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Breast Reduction Surgery in our Miami office
Choosing the right surgeon for your breast reduction surgery is crucial to the overall success of the procedure. Dr. Tal Roudner in Miami specializes in breast reduction, and his patients love him not just for his results, but also for his compassionate and understanding nature.
Breast Reduction also known as Reduction Mammaplasty is a surgical procedure that reshapes and lifts the breast while reducing the size of breasts by excising skin, fatty and glandular breast tissue.
According to the American Society of Plastic Surgeons, in their reconstructive national data bank statistic reports of 2014, breast reduction surgery was performed in 101,192 patients that year. That is a 2.4% decrease from 2013.
Dr. Roudner’s surgical goal is to revive the youthful appearance of the breast by restoring the shape, fullness and projection of the breast while minimizing visible scars.
Dr. Roudner may perform a series of different procedures while reducing the breast tissue such as: removing and repositioning the skin and soft tissue as well as repositioning the areola and nipple. He may perform the breast reduction surgery alone, or in combination with liposuction ( SAL -suction assisted lipectomy).
To discuss whether a breast reduction surgery is right for you, please call our Miami office at 305-767-7719 and schedule your breast reduction consultation with Dr. Tal Roudner.
Breast Reduction Surgery in our Miami office
Breast reduction surgery may alleviate the discomfort and health concerns caused by overly large, sagging breasts, a condition known as macromastia. Chronic head, neck, back and shoulder pain along with circulation and respiratory difficulties are just some of the problems encountered by women with this condition. Skin problems are also common. The weight of the breasts causes the bra strap to dig into the skin and cut or abrade it, which can lead to scarring and bacterial infections. Other bacterial and fungal infections (intertrigo) can develop within the skin folds beneath the breast.
Although not all women suffer from the physical discomfort described above, a number of women feel self-conscious with the size of their breasts in proportion to the rest of their smaller body frame and proceed with breast reduction surgery for aesthetic reasons.
The procedure is usually deferred till after puberty when the breasts are fully developed unless the patient suffers from juvenile gigantomastia also known as virginal breast hypertrophy (sever enlargement of the breast due to sensitivity of the breast to circulating hormones). The procedure is not typically recommended for women who desire to breastfeed due to the possibility of inability to breastfeed after the surgery, although many women that have undergone reduction mammaplasty were able to breastfeed after the procedure.
Your Breast Reduction Consultation at Our Miami Office
When you call our Miami office, you will be scheduled for a consultation with Miami surgeon Dr. Roudner. This initial appointment, which takes place at our Miami office, is very important. You will have the opportunity to discuss your concerns and your goals for your reduction with Dr. Roudner and learn what we can do to help you.
Miami plastic surgeon Dr. Roudner will perform a thorough examination and review your current health as well as your health history. He will also take photographs and measure your breasts. After discussing the benefits and risks of reduction surgery with you, he will make his recommendations.
If you and Dr. Roudner agree that breast reduction surgery is the best option, your reduction surgery will be scheduled. Most reduction surgeries performed by Dr. Roudner are done here at our Miami surgical suite. In some cases, it may be necessary to perform your reduction surgery at one of Miami’s local hospitals. Dr. Roudner will discuss this decision with you.
You will also be scheduled for your preoperative appointment, which takes place here at our Miami office about two weeks prior to your reduction surgery. Before this appointment at our Miami office, you will need to obtain a mammogram and, if you smoke, quit. We require our surgical patients to stop smoking at least four weeks prior to surgery and for at least three weeks following surgery although ideally, you would not start again. If you need assistance quitting, please let us know.
To learn more about breast reduction and whether it is right for you, please call our Miami office at 305-767-7719 to schedule a breast reduction consultation with Miami plastic surgeon Dr. Tal Roudner.
Prepping for Breast Reduction Surgery at our Miami office
In the weeks leading up to your reduction surgery, eat a healthy diet and get plenty of exercise. Your overall health is a good indicator as to how your body will respond and heal following your breast reduction. Avoid alcoholic beverages for a few days before your breast reduction.
The day before your breast reduction, avoid strenuous exercise. Before you go to bed, take a shower and clean your chest according to Dr. Roudner’s instructions. Following your shower, do not apply anything to your skin, including deodorant, perfume, lotions and creams, unless Dr. Roudner has instructed you to do so.
The night before your reduction, do not eat food or drink any liquids, even water, past midnight. When brushing your teeth, avoid swallowing more than a small sip of water. If you are taking any medication the day of your reduction, use the smallest amount of water possible to swallow your medication.
When getting dressed on the morning of your breast reduction, wear clothes that are easy to get in and out of and choose a top that opens in the front. Wear comfortable, flat shoes. These precautions are to make it easier for you to get dressed and walk following your reduction when you are likely to still be affected by the anesthesia.
You must arrive at our Miami office accompanied by a friend or family member who will remain at our Miami office during your breast reduction and drive you home following your surgery. This person should also be able to stay with you for at least 24 hours following your breast reduction as you are likely to need assistance caring for yourself. Ideally, this person should be able to stay with you for at least three days.
Please make arrangements for someone to watch your children or pets and to take care of other important responsibilities. Your primary focus in the days following your reduction should be relaxing and giving your body the time it needs to heal.
What to expect from Breast Reduction Surgery
Breast reduction surgery should improve the appearance of the breasts as well as improve the overall quality of life. Health and emotional problems may be improved or resolved after the surgery. Patient’s complaining of back and neck pain may notice improvement or complete resolution. Neurological symptoms as pain or numbness in the hands may resolve. Consistent rashes under the breasts may resolve without medications. Shoulder grooving from the bra straps may disappear.
The excess weight of the breast tissue is removed during surgery may improve the ability to lead an active life and take part in physical activities that were prohibited by the excess weight in the past.
Large pendulous breasts may have a negative psychological and emotional effect in addition to physical discomfort and pain, those are improved in majority of the cases after surgery.
After surgery the patient should notice a better breast size to body proportion with alleviation of discomfort associated with large breast (most cases).
Anesthesia used during Breast Reduction Surgery
Dr. Roudner performs breast reductions while the patient is under general anesthesia. In select cases were the reduction is small twilight sedation with local anesthesia may be used.
Length of time needed for Breast Reduction Surgery
Breast reduction surgery may take between 2 to 4 hours depending on the size of the planned reduction and the technique used as.
Your Breast Reduction Surgery
The incisions and exact procedure used by Miami surgeon Dr. Roudner during your breast reduction will vary depending on the size and shape of your breasts currently, the size and shape you are hoping to achieve, the placement and size of your nipples and areola, and more. Many breast reductions use an incision that runs under the breast, another that runs up from the underside of the breast to the areola, and then around the areola. It may also be necessary to create a new place for the areola so that it is positioned properly following your breast reduction.
Excess fat and breast tissue will be removed, and extra skin will be trimmed away. Your tissue will be positioned with internal dissolving sutures, and when everything is positioned correctly, your incisions will be closed with sutures.
Breast Reduction Surgery – Post Surgery
It is crucial to follow the post-operative instructions as given prior to surgery and during follow up appointments. The period after surgery should be for rest and recovery. Avoiding excessive forces and motion as well as abrading the surgical incisions will optimize the ability of the incisions to heal and minimize the chances of wound break down resulting in unsightly scaring. A supportive bra will aid in this healing phase and should be used as instructed. Feel free to contact Dr. Roudner’s office if any questions arise during the post-operative period.
Recovery time needed after Breast Reduction Surgery
Dr. Roudner requires the patient to take a week off for rest after the breast reduction procedure. While it may take a few weeks for initial recovery and six weeks to return to full normal activity, it takes from six months to a year for the body to completely adjust to the new breast size and to obtain the final results.
You will notice immediately the difference in weight and breast size following your breast reduction. Your breasts will be tightly bandaged when you leave our Miami office. While it will take time for the swelling to recede and for your breasts to settle into their new shape, you will find immediate relief from the problems that were troubling you prior to breast reduction.
Pain and discomfort are to be expected following your breast reduction. Take the medications prescribed by Dr. Roudner to help with the pain. Clean your incisions as directed to prevent infection from developing. You will have several follow-up appointment scheduled at our Miami office. These follow-ups are very important and allow Dr. Roudner the opportunity to check how you are healing and monitor you for any complications.
Additional information regarding Breast Reduction Surgery
It is important to know that breast reduction surgery is best performed after full maturity unless medically necessary at adolescence. Pregnancy as well as weight loss or gain may alter the results of previous breast reduction surgery. Although careful planning and good surgical technique is executed during surgery the exact size of the breast after surgery may differ from the one originally planned as surgery is not an exact science. Secondary surgery may be needed to correct those results.
Some of the risks and complications associated with breast reduction surgery include the common ones as for any surgery namely bleeding (hematoma), seroma, infection, unsightly scars, blood clots (Deep vein thrombosis), poor wound healing, swelling, bruising, pain, skin pigmentation, injury to nerves, blood vessels, lungs, muscles, allergic reaction to the sutures or tape risk of anesthesia (cardiac and pulmonary complications).
Risks and complications that are specific to breast reduction include contour or shape irregularities, changes to nipple sensation that are temporary or permanent, breast asymmetries, fat necrosis, nipple lose, firmness of the breast, inability or reduced ability to breastfeed. Some of these complications may lead to the need of revisional surgery.
It is imperative to let Dr. Roudner know immediately if you experience any of the following symptoms after surgery such as chest pain, heart palpitations, high fever severe pain or shortness of breath.
If any of these complications occur after surgery further treatment and hospitalization may be required.
It is crucial to follow the post-operative instructions as given prior to surgery and during follow up appointments to minimize the risks and complications and to achieve the best possible outcome.
What is Breast Reduction Surgery?
Breast reduction surgery alleviates the discomfort and health concerns caused by overly large, sagging breasts, a condition known as macromastia. Chronic head, neck, back and shoulder pain along with circulation and respiratory difficulties are just some of the problems encountered by women with this condition. Skin problems are also common. The weight of the breasts causes the bra strap to dig into the skin and cut or abrade it, which can lead to scarring and bacterial infections. Other bacterial and fungal infections can develop on the skin in the folds beneath the breast.
For women who suffer from these conditions, a breast reduction is not considered to be cosmetic in nature, and most insurance providers will cover breast reduction surgery. If you are not suffering from these complications of overly large breasts but feel self-conscious and uncomfortable with the size of your breasts, breast reduction is still an option.
Techniques used during Breast Reduction Surgery
Breast reduction surgery is performed after careful analysis and markings of the breasts are made relating to the ideal incisions for the specific case in order to excise the excess glandular breast tissue, fat and skin. Liposuction may be added to remove excess fat most commonly in the lateral part of the breasts. In cases of excess fat with minimal to no skin excess, liposuction may be used as the only method in breast reduction surgery.
Many different techniques exist for reducing the breast such as the very popular keyhole incision (wise pattern) with an inferior pedical technique and others such as vertical incision with a superior or medial pedical, central mound and many more. The technique used depends on each individuals breast size, excess breast tissue, skin, fat, reduction desired and surgeons preference.
Incisions Types – Breast Reduction Surgery
- Circular pattern around the areola
- Keyhole pattern around the areola and a vertical down to the breast crease
- Inverted t also known as anchor (wise pattern) incision
After the incisions are made the appropriate amount of skin, fat and glandular breast tissue are removed. Careful attention is made to keep a pedical of tissue attached to the nipple areolar complex that maintains adequate blood supply essential for nipple areolar complex survival. In rare cases with long pendulous breasts where there is concern for twisting of the pedical or borderline blood supply to the nipple areolar complex. The nipple areolar complex may be excised and transferred to its new location as a free nipple graft.
The remaining breast tissue is brought together and closed in layers (extended support) lifting and shaping the newly formed breast. The incisions are then closed with sutures and skin adhesives and/or surgical tape.
The incisions form into permanent scars that fade over time. In some cases treatments such as topical silicone, steroid injections or laser treatments may be needed to improve on unsightly scars.
Reasons for Breast Reduction Surgery
Breast reduction surgery should be done to fulfill your own desires and ideal self image and not for some one’s else. Breast reduction surgery is done to improve on the breast shape, fullness, projection and to remove excess glandular breast tissue, fat and skin as well as to improve symptoms caused by enlarged breasts.
What can Breast Reduction Surgery do for me?
Revive the youthful appearance of the breast by restoring the shape, fullness and projection of the breast while minimizing visible scars. Improve or eliminate symptoms of pain, rashes, shoulder grooving and numbness of the hands and fingers. 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.
What anesthesia is recommended for Breast Reduction Surgery?
Majority of the cases are performed under general anesthesia. In some select cases when the reduction is small twilight sedation with local anesthesia may be used.
Who is a good candidate for Breast Reduction Surgery?
Breast reduction surgery is applicable surgery for healthy individuals with realistic expectations that feel that their breast are too large and may have physical limitations due to the size of their breasts. Individuals that experience neck, back or shoulder pain as well as numbness, tingling of the hands and fingers, suffer from recurrent rashes under their breasts and indentations from their bra straps from supporting the heavy pendulous breasts should consider breast reduction surgery to improve those conditions. The patients should be non smokers or stop smoking at least 4 weeks prior to surgery.
In most cases, a breast reduction should be performed once the breasts have fully developed. Some conditions, however, would justify a breast reduction being performed earlier including virginal breast hypertrophy, a condition in which the breast responds to hormonal signals by becoming severely enlarged.
If you are interested in a breast reduction, it’s important to consider whether you plan to breastfeed. While many women are able to successfully breastfeed following breast reduction, in some cases it is no longer possible. Loss of the ability to breastfeed is a risk of breast reduction surgery. This is a personal decision and one which each woman will have to make on her own according to her needs and goals.
How should I prepare for Breast Reduction Surgery?
Patients undergoing breast reduction procedure are seen in the office at time of consultation Dr. Roudner will discuss in details the procedure and where your procedure will be performed. Dr Roudner will evaluate overall health and physical condition as well as access any conditions or risk factors. He will examine your breasts for size, shape, nipple areolar size and position, skin quality as well as take detailed measurements. He will then present the options available and his recommendations for treatment as well as the risks, benefits as well as complications possible. The surgery may be performed at Dr. Roudner’s fully accredited office-based surgical center or at an outpatient/ambulatory surgical center, or a hospital.
Two weeks prior to surgery the patient will be seen for a pre-op appointment. At the time of the pre-operative visit the necessary blood work and other needed tests are performed, consents are reviewed and signed, instructions on what to do on the day of surgery and post-operative care and follow-up are given and medical clearance is obtained as necessary. Pre-op photos are taken. Patients that smoke are required to stop smoking 4 weeks before the procedure and for 3 weeks after the surgery (preferably will not return to smoking). It is important to inform Dr. Roudner if you smoke at the initial consultation. Nicotine testing is conducted by urine test the day of surgery.
Patients preparing to undergo breast reduction procedure will need to obtain a mammogram prior to surgery and a follow up mammogram after surgery to help detect any abnormalities prior to the reduction and a baseline after the surgery to detect any future changes in the breast tissue. Any history of breast cancer or family history of breast cancer should be noted at time of consultation as well as results of any mammograms or previous breast surgery or breast biopsies.
Patients medications will be evaluated prior to surgery and the appropriate adjustments made if needed in coordination with the patients primary care physician. Medications (aspirin, ibuprofen, etc) supplements and herbs can cause bleeding problems during the surgery and post surgery. Therefore a list of any medication, supplements or herbs that should not be taken a few weeks before the procedure is given at the time of the consultation.
Prior to surgery it is important to eat a healthy diet and avoid drinking alcohol a few days prior to the procedure. Exercise and being in good shape prior to surgery is generally good for the patient’s overall health and a speedy recovery; however, day prior to the breast reduction procedure patient’s should avoid strenuous exercise.
Patient’s should not eat or drink anything, including water, after midnight the night before surgery. The patient’s should shower the night prior to the surgery and wash the surgical site with antimicrobial soap. After the shower the patient’s should avoid wearing any products such as: oils, creams, makeup, moisturizers, or lotions — including deodorant.
Removing any nail polish from at least one fingernail and toenail will be helpful for the anesthesia person in order to monitor the blood circulation during the procedure using a pulse-oxy-meter.
The morning of the surgery the patient’s may brush their teeth, but should not swallow more than a sip of water. If instructed by the primer care physician, patient’s may take any needed prescribed medication with sipping a minimal amount of water.
On the day of surgery the patient should wear loose-fitting clothes that open in the front and comfortable flat shoes that are easy to put on.
When the procedure is performed as an outpatient procedure arrangements for transportation of the patient to and from the procedure as well as a someone to stay with the patient for the first 24 hours after surgery should be made in advance.
Care for small children, should be arranged prior to the surgery as well as preparation of extra food and drinks. Responsibilities at home and at work should be taken care of prior to surgery in order to have worry-free and relaxing recover.
Prescription medications may be filled at the time of surgery by the person accompanying the patient to surgery or a in advance prior to the day of surgery.
How long will I need to recover from Breast Reduction Surgery?
After surgery is complete dressings or bandages will be applied to the incisions, as well as a support bra to give support and minimize swelling as the breasts are healing. In rare cases a drain may be placed until the drainage decreases to eliminate excess blood and fluid that may collect. External stitch’s will be removed at day 7 and 10. You will need a week to ten days of rest right after surgery. At 4 weeks gradual return to mild to moderate exercise and at 6 weeks you will resume normal activity.
Is the recovery process after Breast Reduction Surgery painful?
Most patients experience pain and discomfort that is moderate to severe in the first 3 days to a week although some have minimal pain. As healing progresses and you become more active the pain will appear as you over exert yourself at that time you should stop the activity and rest. By 6 weeks rarely do people complain of pain but may have some discomfort.
Your Breast Reduction Preoperative Appointment at Our Miami Office
At your preoperative appointment at our Miami office, Miami plastic surgeon Dr. Tal Roudner will review your current medications. He may make changes to your doses or discontinue some medications that could be contraindicated during reduction surgery. Some medications, herbs and supplements increase the risk of bleeding or other complications, and Miami surgeon Dr. Roudner will discuss these with you.
Dr. Roudner will also give you specific instructions for self-care before and after your reduction surgery. These instructions should be followed carefully as they will affect your healing time and comfort. Not following these instructions could lead to complications and increased healing time.
Dr. Tal Roudner provides consultations for all patients, simply contact our Miami office to reserve your breast reduction surgery consult with Dr. Tal. As a Board Certified Plastic Surgeon, Dr. Tal is an expert in breast reduction and enhancement surgeries.