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Breast Reduction
(Reduction Mammaplasty)

Overview
Large, pendulous breasts may cause a woman to potentially experience various medical problems caused by theexcessive weight of the breast tissue. Commonly associated with this condition may be medical problems such as: skeletal deformities, back and neck pain, posture changes, skin irritations and breathing problems. Bra straps often leave indentations in the shoulder area. These issues may affect a woman or young girls's emotional state or self-conciousness.
Breast reduction removes fat, glandular tissue, and excessive skin, resulting in smaller, lighter and firmer breasts that are better-shaped in proportion to rest of the body. However, changing the appearance of the breasts is not the only outcome of the procedure. It also improves function by liberating movement andpossibly alleviating pain. This procedure is usually performed on fully developed adult women, but in certain cases may be perfomred on teenagers when physical discomfort is a concern. Breast reduction patients frequently express that they wish they'd had to the procedure done sooner because they are so pleased with the results.

Examples of  Breast Reduction & Lift Surgery
Before
After
Before
After

Your Breast Reduction Surgery Consultation
Dr. Ritota will meet with you personally at his office. He will examine your breasts, take measurements to determine the amount of breast tissue he expects to remove to give you your desired results, and gather your medical history. He will discuss your expectations of the procedure and his expectations. You can reviews photographs of prior procedures he has performed.

Your Pre-Operative Visit
Dr. Ritota will askyou to meet with him and his staff on a number of occasions in order to review your surgical desires and ultimate plans. He will review with you a list of precautions to take before you have your surgery. Such precautions include refraining from using any medications or other substances that could possibly be cause an increased risk for surgical complications. Some women (those at risk & over 30 years of age) may be required to  have a baseline mammogram performed before their procedure.

The Day of Your Breast Reduction Surgery
Dr. Ritota will outline the planned incisions on your breasts with a marking pen while you are in an upright position prior to your surgery. These markings provide a guide for the surgery, which is done with you laying down, so that in the upright position the breasts are shaped appropriately and are as symmetrical as possible. \During the procedure, the breast tissue around the nipple and areola is preserved and the extra skin and breast tissue is removed. This is done to preserve the best possible circulation to the nipple and areola and the smaller breast beneath. The flaps of skin are used to wrap the breast tissue in a tighter package, which moves the nipple to a higher position and gives the breast a new contour. Small drainage tubes are placed to remove any excess fluids which may accumulate in the first day or two. All incisions are closed with dissolving type stitches. Soft dressings and a supportive bra are placed for comfort.

The operation usually takes about three hours, depending on breast size. After the operation, you will spend at least an hour in the recovery room while you awake.  The majority of our patients elect to remain overnight for the first night following their surgery.  The patient is monitored and will receive in many cases a choice of types of pain medication.  While this in not generally a procedure that is considered highly painful, the use of a PCA pump (patient controlled anesthesia) may make the postoperative level of comfort that much better.

Your Recovery Process
You will need supervision for at least 24 hours after you opertation. Dr. Ritota will make sure this is something you have planned before your operation. There is some moderate pain and although it is usually well-controlled with prescribed medications, we want to make sure you have assistance in the veent it is needed.

You will also take an antibiotic for several days after surgery. The drain tubes empty into a small reservoir, which needs to be emptied periodically.

You will have a post-operative appointment 2 days after your sugery. After this appointment, you will then be able to shower. You will be asked to wear a comfortable bra 24/7 for the first two week and an a daily basis after that. Your sistitches are dissolvable and will not need to be removed, but you must take care to keep them clean and apply antibiotic ointment. After two days you will be up and around but it is still very important that you limit your activity and allow yourself to heal. You must avoid any heavy lifting, pushing, or pulling and vigorous for four to six weeks. After the first week you may be able to do light stretching and walking exercises. Stress to the incisions and can lead to delayed healing and prominent scars. Sexual activity should also be avoided for a week because hormonal stimulation can make your breasts swell and lead to increased pain.

Your first menstrual cycle may cause more swelling and pain than you are used to. You may may also experience random shooting pains for several months after the operation. Numbness of the nipples and breast skin for up to eight weeks after your surgery is common. This is due to swelling and will subside.
The appearnce youf your breasts will change over time. At first they may appear larger and higher than intended, also due to swelling. It may take one to two years to see optimal appearnce of scars. This is beneficial, in that the breasts look more natural after they have had time to settle and heal.

Risks
While complications of breast surgery are infrequent and usually minor, there is always a possibility of complications. This includes infection, bleeding, or a reaction to the anesthetic or sedative medications. These are risks of any surgical procedure. You may have temporary or permanent areas of altered sensation, including numbness. In some skin types, often ethnic, scarring can be more prominent, and may require further treatment. The doctor will discuss your particular scarring potential in more detail at the time of your consultation.

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