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Breast Reduction in New Jersey
David Evdokimow, MD
If you're a woman with overly large breasts, you know that they are not just a cosmetic concern. They can cause both physical and emotional discomfort. If you are considering breast reduction in New Jersey, you want a surgeon with the experience to provide a result that looks natural and brings your figure back into proportion. Dr. David Evdokimow is a surgeon you can trust to help you achieve optimal results.
To learn more about New Jersey breast reduction with Dr. Evdokimow, you can request your consultation online or call our offices at 908-221-1136. We serve men and women from New Jersey, New York and the rest of the country.
Breast Reduction Considerations
Large breasts sag and make body contours seem disproportionate, but this is just the beginning. There are many other problems associated with large breasts.
- Women may avoid certain situations where their overly large breasts would be apparent, causing unwanted attention and embarrassment.
- Women experience back, shoulder, and neck pain, as well as frequent headaches.
- Painful grooves from bra straps are common.
- Frequent skin irritation and fungal infections also occur.
- There may be problems with sleep.
- Certain physical activities and exercise may become virtually impossible.
- Breathing patterns and lung function may be affected.
- Upper limb function may be impaired due to nerve compression.
- Clothing options are limited.
As you can see, overly large breasts can be a significant health problem and thus are associated with frequent visits to the doctor, loss of productivity, and even disability. However, for these very reasons, breast reduction is the breast procedure with the highest satisfaction rate.
Breast Reduction and Insurance
There is a large body of literature that supports the health-related and economic benefits of breast reduction. However, insurance companies often resist covering the procedure. They may set limits, such as a requirement that at least 400 mg of tissue to be removed, when they have no scientific basis and removal of only 200 mg per breast has demonstrated significant improvement in symptoms and lifestyle. Our friendly staff can help you with insurance and payment arrangements.
Breast Reduction and Breast Cancer
Studies from Denmark, Sweden, Canada and the United States have collected data that suggests breast reduction can decrease the risk for breast cancer, especially in high risk patients. In these studies, the reduction in breast cancer development seems to be proportional to the amount of breast tissue removed.
Breast Reduction, Pregnancy and Breastfeeding
Women who have undergone breast reduction may experience a temporary or permanent increase in breast size and sagging during a subsequent pregnancy. The enlargement and the sagging are usually exacerbated by breastfeeding. If considerable size increase or sagging occurs permanently, a second procedure (usually of lesser extent than the first) may be required.
The ability to breastfeed after breast reduction depends on: the surgical technique used, the amount of breast tissue removed, and the psychological condition of the patient. Some New Jersey breast reduction patients won't attempt to breastfeed after breast reduction, even if it is an option.
All women with breast reduction experience engorgement of the breast and milk production after delivery. However, the number of breast reduction patients who breastfeed varies in literature, but generally falls somewhere between 30% and 60%. For some women, other methods of feeding or a breast pump may be required.
Breast Reduction and Nipple Sensitivity
In terms of nipple sensitivity after breast reduction, there are 3 possibilities:
- Sensitivity improves, usually immediately after the surgery, and continues to improve as the healing process advances (usually in the first 6 months).
- Sensitivity remains unchanged.
- Loss of sensation in one or both nipples. This can be due to anatomic variations of the nerve supply to the nipple, or due to the technique used (rare, but possible).
Before the Procedure
At the initial consultation, Dr. Evdokimow will take a very thorough patient history. He'll want to know about the onset of menarche (your first menstrual period), if you've been through menopause, the onset of your breast enlargement, irregularities in your menstrual cycle, pregnancy, family history of large breasts or breast cancer, and any prior breast surgeries. Next, he will perform a thorough breast exam, evaluating size, shape, nipple position, skin type and stretch marks.
Dr. Evdokimow will discuss the different approaches for breast reduction as well as other options such as liposuction of neighboring areas (such as bra rolls). Preoperative mammograms will be ordered and photographs will be taken. You will be given written information about your procedure to take home and review. The surgical markings are usually placed at our plastic surgery New Jersey office on the night before the surgery.
What can you do to help prepare for your procedure? First of all, stop smoking (and the use of other nicotine products such as patches or gum) for at least a month prior to surgery. Smokers have a higher incidence of problems with wound healing, which may lead to complications after surgery. You should also avoid NSAIDs (such as Aspirin®) and some other vitamins and herbal supplements. Dr. Evdokimow will review the medications you take and tell you which, if any, should be discontinued before your procedure to avoid the possibility of bleeding and hematoma formation.
The Procedure
Breast reduction is usually an outpatient procedure but may require an overnight stay in a hospital for some patients. The procedure is performed under general anesthesia. The surgery typically takes 2 to 3 hours, depending on its extent.
While a variety of breast reduction techniques exist, one of the most common is the inverted "T" (or anchor) pattern. This incision pattern moves the nipple to a higher position on the existing breast mound and allows for the removal of breast tissue and skin from all parts of the breast. If indicated, the incision could be reduced so that it goes around the nipple and vertically down to the breast crease or, in the alternative, around the nipple with a vertical incision down and a short scar in the fold.
For women with very large breasts, the duration of surgery may be longer and the use of liposuction may be required, usually on the chest wall, armpit area, and the area under the breast. The liposuctioned portion of the breast reduction procedure is not covered by insurance, so these additional costs are the responsibility of the patient.
After Surgery
The sutures for breast reduction are placed under the skin surface and will not need to be removed. When the procedure is complete, a surgical bra with soft gauze along the incision sites will be placed. Surgical drains are not usually used. Post-procedure discomfort is moderate and can be easily controlled with oral pain medications.
When it comes to recovery, women generally want to know when they can get back to their usual routine. This depends upon each individual patient, so Dr. Evdokimow will give you specific instructions about when you can return to work and exercise. To ensure that this happens as soon as possible, be sure to get the necessary rest so that your body can heal. Generally, patients resume normal physical activities in 7 to 10 days with strenuous exercise restricted for 3 to 6 weeks.
Scars are permanent, but will fade after a year. Routine use of topical scar therapy can expedite this process.
Possible Complications
- Hypertrophic scarring. A thicker scar is a possible complication in individuals prone to hypertrophic scars or keloids. If it occurs, it will most likely involve the part of the incision at the fold between the chest wall and the breast, especially in its most medial and lateral segment. Routine use of topical scar therapy can prevent or decrease the degree of hypetrophyc scarring. If thicker scars develop, they can be treated with injectable steroids or with fractional non-ablative lasers for scar removal.
- Widening of the scar in the area where the vertical and horizontal limb of the inverted "T" join is very common.
- Smokers can experience delayed wound healing.
- There's also the potential to lose part of the areola, especially if the patient has a very large breast or problems with blood supply to the nipple/areola complex. The chance of this to occurring is much higher (20 times more likely) in smokers. Smokers are strongly advised to discontinue the use of any nicotine products at least a month before the procedure.
- Patients may also see minor size discrepancies, but this is natural because a perfect size match is very difficult to achieve. There is no woman with perfectly symmetric breasts – some size discrepancy is always present. Minor asymmetries do not impair the cosmetic or functional outcome of the procedure and should not be feared.
