The 3 Rs of large breasts

Reduce, Relieve, Return to life

For many years, women have suffered agonizing pain because of large breasts. They often have sought help through their physicians -- trying exercises and physical therapy -- looking for ways to relieve these symptoms. Most patients suffer neck, shoulder and upper back pain and discomfort. Large breasts also can aggravate ongoing orthopedic problems. They can create notches in the shoulders from bra straps and chest wall discomfort with an occasional rash beneath the breasts, especially during warm weather months. Patients say it is like wearing a sack of flour around the neck, and all these problems prohibit the ability to exercise and maintain a healthier lifestyle.

Breast reduction is a common procedure performed by a plastic surgeon and is used to improve these symptoms. The procedure takes about three hours to perform and about an hour in recovery. It is done with general anesthesia, and breast reduction patients are probably the most thankful that I have experienced in my more than 20 years in practice. They all say they cannot believe that they did not have a reduction 10, 20 or 30 years ago. Patients can feel this difference in weight reduction almost immediately after surgery, and I have had them tell me this in the recovery room.

This is an outpatient procedure and really is not painful, but most women experience some discomfort, which is well-controlled with medication. Patients are given pain and nausea medications and antibiotics. A soft bulky dressing or sports bra is worn after surgery. The sutures are in place for 10-14 days, and most patients shower daily and return to work in five to seven days wearing a supportive sports bra.

Most insurance companies cover the costs of this procedure as long as the patient qualifies according to the symptoms and certain guidelines for the amount of weight in breast tissue to be removed. The patient’s height and weight are entered into a formula to calculate the body surface area. A sliding scale dials in the weight in grams to be removed according to that body surface area. This tissue always is sent for examination by pathology. Preoperatively, a mammogram is encouraged if the patient fits the typical age and history requirements. Some insurance policies require therapy prior to surgery and may delay approval, so the patient must get the process of insurance approval in motion with a history, physical examination and letter to the insurance company. General weight loss usually is not required, and does not make a significant difference.

The reduction in the weight of the breasts and lifting the breasts into a higher position give much relief. The patient feels almost immediate relief of symptoms, and thus promotes a healthier and more-active lifestyle. This allows the patient to increase his or her activity level with exercise and recreational measures to help with weight loss.

Breast reduction is an excellent procedure that many patients may not be aware is available to them for relief of lifelong symptoms caused by heavily weighted breasts.

Dr. Dean Kleto is on the courtesy staff at Blount Memorial Hospital. He is board-certified in plastic and reconstructive surgery by the American Board of Plastic Surgery.

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