Breast Reduction

Many women who suffer from oversized breasts experience discomfort, pain, and self-consciousness. This condition can be a result of genetics, weight, or pregnancy, but regardless of the cause oversized breasts can be a large cause of discomfort both physically and emotionally for you. When you have a breast reduction it can change the weight, size, shape, and firmness of your breasts. The end result to having a breast reduction is that you feel a lot more comfortable, not just physically but mentally as well.

If you struggle with oversized breasts then a breast reduction, also known as reduction mammaplasty could be the solution that you are looking for to alleviate your discomfort. Breast reduction surgery removes excess breast fat, tissue, and glandular skin to achieve a breast size that will be more proportionate to your body and will ultimately alleviate pain and self consciousness that goes along with breasts that are too large.

There are a lot of factors to consider when trying deciding if you are a good candidate for a breast reduction. The best candidates for breast reduction are women whose oversized breasts cause health and medical problems, interfere with routine activities, suffer severe self-conscious related issues, or disrupt sleep. Breasts that are too large are often very heavy and can cause back and neck pain, skin breakdown, and serious posture problems. The weight can be so heavy that it actually causes a constant pull on your bra straps that leave painful indentations on your shoulders. Having a breast reduction will almost always alleviate these complaints and most women who have breast reduction surgery are often extremely satisfied with the results.

As with any surgery there are risks associated with breast reduction, the most common risks include scarring, unevenly positioned nipples, loss of feeling in the nipples, and the inability to breast feed after surgery. Risks can vary patient by patient so these can be best discussed and evaluated when you have your one-on-one consultation with Dr. Nuveen.

What to Expect during recovery:

As you heal:

Healing: How quickly and easily you will heal depends on a number of factors such as your genetic background, your overall state of health and lifestyle (exercise, diet, smoking, drinking, etc…). Many people believe your doctor is solely responsible for the healing process, but no one person can make another heal. Dr. Nuveen can facilitate (but not accelerate) your healing but you must also take an active role in that process. Your cooperation and close attention is extremely important when it comes to your post-operative healing.

Another important factor in the course of healing is how well you follow the instructions that are given to you by Dr. Nuveen. You will receive verbal instructions as well as written instructions after surgery and it is imperative that you follow those instructions. We set those guidelines for you to promote your healing process and to prevent the occurrence of any complications that can interfere with your recovery. It is crucial that you recognize that you are a partner in this process and have a responsibility to follow instructions carefully. The instructions we give you are designed to give you the best opportunity for healing without delay or surprise.

Your first 48 hours:

Bra: You will be sent home wearing a support bra and you will need to wear that bra for 4-6 weeks following your surgery. Your bra should be washed and dried daily to avoid infection. You may buy your own sports bra and wear that as well as long as it is snug-fitting or we have bras available for purchase for $20. It is imperative that you do not wear under wire bras during this time. 

Dressing: There are self-dissolving sutures in your incisions that do not need to be removed. You should shower daily, but DO NOT SOAK IN THE BATHTUB, fully submerging your incisions in water will greatly increase your risk of infection. There will be skin glue on top of your incisions, it is purple and should not be scrubbed off or picked at, it will come off on its own in approximately 2 weeks.
If you are going home, a family member or friend must drive you because you have been sedated. If you choose to stay overnight in our guest suite you must have an adult caregiver to stay with you or a caregiver can be provided for an additional fee. 

Activity: Take it easy and pamper yourself. Try to avoid any straining. You may go to the bathroom, try to get up and move a little every hour, but take it easy. No matter how good you feel please do not do any strenuous activities or lifting. We do not want you to bleed and cause any more swelling and bruising that is unavoidable. Do not lift anything more than 10 lbs for the first two weeks, then nothing over 20 lbs for the next four weeks.

Ice packs: We recommend using cold or ice packs for the first 48 hours to help reduce swelling, bruising, and pain. Use frozen peas in the package or crush ice cubes and the ice into a zip-lock bag. Using ice after your procedure should help, not hurt so if the ice feels too uncomfortable don’t use it as often. Leave the ice in place no longer than 20 minutes per area.

Diet: If you have any post-operative nausea, carbonated sodas and dry crackers may help settle your stomach. If nausea is severe, use the Phenergan suppositories you were prescribed. If you feel normal, start with liquids and bland foods, and if those are well tolerated, progress slowly back to your regular diet.

Alcohol: Alcohol dilates the blood vessels and could increase post-operative bleeding. Please do not drink until you have stopped taking the prescription pain pills, as the combination of pain pills and alcohol can be dangerous.

Smoking: Nicotine causes blood vessels to constrict and may interfere with normal wound healing. When blood vessels constrict there is less blood supply that can get to the wound which means less oxygen for normal healing to take place. Smoking may adversely affect wound healing and cause loss of skin and tissue death. Smoking reduces arterial (blood) oxygen supply which is necessary for normal wound healing. Exposure to second hand smoke has also been implicated in delayed or abnormal wound healing. It is best to avoid smoking and/or exposure to second hand smoke in the post-operative period while your incisions are healing. You should also avoid cigarette replacements such as nicotine gum, patches or the inhaler during your post-operative period as these have similar effects as smoking and second hand smoke.

Driving:  Please do not drive while taking prescription pain pills. Please be advised that all medications may impair judgment and the ability to drive or operate heavy machinery

How to Care for Your Scars After Surgery

Our practice is dedicated to making your entire surgical experience enjoyable. Healing is the great variable! The same procedure can be performed on a thousand different patients using the same surgeon, tools, and approach. Even with these constants, some scars will heal better than others. Incision care post-operatively can increase the appearance of your scar. We are dedicated to utilizing evidence based practice in providing you with the most up-to-date information, to ensure you get the results you are looking for.

What is a scar? Think of scarring as a visible healing act. In the beginning stages of recovery, usually the first two to three months, your scars may be very apparent and pronounced. This is normal healing. As time goes by the scars will slowly become smaller and less visible. It may take up to two years for skin to fully heal from surgery. By then, scars are considered "mature" and you will see their final outcome.

What can you do to improve the appearance of your scars? In the initial stage post-operatively, do not pick at the area, or rub abrasively. There may be skin glue along your incision. This can last for two to several weeks post-operatively. It will begin to slowly come off on its own. Nearly all sutures are self dissolving. Keeping the self dissolving sutures moist with Vaseline will help them dissolve faster. After the skin glue is off and the area is fully closed, a scar cream needs to be applied to improve the color and appearance of the incision. Maintaining a well balanced diet with an emphasis of Vitamin E and C will prepare your body for healing.

What scar cream to use? We recommend over the counter scar creams (Mederma, Scar Guard, etc.) and Dermatix, which we also sell in our office. Mederma is a good product for scars on the hands or face. Dermatix is recommended for larger incisions on the body, such as those from breast augmentations, breast lifts/reductions, tummy tucks, and brachioplasties. Dermatix, from Valeant Pharmaceuticals is a transparent, self-drying silicone gel that will significantly reduce the appearance of scars. Dermatix flattens, softens and smoothes scars, relieving the itching and discomfort, as well as reducing discoloration.

Variation in healing? There are many factors that go into how a person will scar. A few examples include age, location, genetics, and lifestyle. Exercising, eating a well-balanced diet, and abstaining from smoking all assist in healthy blood flow, which ultimately plays a significant role in scar healing. Our practice would like to give you the information and products that you need to have the very best results possible.

Family and Friends:  Support from your family and friends is very helpful during your recovery. But because they may not understand what is normal in your post-operative care, their comments may unintentionally create emotional turmoil for you. You can trust that we will tell you honestly how your progress is and what we expect your results to be. Please trust in our knowledge and experience when we evaluate your progress. We know it is difficult not to compare your recovery with other people you may know who also had cosmetic surgery, but it’s imperative to remember progress varies greatly patient to patient and everyone has a different recovery experience.

Cosmetic surgery has certainly become less taboo in the past decade, but your friends may still be reluctant to bring it up and discuss it because they think it may be a private matter to you. Patients occasionally feel upset that “no one noticed” or “said anything.” If you are comfortable discussing your cosmetic procedure then you should do so openly. When people ask how you are, respond saying “I feel wonderful. I just had cosmetic surgery and I’m recovering.” This lets people know that they may talk freely with you. Often if you will open up about your procedure you will find that your friends and acquaintances are very interested in discussing it with you.

One potential drawback after surgery that can take places is that quite frequently patients experience a very brief period of “let down” or depression after cosmetic surgery. Some may subconsciously have expected to instantly look and feel better, even though they rationally understand that this will not be the case. You will be told what to expect during your recovery but the incisions can still come as a shock sometimes to see the initial results. Patients commonly question their decision to have surgery during the first few days after surgery because it’s hard to imagine the incisions once they are healed and everything has settled into place. As the healing occurs, these thoughts usually disappear quickly. If you feel depressed, understanding that this is a “natural” phase of the healing process and that the final outcome will be much different than what it looks like right after your procedure may help you to cope with any emotional “let down” you may feel initially.