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Breast reduction

CPT4 code

Name of the Procedure:

Breast Reduction
Common name(s): Breast reduction surgery
Technical/Medical term: Reduction mammaplasty

Summary

Breast reduction surgery involves removing excess breast tissue, fat, and skin to reduce the size and weight of the breasts. This is often done to alleviate discomfort or achieve a breast size more proportional to the patient's body.

Purpose

Breast reduction surgery addresses issues such as chronic back, neck, and shoulder pain, skin irritation, and posture problems. It aims to create a breast size that is more manageable and aesthetically pleasing, improving both physical comfort and self-esteem.

Indications

  • Chronic pain in the back, neck, or shoulders due to large breasts
  • Skin irritation or rashes under the breast crease
  • Indentations from bra straps
  • Restricted physical activity due to breast size
  • Self-image issues related to breast size
  • Difficulty finding properly fitting clothing

Preparation

  • Patients will often be advised to stop smoking several weeks before surgery.
  • Avoid certain medications and supplements that can increase bleeding, such as aspirin or herbal supplements.
  • Routine lab tests and a medical evaluation will be required.
  • A mammogram may be conducted prior to surgery.

Procedure Description

  1. The patient is given general anesthesia.
  2. The surgeon makes an incision around the areola and down the breast, typically in an anchor shape or keyhole pattern.
  3. Excess breast tissue, fat, and skin are removed, and the remaining tissue is reshaped.
  4. The nipple and areola are repositioned to a more natural height.
  5. Incisions are closed with sutures, skin adhesives, or surgical tape.

Tools used include surgical scalpels, breast tissue markers, and suturing materials.

Duration

The procedure typically takes 2 to 5 hours.

Setting

Breast reduction surgery is usually performed in a hospital or an accredited outpatient surgical center.

Personnel

  • Plastic surgeon
  • Anesthesiologist
  • Surgical nurses
  • Operating room technicians

Risks and Complications

  • Scarring
  • Infection
  • Changes in nipple or breast sensation
  • Difficulty or inability to breastfeed
  • Asymmetry of the breasts
  • Anesthesia risks

Benefits

  • Relief from pain and discomfort
  • Enhanced ability to participate in physical activities
  • Improved posture
  • Better fitting clothing and improved body image
  • Benefits can be realized immediately post-surgery, with continued improvement as swelling decreases

Recovery

  • Patients may need assistance for the first few days post-surgery.
  • Pain and swelling typically subside within a few weeks.
  • Heavy lifting and strenuous exercise must be avoided for at least 4-6 weeks.
  • Follow-up appointments are necessary to monitor healing.
  • Special supportive bras may be required during the healing process.

Alternatives

  • Weight loss, which may or may not significantly reduce breast size
  • Physical therapy for pain management
  • Custom-fitted bras for support
  • Liposuction, though it may not address excess skin or significantly reshape the breast

Each alternative has its own benefits and drawbacks, which should be discussed with a healthcare provider.

Patient Experience

  • Patients will experience varying levels of pain and discomfort immediately following the surgery, which can be managed with prescribed pain medication.
  • Swelling and bruising are common but will subside with time.
  • Long-term, most patients report high satisfaction with the reduction in physical pain and improvement in quality of life.
  • Comfort measures include using cold packs, wearing loose clothing, and following all postoperative care instructions.

Medical Policies and Guidelines for Breast reduction

Related policies from health plans

Breast Surgery
Breast Surgery
Reduction Mammaplasty

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