Breast Reduction Mammaplasty
Type of anesthesia
Breast reduction with Dr. Bermant's Tumescent Technique is usually done under local anesthesia with heavy sedation. You'll be asleep through the entire operation.
Breast Reduction Surgery
Techniques for breast reduction vary, but Dr. Bermant's most common procedure involves a two component sculpture. The deep breast tissues are reduced and then shaped to a smaller lifted more youthful contour. The nipple areola skin is then fitted into it new more natural location. The remaining skin is closed with a Short Scar Technique. The incision extends around the areola and often has a vertical component that extends down under the breast to the chest wall. For larger breast deformities, the extra skin needing removal still benefits from an anchor-shaped incision that circles the areola, extends downward, and follows the natural curve of the crease beneath the breast. Dr. Bermant removes excess glandular tissue, fat, and skin. The shape of the breast is then sculpted with the glandular parenchyma moving the nipple and areola into their new position. Internal sculpting tends to support the breast longer than depending on suspending the tissue by skin alone. Dr. Bermant then brings the skin from both sides of the breast down and around the areola. Liposuction and microliposuction provides refinement to remaining fat contour and may extend to the armpit area.
Incisions outline the area of skin, breast tissue, and fat to be removed and the new position for the nipple.The red region is the surface sculpture. The blue areas are the deeper tissues excised.
In almost all cases, the nipples remain attached to their blood vessels and nerves. However, if the breasts are extremely large or pendulous, the nipples and areola may have to be completely removed and grafted into a higher position. (This will result in a loss of sensation in the nipple and areola tissue.) It is rare that Dr. Bermant recommends nipple grafts.
Skin formerly located above the nipple is brought down and together to reshape the breast. Sutures close the incisions, giving the breast it's new contour.
Stitches are usually located around the areola, in a vertical line extending downward to the chest for a Vertical Short Scar incision. The anchor technique for larger breasts adds a scar along the lower crease of the breast.
Scars around the areola, below it, and in the crease under the breast are permanent, but can be easily concealed by clothing.
See actual pictures during Tumescent Breast Reduction Surgery.