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Sometimes our breasts grow too large for the rest of our body. It:%$#146;s called breast hypertrophy. They can get out of proportion, compared to the length of our spine, and the size and strength of our abdominal, back and chest muscles.

So over time, we develop backaches and neck aches, and maybe headaches. Those bra straps eat into our shoulders. Sometimes a large nerve in the arm is affected and we feel tingling or prickling down the arms. We might even have trouble finding a comfortable position for sleep.

The problems aren:%$#146;t all muscular either. There can be irritation beneath the breasts, or in the cleavage, and this can lead to infections or rashes. We might have trouble finding clothes that fit.

This extra largeness can occur in teenage girls, or after a pregnancy, and isn:%$#146;t necessarily related to any weight gain.

One thing to keep in mind is that after breast reduction, you may not be able to breastfeed. This is because the breast reduction surgery will relocate your nipples, to match the new contours, which means that some of the milk ducts will be damaged or severed.

However, breast reduction surgeons are increasingly able to move the nipple without impairing the milk production system. Also, techniques have been developed to maximize the remaining parts of the milk system that are functional.

Finding a good plastic surgeon

Before rushing into anything, choose a reputable cosmetic surgeon and ask a lot of questions.

Choose a plastic surgeon who:%$#146;s certified by the American Board of Plastic Surgery (ABPS), and preferably one who:%$#146;s a member of the American Society of Plastic Surgeons (ASPS).

The American Board of Plastic Surgery only certifies surgeons who have had at least five years of residency training in general surgery, at least two years of training in plastic surgery. Such certification is a prerequisite for membership in the ASPS.

Since cosmetic surgery has become so popular in the last 10 years or so, some doctors have taken some quickie training to get on the bandwagon. You want a properly trained and experienced surgeon, not one who might gain his basic experience on you!

By all means listen to your friends and acquaintances who may have had breast reduction, or some other cosmetic surgery, and want to recommend their doctor to you. But do you homework too, and check the doctor:%$#146;s credentials.

Some questions to ask when interviewing plastic surgeons

:%$middot; Do you have hospital privileges, and if so, which hospitals$%:

:%$middot; If you do surgery in other facilities, are they accredited$%:

:%$middot; How many breast reductions have you done$%:

:%$middot; Can I speak to some of your previous patients about their experience with it$%:

While you ask such questions, you can evaluate in your own mind whether this person is pleasant, willing to answer questions, willing to spend time with you, and generally easy to get along with. You want a surgeon you feel comfortable with, because

:%$middot; It will make things go more smoothly, and

:%$middot; Because if they don:%$#146;t go as smoothly as you:%$#146;d both hoped, there:%$#146;ll be more interaction between you to repair whatever wasn:%$#146;t right.

Questions to ask your chosen breast reduction surgeon

:%$middot; Am I a good candidate for $%:

:%$middot; What can I do to make this turn out as well as possible$%:

:%$middot; How long should I take off work$%:

:%$middot; What are the possible complications$%:

:%$middot; How will you do this surgery$%:

Ask all the questions you want to. The better you understand the procedure, the better you can care for yourself afterwards and avoid possible complications. It:%$#146;s important to come to a mutual understanding with your surgeon as to exactly how you:%$#146;d like your breasts to look. A good surgeon will be glad to spend this time with you.

How is breast reduction done$%:

Usually breast reduction is done with general anesthesia. There are 3 general methods.
1. The manual method is usually preferred when there:%$#146;s a large amount of tissue to be removed. The cosmetic surgeon will first mark new locations for the nipples, then make incisions for removing excess tissue. When that:%$#146;s done he:%$#146;ll relocate the nipples and suture the incisions.

2. is another method. The surgeon will make small incisions under the breasts and perhaps also at their sides. He:%$#146;ll inject a fluid mix containing

:%$middot; Lidocaine for blocking pain;

:%$middot; Epinephrine to reduce bleeding; and

:%$middot; Salt water to make the fluid compatible with body fluids.

This fluid causes the fat cells to swell, so that they:%$#146;re easier to remove. They:%$#146;ll be suctioned out through a narrow tube.

3. Ultrasound-Assisted Lipectomy (UAL) is a third way of doing it. Ultrasonic waves are directed at the fatty tissue to melt the cells, thus making them easier to suction out. There:%$#146;s some risk in this method of ultrasound damage, so it:%$#146;s not as popular as the tumescent liposuction method.

Recovery period

You can begin preparing for your recovery before you have the surgery. Make arrangements for someone to drive you home afterwards, and for someone to help you out for a few days as you begin recovery.

Also beforehand, prepare your home for maximum comfort and convenience. Stock up on foods you like, put clean sheets on the bed, vacuum and spiff the place up, be sure you have lots of pillows and blankets, and clothing that:%$#146;s easy to get in and out of.

Get some good skin lotion because your breast skin may be quite dry after surgery.

:%$middot; For the first couple of days you:%$#146;ll want to rest. Your breast surgeon will give you instructions on how to care for the incision sites and your breasts in general.

:%$middot; At first there:%$#146;ll be bandages and dressings and probably a drain on each side, to remove excess fluids.

:%$middot; You:%$#146;ll have a pain prescription and perhaps an antibiotic to prevent infection.

:%$middot; On the 2nd or 3rd day, get up and move about some. Good blood circulation is important after any kind of surgery. Save the strenuous activity for about a month though.

:%$middot; After the first days, the bandages will be removed and your surgeon will have you wear a surgical bra for proper support.

:%$middot; The bruising and swelling will recede in several weeks.

:%$middot; After about 3 weeks, the stitches will be taken out.

:%$middot; If your job is a quiet one, you could return to work after a couple of weeks.

:%$middot; Be very gentle with your breasts for a couple of months afterwards.

The final result

You:%$#146;ll experience much relief immediately. The back pain will fade, your silhouette will be more in proportion, you:%$#146;ll be able to fit into many more clothes. Your breasts might take 6 months or even a year to finally settle to their new positions. And they might still change shape somewhat because of hormonal changes, pregnancy and weight changes.

The scars will slowly shrink and fade and you:%$#146;ll be able to wear low necklines. If you:%$#146;re patient with the recovery process you:%$#146;ll eventually be very pleased with your new shape.

Finding a good cosmetic surgeon

Since cosmetic surgery has become so popular in the last 10 years or so, some doctors have taken short cut training to take advantage of this at a disservice to the general public. You want a properly trained and experienced surgeon, not one who might gain his basic experience on you! Choose a plastic surgeon who:%$#146;s certified by the American Board of Plastic Surgery (ABPS), and one who:%$#146;s a member of the American Society of Plastic Surgeons (ASPS) and the American Society for Aesthetic Plastic Surgery (ASAPS).

While you should by all means listen to your friends and acquaintances who may have had cosmetic surgery and want to recommend their doctor to you you should do your homework too, and check the doctor:%$#146;s credentials.

Some questions to ask when interviewing plastic surgeons

:%$middot; Do you have hospital privileges, and if so, which hospitals$%:

:%$middot; Can you do the procedure in the hospital if I want to$%:

:%$middot; If you do surgery in other facilities, are they accredited$%:

:%$middot; How many breast reductions have you done$%:

:%$middot; Can I speak to some of your previous patients about their experience with it$%: