Breast reduction is an extremely popular and effective operation which decreases the size and improves the shape of overly large breasts. Women with large breasts often suffer symptoms of back pain, neck pain, shoulder pain; rashes beneath the breasts, headaches etc., and these symptoms are nearly universally improved with breast reduction surgery. Numerous studies have shown a great improvement in the quality of life for patients who have suffered with large breasts and have undergone breast reduction surgery. Most breast reductions are covered by medical insurance and considered reconstructive in nature.

Consultation - Breast Reduction Surgery
Breast reduction is performed at different times of life - young women who have extremely large breasts that cause symptoms can have breast reduction surgery as long as their breasts have stopped growing - the earliest age is usually 15-16 years old. When patients are in their child bearing years and are planning children in the near future breast reduction is recommended after child bearing is completed. Older women who had no symptoms with large breasts in their younger years may begin to have symptoms as their muscle strength decreases. Women experience great relief from breast reduction even in their 70's and even 80's.

There are several different methods of breast reduction practiced by Dr. Koenig. The most common method is the inferior pedicle reduction with an inverted T scar. In this operation there is an incision around the nipple, from the nipple to the bottom of the breast and along the bottom of the breast. The vertical pedicle reduction has become increasingly popular due to the shorter scar that results. In the vertical reduction there is an incision around the nipple and an incision from the nipple to the bottom of the breast. Other methods are occasionally used when necessary. It is important that the patient not be an active smoker due to the increased complication rate for smokers. Dr. Koenig will not perform breast reduction on active smokers. They must quit smoking for one month before and not restart for one month after surgery to insure the best and safest operation. Patients over 30 years old need pre operative mammography.

The Operation - Breast Reduction
Breast reduction is usually done under general anesthesia but can be performed under local anesthesia with sedation. The surgery takes about 2 hours to complete and the patient returns home the same day. Dr. Koenig does not use drains for his breast reduction patients and all sutures are internal - not requiring removal. The patient is placed in a post operative bra at the time of surgery.

Recovery - Breast Reduction
Most patients have little pain after breast reduction but pain medication is usually needed for the first 24 hours. Patients are sore and tired for the first week after surgery but are able to get around on their own. Most patients can drive and return to work after 2 weeks. The final breast shape is usually not present until 6 months after. Scars take at least a year to mature. Symptom relief is almost immediate and occurs in 95% of patients. The breasts remain swollen for the first 3-4 weeks. Patients who become pregnant after breast reduction and want to breast feed can do so successfully 50% of the time.

Complications
Like any major surgical procedure, complications can occur in breast reduction such as bleeding and infection although these are uncommon. 10-15% of patients lose sensation to their nipples from breast reduction. Occasionally the blood supply to the nipple and skin can be a problem. This can result in partial or complete loss of the nipple or partial skin loss in rare cases. Fat necrosis which can cause hard lumps to appear in the reduced breast can also occur. While all of these complications can occur they are uncommon. The vast majority of patients who have breast reduction are thrilled with their new breasts and the great relief of symptoms that they experience. The most common comment we hear is "I wish I had done this sooner!"

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