The Most Common Symptoms of Enlarged Breasts
During my 30-year career as a plastic surgeon I have noticed that one of the most misunderstood concepts is the difference between a breast reduction and a breast lift.
The woman who is a candidate for breast reduction will often present with a history of an enlarged breast size since high school. She may have found it difficult to participate in athletic activities, and she will often present with complains of back pain, neck strain, chest wall heaviness, bra-strap grooving and, on occasion, rashes beneath her breasts. She will often have a breast size of D cup or larger. She may have tried conservative methods of easing her symptoms including physical therapy for her back, heat treatments, chiropractic care, muscle relaxers and even pain pills. She may have heard about the breast reduction procedure from a friend or may have been referred to us by her family physician.
The woman seeking a breast lift presents with essentially no symptoms; her complaints are that her breasts have begun to sag over the years. This sagging may have been accelerated by a large weight loss or following a pregnancy. She often feels that her breasts are now too long, the nipples too low and that she has lost her natural cleavage.
So in essence, we have the breast reduction patient presenting with symptoms because of the sheer weight of her breast, and the breast lift patient because of the shape of her breasts. The breast reduction procedure may well be covered by insurance because it is an attempt to alleviate the potentially harmful symptoms that come with the weight problem. With the breast lift candidate, the aim is to only improve the shape, and it is therefore considered a cosmetic procedure – one not covered by insurance.
It is worth noting that 50% of my breast lift patients also opt to undergo a breast augmentation at the same time. They feel that they can better achieve that natural-looking cleavage with breast enlargement.
What to Expect
- The Procedure:
The breast reduction and breast lift procedures are very similar. The only major difference is that in a breast reduction, a predetermined portion of both the breast tissue and skin is actually removed. In a breast lift, only a portion of the skin is removed to lift and reshape the breast. Most breast reductions will go from a D cup to a small or medium C cup. Breast lift patients will go from a C cup to a perky C cup. In both procedures the nipple areola complex is left attached so as to preserve sensation and the ability to breastfeed. The two-and-one-half-hour breast reduction procedure is done in a hospital setting under a general anesthetic, and there is usually an overnight stay required. The breast lift procedure is done on an outpatient basis and may require a general anesthetic. In some situations it may also be done with a local anesthetic and sedation in our office operative suite.In order to gauge the improvement of symptoms, we conducted a survey. Of approximately 100 breast reduction patients, 95 stated that their symptoms and quality of life had significantly improved following reduction mammoplasty.
- The Risks:
There is a potential for complications in any operative procedure. The most common being infection, scarring and sensation changes. During your consultation a detailed discussion of these potential risks will be given to you.
- The Recovery:
After performing nearly 1,500 breast reduction procedures and 600 breast lift procedure I have found most patients rate the pain, on a scale from 1 to 10, with ratings between a 2 and 5 for both procedures. The patient may be off work from one week with the breast lift, to two to three weeks with the breast reduction.Light activity is tolerated well in the first week. Most patients are never so incapacitated that they cannot take care of their own basic needs. You will return to see the doctor one week after your procedure. All of your dressings are removed; your postoperative recovery and activity levels are again discussed as well as an anticipated date for your return to work. Light employment is tolerated after two weeks with heavy lifting and regular activity in three to five weeks. You are also given detailed instructions for care of your suture lines so as to help prevent excessive scarring. Your final consultation usually occurs five months after your procedure.
- Results: see Before and After Photographs at ruckermd.com
- The Decision:
The most common thing that I have heard from my breast reduction patients is, “I should have done this ten years ago!”