256-340-5188
1206 Somerville Rd
Decatur, AL 35603
256-340-5188
1206 Somerville Rd
Decatur, AL 35603
The basic goal of reduction mammaplasty is to reduce the weight of the breasts, which will reduce strain on the neck, upper back and shoulders. To do this the breast must be re-shaped at its smaller size. This means a nipple lift will also occur. So a reduction mammaplasty combines making a smaller breast with a nipple lifting procedure. I can only roughly estimate changes in bra size and I don’t make any guarantees about changes in bra size. My goal is to reduce the weight of your breast, meet the insurance requirements for weight removal, but leave you with a breast that matches the size of your body.
Before
After
The plan for the operation starts with selecting the height for the new nipple position and deciding how much of the upper breast skin needs to be saved. The gray area on each side of the nipple gets removed. The arrow indicates how the nipple will move upward.
The nipple moves up to the higher position and then the skin flaps that were saved wrap around the bottom of the breast to close the new smaller and up-lifted breast. The incisions and therefore the scars, area around the nipple-areola complex, down from the areola into the lower breast fold and all along the lower breast fold.
Before
After
Before
After
Before
After
Marks
Marking Plan
During your initial consultation we will discuss all of the aspects of the operation and how it relates to you. We will have a second visit that is the pre-operative visit where I will answer all of your final questions, write the prescriptions for the medicines you will need after the surgery and you will do your pre-operative visit at the hospital.
Most, but not all insurance companies cover reduction mammaplasty. It can also vary by specific insurance contract. The insurance companies require a certain weight of breast tissue be removed to justify the operation. Presently, they require that 500 grams of tissue be removed from each breast. We always send a pre-approval to your insurance company to see if your procedure will be covered. This requires that we send an estimate of the amount to be removed, a history of the problem, a physical examination and pre-operative pictures of you breasts. Your face will not be on the pictures and we process and print all of the photos digitally in the office. It takes 4 to 6 weeks to hear back from the insurance company about you approval. The insurance company will usually send a letter regarding the approval to both our office and you home. Deductibles and co-pays are not covered and are subject to the terms of the patient's insurance contract.
Before 38DDD Cup
After 38C Cup
750 gms Removed From Each Breast
Before 38DDD Cup
After 38C Cup
750 gms Removed From Each Breast
Before 38DDD Cup
After 38C Cup
750 gms Removed From Each Breast
Marks
Marking Plan
The operation is done as an outpatient procedure or day-surgery at Decatur Morgan Hospital using general anesthesia. It is done in the main operating rooms at Decatur Morgan Hospital and takes just over 3 hours to perform. We do the operation in the morning and you will get discharged to home late in the afternoon or the early evening. You will go home with a drainage tube in each breast to remove postoperative blood and fluid so it does not accumulate in the breast. I discharge you from the hospital with a prescription for narcotic pain medication, an antibiotic and a nausea medication.
Before
After
750 gms Removed From Each Breast
Before
After
750 gms Removed From Each Breast
Before
After
750 gms Removed From Each Breast
Marks
Marking Plan
All patients are unique and the response to post-operative discomfort is variable. Most patients state that the discomfort feels like tightness and burning in the bottom portion of their breasts. Some patients take the narcotic medicine only for a day or two and then switch to Tylenol for pain. Some patients take a narcotic medicine for 3 or 4 weeks after the surgery. As I said, patients are all unique and their pain tolerance is very different. Almost all patients feel normal by 4 weeks.
Before
Before
After
After
500 gms Removed From Each Breast
For a desk job that does not require any heavy lifting you should expect to be away from work for 2 weeks. Some women have gone back to a desk job in as little a 1-week. For a job that requires physical exertion or heavy lifting you should expect to be away from work for 4 weeks. If there are any small healing problems with your breast we may keep you off of work for an additional 1 to 2 weeks or consider a light duty job if that is available at your job after the 4 weeks period.
Before
Before
After
After
350 gms Removed From Each Breast
You will need to come to the office one or two days after your surgery and you should arrange for someone to drive you to this appointment because you will be sore and on narcotic medications. At this first postoperative check, I will change your dressings and remove your drain tubes. Removing the tubes pinches a little but is not terribly painful. You will go home with a light gauze dressing that you will change every day for 3 days. I do not use any special postoperative surgical bras. You can take a full shower 24 hours after you drains are removed. You will take off your dressings, shower, soapy water will not hurt your incisions, pat yourself dry and replace your light dressings.
Your next appointment will be in approximately 1 week. The next appointment will be in 2 weeks and at that time we will begin discussing issues like returning to work and shopping for a regular bra.
Your next appointment will be in approximately 1 month. After that I will see you again in approximately 6 months. Therefore, I will see you between 8 months and 12 months after your surgery and do a final assessment of your size and shape, assess the quality of your scars and get your final opinion on the surgery.
This Is A Massive Weight Loss Patient. She Lost Fat In Her Breasts And Became Very Saggy.
Before
After
600 gms Removed From Each Breast
Before
After
600 gms Removed From Each Breast
Before
After
600 gms Removed From Each Breast
You can shop for a regular bra once most of the initial post-operative swelling is resolved and there are no wound problems. This is usually 4 to 6 weeks after the surgery. You can wear a very lightweight sports bra or a camisole earlier then this if you discuss it with me in the office. Generally you can resume all of you normal activities, including physical exertion and exercise after 4 weeks. This could be delayed slightly if there are any wound healing problems.
Mammograms should be continued as usual after a reduction mammaplasty if you are at the age where you were getting mammograms. You should wait at least 6 months after a reduction mammaplasty before getting another mammogram to allow postoperative density changes in the breast to soften and resolve.
This Patient's Breast Were So Long She Needed To Have The Free Nipple Transfer Technique To Re-Position Her Nipples
Before
1,200 gms Removed From The Right And 1,000 gms From The Left
Before
1,200 gms Removed From The Right And 1,000 gms From The Left
Marks
Marking Plan
This Patient's Breast Were So Long And So Asymmetric She Needed To Have The Free Nipple Transfer Technique To Re-Position Her Nipples
Before
2,400 gms Removed From The Right (5.28lb)
2,000 gms From The Left (4.4 lb)
After
2,400 gms Removed From The Right (5.28lb)
2,000 gms From The Left (4.4 lb)
This Patient's Bra Size Changed From 38 DDD To 38 C
975 gm Removed From The Right And 1,325 Grams Removed From The Left
Before
After
Before
After
Marks
Marking Plans
571 gm Removed From The Right and 520 gm Removed From The Left
Before 36 D Cup
After 36 B Cup
Before 36 D Cup
After 36 B Cup
Everyone Has Seen A Construction Crane.
The Mechanics Of A Construction Crane Can Explains What Happens With Large Breasts Before And After A Breast Reduction
Two things can make the tension on the cable greater. The cable is similar to a bra strap.
1. The weight of the load becomes more. This happens with larger breasts.
2. The load moves further outward, away from the crane column. This also happens with larger breasts.
Therefore, a breast reduction does two things to make the tension on the cable = bra strap less.
1. It deceases the weight of the load.
2. It moves the load closer to the crane column.
This is why breast reductions decrease strain on the back, neck and shoulders!
These Figures Show The Research I Have Done Regarding The Mechanics Of Breast Weight On The Shoulders Transmitted By The Bra Straps
The Weight On The Bra Strap Is Greater Than The Weight Of The Breast Itself!
A 1,000 Gram Breast Puts 1,414 Grams Of Weight On The Shoulders!
Tension Created Before Reduction
Reducing The Weight Of The Breast By 50% Results In a 55%Reduction Of Strain
500 Grams Of Reduction Decreases The Strain To 641 Grams From 1,414 Grams!
Relief Of Tension After Reduction
© 2005 - 2020 Gordon M. Telepun, MD
Providing care to patients in Decatur, Huntsville, Madison, Hartselle, Florence, Muscle Shoals
Photographs May Not Be Reproduced, Written Text and Descriptions are Copyrighted and May Not Be Reproduced