Dr. Hakan Gündoğan

Breast Reduction

BREAST REDUCTION

Overly large breasts can cause some women to have both health and emotional problems. In addition to self-image issues, you may also experience physical pain and discomfort.

Also known as reduction mammaplasty, breast reduction surgery removes excess breast fat, glandular tissue and skin to achieve a breast size in proportion with your body and to alleviate the discomfort associated with overly large breasts.

Patients who undergo breast reduction surgery frequently are seeking relief from physical symptoms caused by the excessive weight of large breasts. Breast reduction usually can solve these problems as well as improve the size and shape of your breasts. Following breast reduction, your breasts will be more proportional to the rest of your body, and clothes will fit you better.

The weight of excess breast tissue can impair your ability to lead an active life. The emotional discomfort and self-consciousness often associated with having large pendulous breasts is as important an issue to many women as the physical discomfort and pain.

Am I a good candidate for breast reduction?

Breast reduction surgery is a highly individualized procedure and you should do it for yourself, not to fulfill someone else’s desires or to try to fit any sort of ideal image.

You may be a good candidate for breast reduction if you have one or more of the following conditions:

* Breasts that are too large in proportion to your body frame

* Heavy, pendulous breasts with nipples and areolas that point downward

* One breast is much larger than the other

* Back, neck or shoulder pain caused by the weight of your breasts

* Indentations in your shoulders from tight bra straps

* Restriction of physical activity due to the size and weight of your breasts

* Dissatisfaction or self-consciousness about the largeness of your breasts

Breast reduction is a good option for you if:

* Your breasts limit your physical activity 

* You experience back, neck and shoulder pain caused by the weight of your breasts 

* You have regular indentations from bra straps that support heavy, pendulous breasts 

* You have skin irritation beneath the breast crease 

* Your breasts hang low and have stretched skin 

* Your nipples rest below the breast crease when your breasts are unsupported 

* You have enlarged areolas caused by stretched skin

What is the optimum age for Breast reduction?

Breast reduction can be performed at any age, but Dr. Hakan Gundogan usually recommends waiting until breast development has stopped. Childbirth and breast-feeding may have significant and unpredictable effects on the size and shape of your breasts. Nevertheless, many women decide to undergo breast reduction before having children and feel that they can address any subsequent changes later. If you plan to breast-feed in the future, you should discuss this with Dr. Hakan Gundogan.


Your Breast Reduction Surgery Consultation with Dr. Hakan Gundogan

During the consultation, you will be asked about your desired breast size as well as anything else about your breasts that you would like to see improved. This will help Dr. Hakan Gundogan to understand your expectations and determine whether they realistically can be achieved.

Dr. Hakan Gundogan will examine your breasts, taking measurements and photographs for your medical record. The size and shape of your breasts, the quality of your skin, and the placement of the nipples and areolas will be carefully evaluated.

You should come to the consultation prepared to discuss your medical history. This will include information about any medical conditions, drug allergies, medical treatments you have received, previous surgeries including breast biopsies, and medications that you currently take. It is important for you to provide complete information.

You should tell Dr. Hakan Gundogan if you plan to lose a significant amount of weight, particularly if you have noticed that your breasts become smaller with weight loss. Dr. Hakan Gundogan may recommend that you stabilize your weight before having surgery.

Where are the incisions placed?

There are many variations to the design of the incisions for breast reduction. The size and shape of your breasts, as well as the desired amount of reduction, are factors that will help Dr. Hakan Gundogan to determine the best technique for you.

The most common method of reducing the breasts involves three incisions. One incision is made around the areola, which is neither performed nor suggested by Dr. Hakan Gundogan. Another runs vertically from the bottom edge of the areola to the crease underneath the breast. The third incision follows the natural curve of the breast crease.

Rarely, if your breasts are extremely large, the nipples and areolas may need to be completely detached before they are shifted to a higher level. In such a case, you will need to have made the decision to sacrifice sensation and the possibility of breast-feeding in order to achieve your desired breast size.

After Dr. Hakan Gundogan. has removed excess breast tissue, fat and skin, the nipple and areola are shifted to a higher position. The areola, which in large breasts usually has been stretched, also is reduced in size. Skin that was formerly located above the nipple is brought down and together to reshape the breast. Liposuction may be used to improve the contour under the arm.

How should I prepare for surgery?

Depending on your age, or if you have a history of breast cancer in your family, Dr. Hakan Gundogan may recommend a baseline mammogram and breast ultrasonography before surgery and another mammographic examination some months after surgery. This will help to detect any future changes in your breast tissue. Following breast reduction, you will still be able to perform breast self-examination. Breast reduction surgery will not increase your risk of developing breast cancer.

If you are a smoker, you will be asked to stop smoking well in advance of surgery. Aspirin and certain anti-inflammatory drugs can cause increased bleeding, so you should avoid taking these medications for a period of time before surgery. Dr. Hakan Gundogan will provide you with additional preoperative instructions.

Breast reduction surgery may be performed on an inpatient or outpatient basis. If you are to stay in the hospital, it will most likely be for only one night. Whether you are released the day of surgery or the following day, you will need someone to drive you home and to stay with you for the next day or two.

Your Surgical Experience

The goal of Dr. Hakan Gundogan and the entire staff is to make your surgical experience as easy and comfortable for you as possible.

What will the day of surgery be like?

Your breast reduction surgery will be performed in a hospital. Usually, a general anesthetic is administered, so that you will be asleep throughout the procedure. When surgery is completed, you will be taken into a recovery area where you will continue to be closely monitored. In rare instances, small drain tubes will have been placed in your breasts to help avoid the accumulation of fluids. Gauze dressings will be placed on your breasts and covered with a surgical bra.

Breast reduction procedural steps

Breast reduction surgery is usually performed through incisions on your breasts with surgical removal of the excess fat, glandular tissue and skin.

In some cases, excess fat may be removed through liposuction in conjunction with the excision techniques described below. If breast size is largely due to fatty tissue and excess skin is not a factor, liposuction alone may be used in the procedure for breast reduction; however Dr. Hakan Gundogan does not suggest this modality.

The technique used to reduce the size of your breasts will be determined by your individual condition, breast composition, amount of reduction desired, your personal preferences and the surgeon’s advice.

Step 1 - Anesthesia

Medications are administered for your comfort during breast reduction surgery. The choices include intravenous sedation and general anesthesia. Dr. Hakan Gundogan will recommend the best choice for you.

Step 2 - The incision

Incision options include:

* A circular pattern around the areola (is not suggested and not performed by Dr. Hakan Gundogan).

The incision lines that remain are visible and permanent scars, although usually well concealed beneath a swimsuit or bra.

* A keyhole or racquet-shaped pattern with an incision around the areola and vertically down to the breast crease

* An inverted T or anchor-shaped incision pattern

Step 3 - Removing tissue and repositioning

After the incision is made, the nipple (which remains tethered to its original blood and nerve supply) is then repositioned. The areola is reduced by excising skin at the perimeter, if necessary.

Underlying breast tissue is reduced, lifted and shaped. Occasionally, for extremely large pendulous breasts, the nipple and areola may need to be removed and transplanted to a higher position on the breast (free nipple graft).

Step 4 - Closing the incisions

The incisions are brought together to reshape the now smaller breast. Sutures are layered deep within the breast tissue to create and support the newly shaped breasts; sutures, skin adhesives and/or surgical tape close the skin. Incision lines are permanent, but in most cases will fade and significantly improve over time.

Step 5 - See the results

The results of your breast reduction surgery are immediately visible. Over time, post-surgical swelling will resolve and incision lines will fade. Satisfaction with your new image should continue to grow as you recover.

How will I look and feel initially?

The day after surgery, you will be encouraged to get out of bed for short periods of time. After a few days, you will be able to move about more comfortably. Straining, bending and lifting must be avoided, however, since these activities might cause increased swelling or even bleeding. You may be instructed to sleep on your back to avoid pressure on your breasts.

Any surgical drains will be removed a day or two after surgery, at which time your dressings may also be changed or removed. You will be instructed to wear a support bra for a few weeks, until the swelling and discoloration of your breasts diminishes. Generally, there will be no stitches need to be removed after surgery.

You may notice that you feel less sensation in the nipple and areola areas. This usually is temporary. It may, however, take weeks, months or even more than a year before sensation returns to normal. Your breasts may also require some time to assume a more natural shape. Incisions will initially be red or pink in color. They will remain this way for many months following surgery.

When can I resume my normal activities?

After breast reduction surgery, it is often possible to return to work within just a couple of weeks, depending on your job. In many instances, you can resume most of your normal activities, including some form of mild exercise, after one week. You may continue to experience some mild, periodic discomfort during this time, but such feelings are normal. Severe pain should be reported to your doctor.

Any sexual activity should be avoided for a minimum of one week, however Dr. Hakan Gundogan may advise you to wait longer. After that, care must be taken to be extremely gentle with your breasts for at least the next six weeks.

How long will the results last?

Unless you gain or lose a significant amount of weight or become pregnant, your breast size should remain fairly constant. However, gravity and the effects of aging will eventually alter the size and shape of virtually every woman's breasts. If, after a period of years, you become dissatisfied with the appearance of your breasts, you may choose to undergo a breast "lifting" procedure to restore their more youthful contour.

Results of Breast Reduction

Breast reduction surgery will make your breasts smaller and firmer. Without the excessive weight of large breasts, you may find greater enjoyment in playing sports and engaging in physical activity.

The incisions from your breast reduction surgery will heal and fade over time. It is important to realize, however, that the incision lines will be permanently visible, more so in some individuals than others. Fortunately, the incisions for breast reduction are in locations easily concealed by clothing, even low-cut necklines.

Breast reduction often makes a dramatic change in your appearance. For this reason, it may take some time to adjust to your new body image. Most women, however, eventually become comfortable with their smaller breasts and feel very pleased with the results of surgery. In fact, the level of patient satisfaction resulting from breast reduction is among the highest of any plastic surgery procedure.

Understanding Risks

Fortunately, significant complications from breast reduction are infrequent. Every year, many thousands of women undergo successful breast reduction surgery, experience no major problems and are pleased with the results. Anyone considering surgery, however, should be aware of both the benefits and the risks.

The subject of risks and potential complications of surgery is best discussed on a personal basis between you and Dr. Hakan Gundogan.

You can help to lessen certain risks by following the advice and instructions of Dr. Hakan Gundogan, both before and after surgery.

Maintaining a Relationship with Your plastic surgeon Dr. Hakan Gundogan

You will return to Dr. Hakan Gundogan for follow-up care at prescribed intervals, at which time your progress will be evaluated. Once the immediate postoperative follow-up is complete, Dr. Hakan Gundogan. encourage their patients to come back for periodic checkups to observe and discuss the long-term results of surgery.

Please remember that the relationship with Dr. Hakan Gundogan does not end when you leave the operating room. If you have questions or concerns during your recovery, or need additional information at a later time, you should contact Dr. Hakan Gundogan.