Can I have advice on breast reduction surgery?

Question

1. Are drains recommended? 2. Is an overnight hospital stay recommended? 3. Is general anesthesia always necessary? 4. What is the average recovery time? Thank you.

William T. Stoeckel, MD · Answer

1. Drains are sometimes used and sometimes not. I typically do not use drains unless I have removed a very significant amount of tissue from each breast (1000 grams per breast) in most cases. Other surgeons use drains with every case. There is no right or wrong answer. There are pros and cons to both. I do think that there is a slightly higher risk of infection with a drain. But there is a higher risk of seroma without a drain. 2. Staying overnight at the hospital is very patient dependent. I would say that most people do not really need to stay overnight, but most people do stay overnight. At least when general anesthesia is used. I give my patients that have general anesthesia the option of staying or going home after they have recovered for a few hours. Some of them feel wiped out and want to stay whiled others can't wait to get home to their own bed. All of my patients that have MAC anesthesia go home the day of surgery.3. General anesthesia is not necessary. All of my self pay patients have their breast reductions in my private surgical suite with CRNAs that are extremely good at deep sedation anesthesia (MAC). I utilize both tumescent solution and intercostal nerve blocks with local anesthesia and patients do extremely well. If the surgery is done at the hospital, at least at my hospital, the anesthesia teams are just much more comfortable with general anesthesia. It is completely safe and patients do well, but the recovery is certainly more involved. 4. Recovery time is usually faster than most patients expect. Most patients use narcotic pain medication for only 1-3 days. After that, the chest is sore for another 7-10 days, but narcotics are not usually needed. The bruising is usually gone after about 7-10 days. The final results are not seen for about 3 months, but patients can usually return to a desk job in as little and 3-4 days. Getting back to a heavy lifting job might take about 6 weeks though.

Tom J. Pousti, MD · Answer

Congratulations on your decision to proceed with breast reduction surgery; it is one of the most patient pleasing operations we perform. Generally speaking, it is a very well-tolerated operation. Most patients require a period of rest/care for about one week after the procedure is performed. Pain medication is usually required for the same period of time. I would suggest that you take about 2 weeks off work;  your plastic surgeon will be your best guided in this regard, depending on how you are progressing  Keys to success: select your plastic surgeon carefully;  ask to see lots of examples of his/her work achieving the types of outcome you will be pleased with. Then, communicate your goals carefully as well. You will find that the answers to most of your questions will vary from one  plastic surgeon to another. Best wishes for an outcome that you will be very pleased with.

Karen M. Horton, MD · Answer

A breast reduction procedure is a wonderful, life-changing surgery!  However, once you have made the decision to have surgery and you have found a surgeon you like and trust, logistics in planning your recovery is key.  Surgery is usually performed under general anesthesia (GA), in a formal operating room setting.  I keep my patients overnight, as they may feel nauseated and be sick to their stomach at least once after surgery.I don't usually place drains, but if they are necessary, they are usually removed the next morning when I do rounds, before the patient goes home.  "Recovery" takes at least 6 weeks.  There can be bruising for 2-3 weeks, incisions are actually wounds rather than scars for 6-8 weeks, and the final results are often not evident for 3 months.  Scars are not mature until approximately one year.  Karen M. Horton, M.D., M.Sc., F.A.C.S., F.R.C.S.C.San Francisco Plastic Surgeon

Steven Wallach, MD · Answer

I usually drain most breasts that I perform a reduction on.  The anesthesiologist usually use general anesthesia, overnight stay is not common, recovery to go back to desk work can be as little as a few days but realistically a week.

Tracy Pfeifer, MD · Answer

Thank you for your question.  My breast reduction patients tend to be some of my happiest patients.  I normally use a drain.  It is removed 7-10 days after surgery in the office.  The drain is a short term "annoyance".  I always use general anesthesia which is very safe.  You do not need to stay overnight as long as you are an otherwise healthy person and you someone who can stay with you after the surgery.  I advise my patients to take one week off from week, unless their work involves heavy lifting.  No heavy lifting and/or excercising for 2 weeks.  Some plastic surgeons recommend longer time before exercising.  Hope this helps.Tracy Pfeifer, MD, MS

John Whitt, MD (retired) · Answer

I most always use drains with reductions.  I did not until about 10 years ago, but feel there is less bruising and swelling when they are used.  I typically keep patients in hospital overnight but this is not absolutely necessary.  True reductions almost always require general anesthesia.

Can I have advice on breast reduction surgery?

Answers (6)

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