclear at best. I do believe that pressure and massage of a scar may help it to remodel sooner. While there are many scar treatments on the market and I don’t object to them, genetics and choosing your parents carefully is key. I usually have my patients begin scar massage at about three weeks when the incisions are strong enough.

Lotions and potions

Because I believe that scar massage is the best way to soften scars the lotion or vehicle is of less importance. While there are many expensive scar lotions on the market I tend to favor simple inexpensive things such as cocoa butter, vitamin E or bio-oil. 

Silicone

Silicone strips may help to put pressure on the scar tissue, producing quicker remodeling of the scar tissue. They should only be started once the wound has fully healed after two to three weeks. Because it’s difficult to maintain pressure on a breast I don’t promote this but I don’t object if a patient wants to try it. 

Massage Techniques

Gently massaging with cream or oil helps to soften and flatten the scar. You should only massage the area once the scar has had about 21 days to heal. Massaging helps with distributing the collagen, preventing it from building up. Applying pressure can also increase blood flow in the skin, speeding up the healing process.  

Can Breast Tissue Grow Back after Breast Reduction Surgery?

One of the most common questions I get from women who want a breast reduction – also known as reduction mammoplasty – is, “Can my breasts grow back after a reduction?”  The answer is yes, under certain circumstances, though it’s not very common.

But, will you need to undergo a second breast reduction surgery at some point? There’s always that possibility, but again, it doesn’t happen often. In the consultation, I tell my patients that a woman’s breasts continue to evolve over a lifetime and that the breasts may increase in size again as you get older. Here are the circumstances under which that may occur:

  • Pregnancy and Breastfeeding – Both pregnancy and breastfeeding can cause the size of your breasts to increase.
  • Excessive Weight Gain –  Generally speaking, it’s essential to maintain a healthy, stable weight, eat a well-balanced diet, and exercise regularly. Breasts can enlarge with fat with weight gain.
  • Menopause & Hormonal Changes – Hormonal changes, especially during menopause, can cause breasts to become bigger.
  • Adolescents and Physical Growth – While there are generally no age restrictions for breast reduction surgery, I recommend younger women and adolescent girls have completed puberty. That’s because, as I mentioned earlier, the breasts are still changing and developing, and having the surgery done too soon increases the chances of having to get it done a second time.

So, can your breasts regrow after reduction? Yes, but those changes rarely lead to a second surgery. And if they do, a wise pattern reduction can be repeated, but other types of lifts can be more difficult to repeat.

Breast Reduction Consultation

Again, breast reduction surgery has a high rate of satisfaction. If you’re ready to explore your options or have more questions about breast growth after reduction surgeryDr. Tattelbaum serves patients in three locations including Maryland, North Virginia and Washington D.C. patients. With years of experience, we can create your ideal breasts. Call now for a consultation: 301-804-6832. 

March 15, 2022 9:57 am
Categories: Blog

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