1206 Somerville Rd
Decatur, AL 35603
The basic goal of reduction mammaplasty is to reduce the weight of the breasts, which will reduce strain on the neck, upper back and shoulders. To do this the breast must be re-shaped at its smaller size. This means a nipple lift will also occur. So a reduction mammaplasty combines making a smaller breast with a nipple lifting procedure. I can only roughly estimate changes in bra size and I don’t make any guarantees about changes in bra size. My goal is to reduce the weight of your breast, meet the insurance requirements for weight removal, but leave you with a breast that matches the size of your body.
During your initial consultation we will discuss all of the aspects of the operation and how it relates to you. We will have a second visit that is the pre-operative visit where I will answer all of your final questions, write the prescriptions for the medicines you will need after the surgery and you will do your pre-operative visit at the hospital.
Most, but not all insurance companies cover reduction mammaplasty. It can also vary by specific insurance contract. The insurance companies require a certain weight of breast tissue be removed to justify the operation. Presently, they require that 500 grams of tissue be removed from each breast. We always send a pre-approval to your insurance company to see if your procedure will be covered. This requires that we send an estimate of the amount to be removed, a history of the problem, a physical examination and pre-operative pictures of you breasts. Your face will not be on the pictures and we process and print all of the photos digitally in the office. It takes 4 to 6 weeks to hear back from the insurance company about you approval. The insurance company will usually send a letter regarding the approval to both our office and you home. Deductibles and co-pays are not covered and are subject to the terms of the patient's insurance contract.
The operation is done as an outpatient procedure or day-surgery at Decatur Morgan Hospital using general anesthesia. It is done in the main operating rooms at Decatur Morgan Hospital and takes just over 3 hours to perform. We do the operation in the morning and you will get discharged to home late in the afternoon or the early evening. You will go home with a drainage tube in each breast to remove postoperative blood and fluid so it does not accumulate in the breast. I discharge you from the hospital with a prescription for narcotic pain medication, an antibiotic and a nausea medication.
All patients are unique and the response to post-operative discomfort is variable. Most patients state that the discomfort feels like tightness and burning in the bottom portion of their breasts. Some patients take the narcotic medicine only for a day or two and then switch to Tylenol for pain. Some patients take a narcotic medicine for 3 or 4 weeks after the surgery. As I said, patients are all unique and their pain tolerance is very different. Almost all patients feel normal by 4 weeks.
For a desk job that does not require any heavy lifting you should expect to be away from work for 2 weeks. Some women have gone back to a desk job in as little a 1-week. For a job that requires physical exertion or heavy lifting you should expect to be away from work for 4 weeks. If there are any small healing problems with your breast we may keep you off of work for an additional 1 to 2 weeks or consider a light duty job if that is available at your job after the 4 weeks period.
You will need to come to the office one or two days after your surgery and you should arrange for someone to drive you to this appointment because you will be sore and on narcotic medications. At this first postoperative check, I will change your dressings and remove your drain tubes. Removing the tubes pinches a little but is not terribly painful. You will go home with a light gauze dressing that you will change every day for 3 days. I do not use any special postoperative surgical bras. You can take a full shower 24 hours after you drains are removed. You will take off your dressings, shower, soapy water will not hurt your incisions, pat yourself dry and replace your light dressings.
Your next appointment will be in approximately 1 week. The next appointment will be in 2 weeks and at that time we will begin discussing issues like returning to work and shopping for a regular bra.
Your next appointment will be in approximately 1 month. After that I will see you again in approximately 6 months. Therefore, I will see you between 8 months and 12 months after your surgery and do a final assessment of your size and shape, assess the quality of your scars and get your final opinion on the surgery.
You can shop for a regular bra once most of the initial post-operative swelling is resolved and there are no wound problems. This is usually 4 to 6 weeks after the surgery. You can wear a very lightweight sports bra or a camisole earlier then this if you discuss it with me in the office. Generally you can resume all of you normal activities, including physical exertion and exercise after 4 weeks. This could be delayed slightly if there are any wound healing problems.
Mammograms should be continued as usual after a reduction mammaplasty if you are at the age where you were getting mammograms. You should wait at least 6 months after a reduction mammaplasty before getting another mammogram to allow postoperative density changes in the breast to soften and resolve.