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Breast Reduction Recovery
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Upon completion of Breast Reduction surgery, stitches will remain around the areola and nipple area, in a vertical line beneath the nipple and horizontally under the breast for a period of two or three weeks depending on how well you heal. The incisions and tissue movement will cause your breasts to be very sore, swollen and bruised. Pain is usually taken care of by the medication that the Plastic Surgeon writes for or you might even be getting a pain pump. Some Plastic Surgeons prefer that you do not take a shower until the sutures come out, and others might allow you to take one at a couple days Post Op. You more than likely will have drains to help in to help aid in the reduction of the accumulation of the fluids after surgery which tend to contribute to edema or swelling. These drains will stay in place for several days until there is no more drainage of fluid. Activities should be kept to a minimum for at least 2 – 6 weeks Post Op, which will include no heavy lifting or pushing. It is best to have someone help you during recovery if you have young children, as the patient should not be lifting anything over 5 - 10 lbs. After the surgery you will feel tender, stiff and sore for a few says and will more than likely not want to move too much. This will subside and your bruises will get better as your progress in your healing. It is important after your surgical procedure that you get up and walk around as soon as you are able. Lying still for a long period of time increases the chance of developing clots and swelling will tend to last longer.
Call your plastic surgeon immediately if the following occurs after surgery:
After the surgical procedure is completed, a drain is sometimes inserted to allow the fluids an exit from the incision sites. The use of the superior pedicle technique for the breast reduction method is associated with a significant increase in postoperative drainage. Surgeons using this technique should consider the routine use of drains to avoid possible complications of seroma, infection, and poor wound healing.
Expect to be swollen and bruised for a few weeks after your surgical procedure. The drains will help tremendously with the edema. Bruising normally goes away within a couple of weeks. Swelling can last up to several months after the surgery. Breast reductions normally take more than a month before all the swelling and bruising disappears. It is also during this time that the final breast lift results will be seen. Follow your surgeon’s post operative instructions and also ask him before doing anything you might find questionable. Arnica Montana, bromelian or vitamins A and C all help reduce swelling and discolorations and improve healing. Ask your plastic surgeon if this is right for you. Arnica is currently used in liniment and ointment preparations used for strains, sprains, and bruises. Applying a warm gentle compress can also help with some of the bruising. By dilating the superficial blood vessels – the body will remove the blood and damaged tissue from the treatment area.
Some minor ooze from the surgical wounds is normal for a few days after the surgery. You will need to keep dressings in place until instructed by your surgeon. Some patients may experience a prolonged wound healing time. Delayed wound healing may increase the risk of infection, extrusion, and necrosis. Depending on the type of surgery or the incision, wound healing times may vary. Smoking may interfere with the healing process. Nicotine is the root cause of the decreased blood supply in that it causes constriction of the capillaries and small blood vessels that feed the skin with its required oxygen. Read more about Delayed Wounds
Some patients do experience itching following surgery, especially at the incision sites - as well as dry skin. If your plastic surgeon says it is okay for you to use a moisturizer, you will need to make sure you keep it away from your incision sites. It is very important to keep the suture area and also the Steri-Strips completely dry.
Steri-Strips are common to have on top of your incision line and sutures – or if you have internal sutures with tissue glue to help bind the external incision edges. Your surgeon will remove these when you have your sutures removed, and more than likely re-apply the strips to the incision after the stitches are removed. Most surgeons will ask their patients to leave these strips on the incision to help keep tension off of the incision line during recovery. By doing this you will allow your scar to heal into a thin line.
Your sutures will be removed within a couple of weeks, and is done in the office at one of your post operative appointments. Your surgeon has used a combination of dissolvable and permanent sutures in your surgical procedure. Dissolvable sutures are meant to be absorbed by the body within 90-120 days after surgery; however sometimes these dissolvable sutures can work their way to the surface of the skin. This is called “spitting a stitch”.
Read more about “spitting a stitch”
More than likely you will be wearing a type of compression garment or surgical bra with an ace bandage binding the breasts to your body. Patients are required to wear a surgical bra for the first few weeks following surgery. This bra will help support your breast so that you can keep tension off of the incision line. Do not wear an under-wire bra or sports bra for the first several weeks because these tend to cut into your incisions (inverted-T Mastopexy – or Anchor Lift Incision). An under-wire bra may push your breasts to set in a location too high. Each surgeon has his or her preference in regards to a post operative bra, so make sure you ask what they would want their patient to wear. Although the results of a breast reduction are typically long lasting, significant weight fluctuations can have an impact, along with subsequent pregnancies. Most plastic surgeons will not even recommend a reduction for those patients who are not done with child bearing, as the results can be compromised with a birth and breast feeding of a child.
During the first several days it is important to monitor your temperature. This is done so you can check to see if you might have an infection started. It is very important to make sure you take the antibiotics on time. If the breast becomes increasingly warm or hot to the touch and you see redness occurring – call your plastic surgeon immediately.
Take your medication when your surgeon has told you to do so. You will have an antibiotic to make sure you do not get an infection, and also pain medication to help alleviate any discomfort you might have. It is very important you take your medication on time as prescribed. If you are taking any oral contraceptives, make sure you tell your surgeon as this can interfere with some antibiotics. You might have a pain pump after your surgery, which will help tremendously with making sure you will not have any discomfort at all for the first few days.
Your surgeon will instruct you not to exercise or engage in strenuous activities for at least 6 weeks. It is important to listen to your physician, as you do not want to get your heart rate up too high, which can lead to increase bleeding possibly – which can lead to a hematoma or a seroma.
It is preferred that if you do smoke, to quit if possible. Smoking reduces circulation which can lead to poorly oxygenated blood – which is needed to heal from the surgery.
It is not uncommon for your menstrual cycle to be altered for a month or two after you undergo surgery. The stress of the surgery and anesthesia plays havoc on your system. Your period will return to normal within a couple of months. Your first menstrual period following your breast reduction surgery might cause your breast tissue to swell and hurt. This will go away shortly after your period.
Numbness in the nipples and the surrounding breast tissue after breast reduction surgery is normal. This will go away after a few weeks or so. In some rare cases this numbness can be permanent. Plastic surgeons will tell their patients to give this at least a year before diagnosing this as permanent sensation loss, as nerve fibers grow at a very slow rate and can take months before the feeling comes back into the breast area. Shooting pain from the nerves and tingling during breast lift recovery is also normal. This means the nerves are trying to regenerate, so these sensations are a good sign that the nerves are returning to normal function.
Hypersensitive nipples can occur after breast surgery. To help with the discomfort patients should try wearing some sort of gauze pad or Band-aid to help prevent the clothing from rubbing the affected area.
To help with any hypertrophic scarring or keloid prevention, some surgeons will suggest silicone gel sheeting. This silicone sheeting comes in gel shapes which are commonly used for mastopexy or a breast lift; however are suitable for common breast reduction with lift incisions. Keloid scarring resembles a lumpy pink raised scar and normally occur in people who have this tendency. Read more about Keloid and Hypertrophic scarring
Having the procedure of breast reduction sometimes finds that it is not possible for the patient to have lactation or to breastfeed after the procedure. Significant amounts of breast tissue may have been removed along with many of the lactiferous or milk ducts passing from the breast tissue to the nipple are detached or scarred when the nipple/areola complex is repositioned during breast reduction. Following the Inferior Pedicle or Vertical Breast Reduction, breastfeeding may or may not be possible. In some patients nipple/areola sensation is unchanged, yet in other patients it may be diminished or completely absent following surgery. These sensory changes when occur can be temporary or permanent. We cannot predict who will experience an inability to breast feed or sensory changes following surgery. Certain women with large breast report diminished nipple sensation before surgery. This is likely related to nerve stretching by the heavy weight of the breast. Some of these patients notice improved nipple sensation following breast reduction using Inverted T or Vertical breast reduction technique. There have been a number of studies looking at the ability of women who had breast reduction surgery to nurse their children afterwards. Most have shown that milk production varies widely. However, these studies have demonstrated a similar ability to breastfeed when breast reduction patients are compared to control groups. Breastfeeding and Breast Reduction
The results of breast reduction are seen and felt immediately but are not always permanent. After reduction, significant weight gain or loss and pregnancy can affect breast size and the results of your surgery. When timing a breast reduction – there are a few considerations to keep in mind. Many women experience difficulties with breastfeeding, but a breast reduction can make it even more difficult. Make sure you tell your Plastic Surgeon when you might anticipate your desires to have children. More people are recognizing the health and quality of life benefits of breast reduction, including pediatricians who might recommend teenage girls age 15-17 years. The stress that excessively large breast place on the back and neck of a young woman - can be huge.
Insurance reimbursements for breast reduction are defined by the individual insurance companies and what their policies might be. Many plastic surgeons are finding that coverage for this procedure can be arbitrary at best. Breast Reduction is not threatened across the board, but can be rejected despite recognized standards for coverage relative to a woman’s physical build and the amount of breast tissue reduced. Make sure you check with your own insurance company policy limits.
More Links on Breast Reduction
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