Breast Reduction



10.1055/b-0034-97719

Breast Reduction

Louis H. Poppler & Marissa Tenenbaum
A 49-year-old healthy woman presents for evaluation for breast reduction. She currently wears a size 48DD bra.


Description




  • Obese woman with macromastia and asymmetry




    • Right breast larger than left.



    • Large, pendulous breasts consistent with reported bra size of 48DD.



    • Protuberant abdomen.



  • Grade III ptosis: Regnault classification (see Table 26.1).



Work-up



History




  • Age and symptoms




    • Pain associated with enlarged breasts: Back pain, neck pain, shoulder pain,



    • Grooving in shoulders from weight of bra.



    • Skin breakdown along inframammary fold.



  • Determine desired cup size.



  • History of scarring




    • May consider limiting incisions in patients with history of hypertrophic scarring/keloids. Informed consent includes discussing management of unsightly scars.



    • Patients must understand the possibility of unsightly scars from the procedure.



  • Lactation potential




    • Preserve lactation potential in younger women, even if they state no intention to breastfeed.



    • Consider/offer delay of procedure until childbearing is completed because breast may change with pregnancy.



  • Oncologic history: Family and personal history and risk factors for breast cancer




    • Obtain baseline mammogram preoperatively in all women 35 years of age or older.

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Jun 18, 2020 | Posted by in General Surgery | Comments Off on Breast Reduction

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