Fortunately, surgical options are available that can greatly reduce your discomfort. Thousands of women have found relief through breast reduction surgery. Authors Alain Polynice, M.D. and Aloysius Smith, M.D. are board-certified plastic surgeons who have performed hundreds of these breast procedures and now share their expertise and experience with you. They answer such questions as:
• How much can breast size be reduced?
• What kind of anesthesia is used?
• Where are the incisions placed?
• Where will I have scars?
• Is there much pain after surgery?
• How long is the recovery period?
• What are the potential complications?
In Your Complete Guide to Breast Reduction and Breast Lifts, the authors guide you through the entire experience of breast reduction surgery; they also cover another popular procedure—breast lifts. From your first consultation to post-surgical care, they deliver information that will help you decide whether cosmetic breast surgery is for you.
This book also contains 60 color photos, including dozens of "before and after" photos of women who have had breast reductions and breast lifts, a resource section, glossary, and index.
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Your Complete Guide to Breast Reduction & Breast Lifts
By Alain Polynice, Aloysius Smith, Jack Kusler
Addicus Books, Inc.Copyright © 2006 Alain Polynice, M.D., and Aloysius Smith, M.D.
All rights reserved.
Contemplating Breast Reduction Surgery
If you have large breasts, you are all too familiar with the frustrations that may come with having them. You know what it feels like to have people "talking to your chest." Perhaps you avoid days at the beach or pool because you feel self-conscious of your large breasts. Have you ever turned down offers from friends to shop for clothes because of the embarrassment you feel when shirts and dresses don't fit across your chest? Do you turn down the invitation to participate in physical activities?
If you answered "yes" to these questions, you're not alone. Many women feel restricted by their bodies and actually avoid certain activities that others enjoy because of this discomfort. They don't remember the last time they felt carefree at the beach. They don't even try on sexy lingerie anymore, because they know it won't fit quite right. All of this is because they are not comfortable with their own breasts.
What might life be like without large, heavy breasts? Maybe you'd notice people paying attention to you and not just your chest. Maybe you'd exercise at the gym without pain. Maybe you'd stand taller, because you wouldn't feel self-conscious about your breasts. There's a good chance that you'd notice a difference in the way you feel, the way you move, and how you carry yourself.
How Breasts Develop
Think back to your adolescent years for a moment, back to when it all began. Some girls developed breasts early and some were late bloomers. Either way, it seemed that very few were pleased with the rate of their development. Some girls, embarrassed, changed for gym class in bathrooms down the hall, instead of the locker rooms to hide the fact that their breasts were more fully developed than many of the other girls'. Other girls, equally ashamed, tried to hide their underdeveloped breasts and wondered when on earth they would ever catch up to the others.
These girls were simply caught in various stages of breast development. Breast growth is one of the earliest indications that puberty has begun. The process begins with the secretion of hormones from the pituitary gland, at the base of the brain. This gland controls bodily functions such as growth and ovary production. It's common for breasts to begin to grow sometime between the ages of eight and twelve. Whenever the onset of breast development, it's likely that breasts will continue to grow for approximately four years after girls begin menstruating.
Breasts develop in five separate stages. The first stage is actually the flat chest that children have before development begins. Stage two begins when children begin to bud, meaning that their breasts form small peaks as nipples swell, and tenderness sets in. The third stage of breast development starts when adolescents begin to build fat in their breast tissue. Breasts grow more rapidly in this stage than in any other. Often, it's during this time that girls begin to menstruate. After this point, breast size does not usually increase much; instead, during stage four, the shape of the breasts changes as the nipples begin to protrude. Only during the teenage years will nipples point straight ahead and not sag at all. Stage five is full maturation, and breast development is complete. This entire process should conclude around age seventeen or eighteen. Permanent breast size should be evident at this point.
Why Some Woman Have Large Breasts
All of us have the same basic breast anatomy, so why does breast size vary so much from woman to woman? The answer is deceptively simple — fat! It's true. We all do have roughly the same number of breast ducts and lobules, which allow lactation to occur, but we do have different amounts of fat deposited within our breasts.
Breast size is generally determined by genetics. In fact, breast size has much more to do with your genes than it does with your hormones or diet. This fact can be confusing, though, if your breast size greatly differs from that of your mother's or your sister's. Understanding genes is sometimes tricky, because they're complex. Your genes are derived not only from your mother's but also from your father's side of the family. You may have a breast size similar to many of your close female relatives, or you may take after your Great-Aunt Betty.
Estrogen is a hormone that surges during puberty, ages eleven to fifteen, and during pregnancy. Any increase in estrogen levels causes breasts to enlarge. Although breasts do become enlarged during pregnancy because of the increase in estrogen, they often shrink and sag after childbirth or after breastfeeding ceases. Usually breasts will regain some of their previous fullness a few months afterward.
The use of oral contraceptives or post-menopause estrogen replacement pills may enhance breast size because of their estrogen content.
Gaining weight will typically cause the breasts to become bigger. However, breasts usually return to their previous size once weight is lost.
What Is Breast Reduction Surgery?
Breast reduction surgery, also referred to as a reduction mammoplasty, is a surgical procedure that involves reducing the size, weight, and mass of the breasts. This is accomplished by excising fat, skin, and glandular tissue. The skin is then pulled together and sutured. As a result of this surgery, the breasts are smaller and more shapely. Although the intent of breast reduction surgery is to decrease the size and weight of the breasts, the procedure also lifts the breasts to correct drooping. This procedure is most commonly performed on women who have large, pendulous breasts, which may be causing both physical problems and social embarrassment.
The number of women seeking breast reduction has remained steady over the past few years. According to the American Society of Plastic Surgeons (ASPS) more than 100,000 women have breast reduction surgery annually.
Reasons for Breast Reduction Surgery
Most people seem to think of large breasts as a symbol of beauty and attractiveness. However, many women with large breasts consider them more of a curse than a blessing. They complain of a variety of physical ailments, including neck, back, and shoulder pain, bra strap grooving, skeletal deformities, rashes underneath their breasts, trouble breathing, difficulty exercising, and poor posture.
Physical symptoms are not the extent of a woman's plight if she is burdened with large breasts. Often, these women also experience a range of significant emotional issues — from self-consciousness to self-esteem problems — because their breasts have been the topic of teasing and objectification since puberty. Because these women view their chests as unattractive or the source of too much attention, they work hard not to reveal this area to anyone else, especially those whose opinions they value most. This means that they often don't feel comfortable changing their clothes in front of others, which may cause them to avoid sports activities or fitness centers or even sex sometimes. Are you one of these women?
Are You a Candidate for Breast Reduction?
If any of this sounds familiar and you are in good health overall, you may be a candidate for breast reduction surgery. Breast reduction surgery has helped thousands of women — from teenagers to ladies in their eighties — feel more comfortable physically and emotionally. To be a breast surgery candidate, you need to be in good general health. If you do have a medical condition, such as diabetes, you may still be able to have your procedure performed, but you'll need to follow your surgeon's recommendations.
Most plastic surgeons recommend that women wait until they are at least eighteen to twenty years old before they consider undergoing breast surgery of any kind, to make sure that their breast development is complete. The exception to this rule is teenagers who suffer from virginal breast hypertrophy — the condition of having developed large breasts at a very early age, usually during grade school. When this condition is present, many surgeons will feel comfortable performing a breast reduction to increase the adolescent's quality of life and decrease any related physical symptoms.
When Breast Reduction Surgery Might Not Be for You
If you are currently pregnant or breastfeeding, you are not a breast surgery candidate right now, in part because of the adverse effects anesthesia could have on your unborn baby. In fact, it's a good idea to delay breast surgery until after your last child breastfeeds because the results of your surgery could be reversed with another pregnancy or period of breastfeeding.
If You Are Overweight
You may not be a candidate for breast surgery if you are obese or overweight. Many surgeons will not perform breast surgery until patients have reached a stable weight because surgery results will not be optimal; further, the results would be lost after a dramatic weight loss — sagging would occur.
Also, your insurance company may refuse to pay for your surgery if it learns you have not tried to lose weight first. A good starting point may be a weight-loss program consisting of a nutrition plan and an exercise regimen that your doctor recommends. This way, you'll know for sure whether you actually require a breast reduction or if you just needed to loose a few pounds to feel good about your body again.
If You Smoke
If you are a smoker, you are not an ideal candidate for any type of surgery. Nicotine restricts blood flow in smaller blood vessels, and as a result, the blood cannot move oxygen efficiently to help the body heal from surgery. At the very least, a plastic surgeon will recommend you stop smoking for several weeks before and after the procedure. Excessive alcohol consumption, marijuana smoking, and steroid use will also increase your risk of complications during and after surgery.
If You Have Major Health Concerns
Generally speaking, it's not safe to undergo any kind of surgery if you have any major medical condition, but often it can be controlled enough to make breast surgery possible for you. Your surgeon can usually refer you back to your general practitioner, who can often create a plan to prepare you for surgery. You may need to closely follow your doctor's instructions for a designated period of time, though, before he or she will consider surgery safe for you. Once your doctor is confident in your ability to safely have surgery, you will be released for your breast procedure.
If You Develop Keloid Scars
Some individuals are prone to develop keloid scars — fleshy masses of scars. Unfortunately, this condition is very difficult to treat, and those who are aware of their vulnerability to keloids should seriously reconsider undergoing breast surgery. Most people who are at risk for this condition already know it, because they probably have developed keloids at some earlier point in their lives. If you think you are prone to forming keloids, ask your surgeon if he or she has experience with patients who have developed them; a surgeon can take actions which may minimize the formation of severe keloid scars.
Making the Decision
Surgery is serious — it poses risks, discomfort, and a significant recovery period. Breast surgery is not something to take lightly or commit to impulsively.
Despite the inconvenience, many women who have undergone breast reduction surgery report that they would do it all again. They say they have a whole new lease on life once they recover from their procedures, finding themselves able to exercise in ways they never could before and being more active than ever. They continually discover new physical activities they enjoy and often meet new friends in the process. These women also report that their personal lives dramatically improve with their newfound confidence. They state that their lives are much more fulfilling.CHAPTER 2
Choosing a Plastic Surgeon
If you wish to further explore breast reduction surgery, it's now time to choose a plasticsurgeon to perform your procedure. You may already know about the plastic surgeon whom you wish to perform your surgery. If you don't have a surgeon in mind, you'll need to do some searching. Finding a competent plastic surgeon with whom you feel comfortable is essential to achieving your desired results.
It's important to keep two things in mind as you embark on your quest for the ideal plastic surgeon — a surgeon's competence to deliver the results you are looking for and his or her ability to make you feel comfortable throughout the entire process. Thoroughly researching a surgeon's qualifications is key, but don't forget to follow your instincts as you search for the right plastic surgeon for you.
Finding a Plastic Surgeon
You will need to find a surgeon who is experienced in breast surgery. In fact, breast surgery should be a significant part of the surgeon's practice, not just a procedure that he or she performs from time to time. There are several ways to find a plastic surgeon.
If you have any friends who have undergone breast surgery, ask them if they are pleased with their results. If they are, inquire about what they appreciated, specifically, about the process. Then ask them who performed their operations.
You may also be able to get referrals from your general practitioner or gynecologist. These physicians may know several local plastic surgeons, and they may have even seen their work in patients they have in common.
If you're interested in doing some online research, one of the best Web sites for obtaining overall information about plastic surgery procedures and board-certified plastic surgeons is that of the American Society of Plastic Surgeons (ASPS). Another resource is PlasticSurgery.com, which provides viewers with local plastic surgeon referrals and links to pertinent sites.
Training and Experience of the Plastic Surgeon
For most of us, trying to understand the qualifications and credentials of plastic surgeons is a bit confusing. Here's an overview of the process of training and education. Plastic surgery requires years of specialized training, starting with medical school. To become a plastic surgeon, the surgeon must first have graduated from medical school, and have a license in the state to practice medicine. The medical school should be "accredited," which means that the school meets standards set by a national authority for medical education programs.
Once graduated from medical school, a plastic surgeon must complete a minimum of six to seven years of additional training in a hospital where he or she is performing surgery. This is often a combination of general and plastic surgery. This period of training is called a residency. So, by the time a surgeon goes into practice, he or she has had plenty of real, hands-on experience working side by side with senior surgeons.
A plastic surgeon's training is ongoing. Surgeons are required to take continuing medical education courses to keep their certification up-to-date.
Board Certification: What Does It Mean?
Perhaps you have heard that it is important to go to a plastic surgeon who is "board certified." What does this mean? Being board certified means that after the surgeon has completed residency training, he or she has passed a rigorous written exam, which is followed by an oral exam. These tests are given by a recognized board of senior physicians who oversee the plastic surgery specialty. Once the surgeon has passed these tests, board certification is granted. Any plastic surgeon you consider should be certified by the American Board of Surgery as well as the American Board of Plastic Surgery.
Excerpted from Your Complete Guide to Breast Reduction & Breast Lifts by Alain Polynice, Aloysius Smith, Jack Kusler. Copyright © 2006 Alain Polynice, M.D., and Aloysius Smith, M.D.. Excerpted by permission of Addicus Books, Inc..
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.
Table of Contents
1 Contemplating Breast Reduction Surgery,
2 Choosing a Plastic Surgeon,
3 Your Consultation,
4 Preparing for Breast Reduction Surgery,
5 Your Surgical Procedure,
6 Breast Lifts,
7 Follow-up Care,
8 The New You!,
About the Authors,