Breast Reduction Options

Dr. John Q. Cook provides an individualized solution for each breast reduction patient.
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John Q. Cook, M.D.

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A Customized Solution for Each Patient

Each breast reduction patient in our practice spends considerable time with Dr. Cook in order to design an individualized plan for breast reduction surgery. This plan takes into account the patient’s current breast structure, her goals, her available time for recovery, and her pattern of activity.

Structural Breast Reduction

For patients with moderate degrees of breast enlargement, the structural reduction technique offers several advantages. All properly-performed breast reductions involve a breast lift as well; otherwise the result would be a smaller sagging breast. For some breast reduction techniques, the lifting part of the operation simply involves a tightening of the skin by removing a section of skin excess and sewing the skin back together. For some patients the skin may stretch out rather quickly, so that the breast “bottoms out.” With the structural technique, the breast is anchored at multiple levels, so that it is better supported than with a skin lift technique. Another problem that may occur with conventional breast reduction surgery is that the upper portion of the breast may look hollow, even after the surgery has been carried out. With the structural technique, it is possible to shift a portion of the breast tissue into the upper portions of the breast. This has two benefits. It provides a pleasing fullness in the upper breast. It also is part of the deep structural anchoring that holds the breast in proper position. The structural reduction technique also avoids the scars along the inner portion of the fold under the breast, which is the area most likely to be exposed in swim suits and evening gowns. Structural breast reduction has several advantages, but it is not the solution for all patients seeking breast reduction. Dr. Cook will help you decide during your consultation if structural reduction is suited for your breasts and your goals.

Classical Breast Reduction

Like the structural reduction this technique produces a scar around the areola and from the areola to the fold under the breast.  There is also a scar that runs along the fold under the breast (the inframammary fold in the language of plastic surgery).  This technique is well-suited to very large breasts that have a large amount of settling.  Often this breast shape has a great amount of excess skin in the lower curvature of the breast which may not respond ideally to more limited scar techniques.  This technique allows for a precise sculpting of excess breast tissue from the areas of greatest concern to the patient.  It is also well-suited to patients with asymmetric hypertrophy, in which one breast is considerably larger than the other.

Vertical Breast Reduction

This technique was pioneered by surgeons in Europe and South America and is becoming more popular in the United States. With this technique the patient has scars that follow the border of the areola, and extend from the bottom of the areola to the bottom of the breast. There is a gathering of skin at the bottom that can be addressed in several ways. In Dr. Cook’s practice the vertical reduction has been replaced by the structural reduction technique. The structural technique has several important advantages over vertical reduction techniques. These differences will be explained during your consultation.

Periareolar Breast Reduction

This technique finds a greater range of applications for mastopexy or pure breast lift procedures than for breast reduction.  The only scar is one that follows the areolar border.  This technique can be helpful for patients who desire a modest degree of reduction and do not require an aggressive breast lift.

Breast Reduction Surgery Combined with Implants

At first glance this procedure might seem to be a contradiction.  There are some patients where a reduction of breast tissue is combined with the placement of a breast implant.  Particularly in patients who have lost significant weight, the breasts may be severely settled and completely emptied out in their upper portions.  Even the most powerful techniques of breast reduction may leave these breasts with an undesirable hollowness in their upper portions.  A properly placed saline or silicone gel implant can help to restore a pleasing balance to breast form.

Breast Reduction Surgery for Men

Enlarged breasts do not only afflict women – the condition also affects many men and can be the source of significant self-consciousness.  Dr. Cook offers male breast reduction surgery to help men who suffer from gynecomastia, the medical term for excess fatty or glandular tissue in the male chest area.  Often beginning in adolescence, gynecomastia is more common than most people realize.  In severe cases it can lead to a lack of self-confidence and cause the patient to avoid circumstances that would draw attention to his chest, such as going to the beach or swimming. A variety of techniques are available. Dr. Cook makes the specific selection based upon the degree of loose skin and the relative amounts of glandular and fatty enlargement.  In many cases, the surgery can be accomplished entirely with laser lipoplasty (I.e., Smartlipo® or Slimlipo® technology) or with Vaser® lipoplasty, an advanced form of ultrasonic liposuction.  If this is the case, the only scars are tiny incisions in discreet locations.

The Breast Reduction Procedure

Breast reduction is well-suited to outpatient surgery.  Dr. Cook will carry out the surgery either at Rush University Medical Center or at a fully-accredited outpatient surgical facility near the North Michigan Avenue Office.  Depending on the technique of reduction the surgery takes from three to five hours to carry out.  Most patients are able to leave the surgical facility in less than an hour after the procedure is completed.  Patients from the Chicago metropolitan area usually choose to recover from breast reduction surgery at home.  Patients from out-of-state will recover at a fine hotel near our office. We can arrange to have one of our highly-experienced caregivers stay with you for one or several nights.

Recovery from Breast Reduction Surgery

Dr. Cook makes use of a long-acting local anesthetic, so for most patients pain is well-controlled with standard prescription pain medications.  The breasts are protected by a fluffy dressing that is covered by a gentle stretch bra.  Patients typically come for their first post operative visit three or four days after the surgery.  At that time the dressing is removed and the patient is fitted with a gentle support bra. Most patients can return to normal light activity in leas that a week after the surgery, but heavy lifting and vigorous exercise should be avoided for four to six weeks.  Patients with young children should make arrangements for help with child care for the early weeks after surgery.  We provided each patient of our Chicago centers with specific recommendations that depend on the extent of her breast reduction procedure.

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