Breast reduction is surgery that removes fat and/or glandular tissue to reduce size and reshape a woman’s breasts. While it is most often performed on women who have overly large, pendulous breasts-a condition called macromastia-some women choose breast reduction simply to bring better proportion to the female figure. Don’t mistake breast reduction as a procedure for women who are overweight. Breast size is primarily determined by heredity, but can be influenced by a woman’s weight.While engaging in a healthy and active lifestyle may be difficult if you have overly large breasts, women who are significantly overweight may likely be advised to first achieve a healthy, stable weight, and then undergo breast reduction. The reason is simple: As weight fluctuates, so too will your breast size fluctuate. Having breast surgery when you are at a stable weight is likely to produce results that are stable as well. In addition to the influences of weight on breast size, pregnancy and hormonal changes also may influence breast size. Some women develop larger breasts during pregnancy that remain large post-partum (after the baby is born), and this is as normal an occurrence as other women who lose breast volume post-partum. Some women experience hormonal changes in life that result in significant changes in breast size, and this may not be a normal occurrence. If you have had a sudden change in breast size without having changes in weight or a recent pregnancy, it is best to first have a complete health evaluation with your primary provider to ensure that breast size is not related to an illness or hormonal imbalance.
Only you can determine if you want to make your breasts smaller. This is a very important decision in your life, and requires research, consultation with a board-certified cosmetic surgeon, and a great deal of personal thought. Research indicates that women who do choose breast reduction are immensely satisfied by the experience, and that following breast reduction a woman’s quality of life is greatly improved. If you ever desired smaller breasts, or felt that your breast size has negatively influenced your self-esteem or quality of life, take the time to answer these statements with a simple "yes" or "no":
If you answer "yes" to any of these questions, take a little more time to detail your answer or experience. Then you may wish to discuss your concerns with your personal physician first, but certainly take the time to consult with a board-certified cosmetic surgeon. Cosmetic surgeons are the only surgical specialists with training specific to changing the size, shape, and proportion of a woman’s breasts, and this specifically includes breast reduction. The American Society of Cosmetic Surgeons conducted a study funded by the Cosmetic Surgery Educational Foundation called BRAVO (breast reduction assessment and value outcomes) in 1999 to help measure the effectiveness and patient satisfaction of breast reduction surgery. The study specifically addressed women with macromastia, a D-cup or larger, who underwent breast reduction. Evidence showed that breast reduction patients experienced health-related, quality-of-life improvements following surgery, including a significant reduction of physical pain, and a boost in selfesteem and physical activity.
Pain in the back, neck, shoulder, arms, or breasts is a common symptom of macromastia, but women don’t always make the connection to these symptoms and their breast size. However, large pendulous breasts can cause stress on the back, neck, and shoulder muscles that keep a woman upright and support the weight of her breasts. For this reason, it is often advised that a woman with large breasts work actively to keep her back strong and healthy. But breast size can in fact hinder a woman’s ability to engage in many forms of exercise. In addition, the strain on bra straps can cut into the shoulders, causing deep grooves and sometimes even bruising. Over time, this can affect the thoracic outlet, a nerve center running through the neck and shoulder. Thoracic outlet syndrome commonly presents as numbness and tingling in the fingers, weakness in the arms, and, literally, a pain in the neck. There is no standard for what size breast causes pain of any kind or severity, just as there is no standard for the size, shape, and physical condition of all women. A very small-framed woman may experience pain from a much smaller breast size than a woman with a larger frame, broader shoulders, or stronger stance.
Equally, a very large-framed woman with a weak back or other overriding conditions such as arthritis or scoliosis may suffer immense pain from her breasts, where a healthy woman of similar size may have few, if any, symptoms of pain. If you have overly large breasts, or a breast size that you feel self-conscious about, breast reduction is equally as appropriate in your case as in the case of a woman who experiences significant pain. However, while breast reduction is considered a reconstructive procedure-one to restore a more normal appearance and to improve a physical condition and a woman’s health and quality of life-in those cases where it is simply your desire to reduce breast size, the procedure may be considered aesthetic, simply to enhance your goals for your appearance.
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