Breast

Breast Reduction

Women with large, heavy breasts which may contribute to back, shoulder and neck pain, poor posture, bra-strap indentations, and chafing under the breasts, or which may cause a woman to feel out of proportion or to receive unwanted attention may benefit from breast reduction.

Appropriate candidates for this procedure are non-smoking women in good general health.

Women desiring surgery are seen in consultation with Dr. Casso. Their overall health is assessed. Patients with significant medical problems are encouraged to see their medical specialists for medical clearance prior to surgery.

Patients are queried regarding their goals. To the extent possible, patient’s size preferences are honored.

Generally, in this procedure, excess tissue is removed from the undersurface of the breast, the areolas are made smaller and shifted higher on the breast mound, and the wounds closed underneath the areolas, thereby pushing the breast tissue up higher on the chest wall. Oftentimes, a drain is inserted, which removes fluid which would otherwise collect in the wound.

Almost always, the nipple and areola remain attached to breast tissue, and are merely shifted higher on the breast. In a few cases, particularly in women with vertically long breasts, the circulation to the nipple and areola may not permit this technique; in these patients, the nipple and areola are detached and reapplied as grafts to the appropriate site on the breast. While generally yielding a good cosmetic result, generally sensation is lost with this “free nipple graft technique”.

This procedure is performed by Dr. Casso under general anesthesia at Houston Methodist St. John Hospital. While this procedure is sometimes performed under local anesthesia in outpatient facilities and doctors’ offices, Dr. Casso recommends general anesthesia at Houston Methodist St. John Hospital, which provides the patient with a comfortable surgical experience, and close, expert nursing attention, treatment of postoperative nausea, if present, and immediate medical attention in the event of any unforeseen emergency. The option for surgery in a full-service, state-of-the-art facility such as Houston Methodist St. John provides patients with a measure of safety and security which is unmatched.

Incisions are made around the areola, extending vertically below the nipple, and in the fold under the breast. During surgery, the nipple-areola complex is moved upward and excess breast tissue, fat, and skin are removed. Usually, the breast tissue which is removed is sent to the pathologist for examination. The wounds are carefully repaired and bulky bandages are applied. This procedure normally takes about 3 hours.

An overnight stay is optional following breast reduction surgery. Initial discomfort is usually well controlled with oral medication. Patients are seen the following day, if possible, and dressings are changed. The patient returns for several visits in the post-operative period. Drains are typically removed within about a week. Patients are allowed to shower beginning about 4 days after surgery. Sutures are removed within ten days. Most patients can return to light activities within one week. Vigorous activity is discouraged for about one month. Scars generally fade substantially within six to 12 months.

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