Reducing the Size of the Female Breast for Medical or Cosmetic Reasons
Breast reduction, or reduction mammaplasty, is a surgical procedure to reduce the size of a woman's breasts. There are many reasons a woman may prefer to have smaller breasts:
Regardless of the reason a woman wishes to have smaller breasts, breast reduction has an extremely high satisfaction rating among our patients. Patients literally feel that a weight has been lifted from them. Women of all ages seek breast reduction surgery, beginning in the teen years and extending well into the 70s.
If you think you might be a good candidate for breast reduction surgery, this page will give you a basic understanding of the procedure and the results you can expect. The cornerstone of Dr. Revis' approach is to individualize treatment to your specific circumstances and goals and to ensure that you have an adequate understanding of the issues involved so that you are able to make a fully informed decision. This will help you achieve the appearance you desire with the least invasive procedure available, thus creating a mutually rewarding experience. Dr. Revis invites you to visit his office for a complimentary consultation to discuss the procedure in greater detail. You are also invited to email Dr. Revis with your questions, or we can mail you more detailed information regarding the procedure.
As you consider plastic surgery, one of the most important decisions you will make is choosing your surgeon. Our pledge to you is to provide the latest, state of the art cosmetic plastic surgery in a safe and professional environment. Dr. Revis is a recognized specialist in the field of cosmetic plastic surgery and is board certified by the American Board of Plastic Surgery, the only plastic surgery board recognized by the American Board of Medical Specialties. He is also an active member of the American Society of Plastic Surgeons and has also been named among "America's Top Surgeons" by the Consumers' Research Council of America.
Our goal is to provide you with the ultimate patient experience. Our well-trained staff will help you understand your procedure, our financial policies, the scheduling of your surgery, and your post-operative care. We are available to assist you during our regular office hours, Monday through Friday. Dr. Revis is also available 24 hours a day to post-surgical patients; he will give you his cell phone number after surgery so that you will always be able to reach him with any questions or concerns you might have during your recovery.
During your initial consultation, Dr. Revis will inquire about your medical history, prior procedures, medications, allergies, and your motivations for seeking plastic surgery. It is very important that you be thorough when providing your medical history, as this information helps to prevent complications during your care. When asked about medications, be sure to include any vitamin or herbal preparations, as these can affect your blood pressure and clotting ability. Honesty regarding your use of tobacco and alcohol is also very important, as these may have a profound impact on your recovery period and your ability to heal following your procedure.
After reviewing your medical history, Dr. Revis will discuss your concerns, priorities and motivations for pursuing plastic surgery, as well as your fears. After examining you, Dr. Revis will be able to offer advice and options to help you achieve the appearance you desire. He will also explain the advantages and disadvantages of the different options you have before you.
At the completion of your consultation, you will also have the option to schedule your procedure if you so choose. The decision to undergo surgery is a very important one, and the final decision should be given very careful consideration. You are also encouraged to bring your spouse, significant other, family member, or a friend to your consultation.
Where Your Procedure Will Be Performed
Dr. Revis has been granted staff privileges at our local hospitals and outpatient surgery centers. In the interest of the safety of his patients, he only performs surgery in fully accredited facilities with the proper services and staff. Dr. Revis usually performs breast reduction surgery at Broward General Medical Center or Imperial Point Medical Center (both fully accredited hospitals) or the Imperial Point Surgery Center (a fully accredited ambulatory surgery center). The staff of these facilities are very experienced in the care of plastic surgery patients in general and specifically in the care of Dr. Revis' patients.
Types of Anesthesia
Anesthesia is an essential part of any surgical procedure and must be performed safely. General anesthesia is the deepest form of anesthesia. You are asleep, feel no pain, and will not remember the procedure. This form of anesthesia is usually not required for breast reduction unless the patient specifically requests general anesthesia.
Intravenous sedation, called twilight sleep, is a combination of local anesthetic administered at the surgical site by Dr. Revis and intravenous sedation administered by the anesthesiologist. You breathe for yourself, but you are in a deep sleep throughout the procedure. You should feel no pain, and you will not remember the procedure.
An intermediate form of anesthesia, the laryngeal mask airway (LMA), is a relatively new technique. This technique is similar to twilight sleep in that you are breathing on your own, but the method of sedation differs. With an LMA, you actually breathe anesthetic gases administered by the anesthesiologist, rather than receive intravenous sedation via your intravenous line. These anesthetic gases cause you to sleep during the procedure. At the completion of the procedure, the gases are turned off and you wake up from your sleep. You will feel no pain, and you will not remember the procedure. This is the most common type of anesthesia used by Dr. Revis because he feels that the effects of this type of anesthesia leave your body the fastest, allowing you to feel better faster with very little likelihood of post-operative nausea.
The prevention of post-operative nausea and vomiting is also a focus of Dr. Revis' approach to breast reduction surgery. To improve your overall experience and ensure you feel better faster following your reduction, he has developed a technique that has resulted in a very low incidence of post-operative nausea and vomiting. You will be given an intravenous dose of Zofran at the beginning of your operation. Zofran is a new drug which is currently the best medication available to prevent nausea and vomiting. Dr. Revis feels it is a very important component of his overall approach to make sure that your experience is as pleasant as possible.
Dr. Revis will discuss all of these options with you more thoroughly at the time of your consultation, and please ask him about anything you do not understand.
Details of the Procedure
Breast reduction usually takes four to five hours to perform. After you have changed into a gown and had your intravenous line started, you will be given a dose of intravenous antibiotics as a precautionary measure. Dr. Revis will use a surgical marking pen in the preoperative holding area to identify certain landmarks on your chest. This ensures proper reduction and symmetry post-operatively. He will also review the entire operative plan with you including incision location and reduction size.
After you are properly anesthetized in the operating room, Dr. Revis will inject a solution of local anesthetics along the borders of the breasts, and underneath the intended incision site(s). This injection solution consists of a special combination of lidocaine (xylocaine), marcaine (sensorcaine, bupivicaine) and epinephrine. This accomplishes several objectives. First, the epinephrine causes vasoconstriction of the area, reducing your potential for bleeding and bruising. Secondly, the lidocaine provides a rapid numbing of the area. Although you are asleep, this prevents the brain from registering any pain from the region during the operation. Studies have shown that this so-called preemptive analgesia actually decreases your sensation of pain post-operatively, decreases the amount and length of time you will need to take pain medication post-operatively, and also leads to a more rapid return to normal daily activities. Finally, the marcaine component of this local anesthetic mixture is a long-acting local anesthetic. This actually prolongs the numbness of the area, making you more comfortable following surgery and delaying the time at which you will begin to need any pain medications.
After allowing time for the local anesthetic mixture to take effect, Dr. Revis will make the incisions necessary for your procedure. After performing the reduction, the incisions are carefully closed with absorbable sutures to minimize your scar. A sterile dressing is applied to the incisions, and a soft surgical bra is placed over your breasts. Dr. Revis uses a technique in which all of the sutures are placed beneath the skin and are absorbed by your body. Not having to undergo suture removal has improved patient comfort and satisfaction.
Products to Help You Heal
SinEcch Arnica Montana is a natural product from Sweden which has been shown in clinical studies to reduce post-operative bruising and swelling. Begun the evening prior to surgery, this product is continued for four days post-operatively.
Scarguard MD A combination of hydrocortisone, silicone and Vitamin E, this product is painted on your scars topically like nail polish beginning three weeks after surgery, and it helps your scars fade so that they fade as much as possible.
These products are available for purchase in our office. Please ask us about these products and others if you have any further questions about whether or not these would be beneficial for you during your healing period.
After Your Procedure
Most patients spend one night in the hospital following breast reduction, particularly if you live alone or if you live out of town. Occasionally patients go home the same day of surgery, but this is the exception rather than the rule. We also have a private duty nurse available to care for you in the comfort and privacy of your own home if you so choose.
The following morning, Dr. Revis will remove your post-operative dressing. Drains placed at the time of surgery will be removed by Dr. Revis within a few days of the surgery.
When you wake up from your procedure, you will be in the recovery room and will be wearing a soft surgical bra or sports bra. You may remove this bra on the second day following surgery and begin showering daily. You should wash your surgical bra daily while you are bathing. After showering, simply pat your incisions dry and replace your surgical bra.
The antibiotics that were prescribed during your preoperative visit (usually Augmentin) should be taken twice daily beginning on the evening prior to surgery. Continue this medication for five days post-operatively or until it is gone. The pain medication prescribed by Dr. Revis during your preoperative visit (usually Lortab or Vicodin) should be taken fairly regularly, every four hours or so, during the first 24 hours (when you are not asleep, of course). Most patients find that they are able to transition to Tylenol after three or four days. It is not safe to drive a car within 24 hours of taking pain medication, as your reflexes and alertness may be altered. Dr. Revis may prescribe a muscle relaxant (usually Flexeril) for you if he suspects that your muscles may be tight and uncomfortable following surgery. If so, you may take one tablet every eight hours if needed for muscle tightness.
You should plan to take it easy following your breast lift. No strenuous activities, heavy lifting (over 20 pounds), aerobic exercises, swimming, contact sports, tennis, or golf should be planned for the first several weeks. As Dr. Revis monitors your recovery, he will advise you when it is safe to resume specific activities.
The Results You Can Expect
After your surgery, you will notice the change immediately. You may find that your back, neck or shoulder pain improves or even disappears. Many women find that they are able to wear a wider variety of fashions and are more comfortable socially.
Please call (954) 630-2009 or send an email to Dr. Revis for further information.
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