DEAR MAYO CLINIC: I've had back and neck pain for years that I can attribute to large breasts. I'm 27 and in good health. Is breast reduction surgery a safe option? What are the risks?
ANSWER: Breast reduction surgery is a safe and effective procedure for relieving neck and back muscle pain, as well as other problems that can be caused by large breasts. As with all surgery, there's some risk involved with breast reduction. But in the hands of an experienced surgeon, those risks typically are low.
During breast reduction surgery, extra tissue and skin are removed from the breasts. The specific technique used for the surgery may vary somewhat, depending on your surgeon. Generally, though, the surgeon makes an incision around the areola (the dark skin that surrounds the nipple) and down the breast. The excess breast tissue, fat and skin are then removed to reduce the size of each breast.
In most cases, the nipple and areola remain attached to preserve their blood supply and feeling in the nipple. In some cases, though, the nipple and areola might need to be removed and reattached at a higher position on the breast as a skin graft. This makes the nipple numb after surgery.
To be a good candidate for breast reduction surgery, you need to be in good health and be able to tolerate general anesthesia. You also need to have enough breast tissue left over after the procedure to be able to have it reshaped into a smaller breast that will fit your weight and frame.
In most cases, it is recommended that teenagers wait until their breasts finish developing before having breast reduction. If symptoms make day-to-day tasks difficult or interfere with a teen's quality of life, however, breast reduction may be possible before a girl is done growing.
Breast reduction surgery often effectively relieves chronic back pain, neck muscle spasms and shoulder pain due to large breasts. Other common benefits include better posture, improved breast appearance and less skin irritation under the breasts. In addition, research has shown that breast reduction surgery lowers a woman's risk of breast cancer, usually by about 60 percent.
Some of the risks of breast reduction surgery are the same as any surgery: infection, bleeding, wounds and blood clots. You may have numbness in the nipples and areolae after the surgery. You will have permanent scarring on both the inside and the outside of your breasts. The scars fade over time, but they never go away. If you've developed deep shoulder grooves due to bra strap pressure, those grooves will likely remain after surgery, but the pressure will be lessened.
In some cases, breast reduction surgery may make it hard to breastfeed. But that often depends on the surgical technique used. If you would like to breastfeed in the future, talk to your surgeon about the technique he or she uses and the likelihood that it may interfere with breastfeeding.
Although you may have some pain after surgery, it usually does not last long and often can be effectively controlled with pain medication. Recovery after surgery usually takes several weeks. Many people can go back to work in an office setting after about two weeks. For jobs that involve lifting or other physical activity, it may be about four weeks before returning to work is possible.
As you decide whether breast reduction surgery is right for you, talk to your surgeon about your individual needs and expectations. Ask if there are specific risks for your situation that you need to be aware of. If you have any questions or concerns, make sure they are thoroughly addressed before you have surgery. -- Nho Tran, M.D., Plastic Surgery, Mayo Clinic, Rochester, Minn.
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