Large breasts were at one time considered extremely aesthetic and very sociable, but in todays world it is often a source of embarrassment. It also brings with it the problems of ill-fitting clothes, inability to wear modern, designer kind of hep clothing as well as the problem of back pain, bra strap marks on the shoulder, sweating and fungal infection below the breast line, and a general decreased self esteem. Large breasts may be from teenage itself or more commonly after childbirth and lactation.

The major complaint women have after childbirth and feeding is that the breast have now sagged down, and started to look very bad. The only treatment for these problems is surgical reduction known as reduction mammoplasty or breast reduction. No other non surgical procedure is successful, may it be use of ultrasound technology or radio frequency based devices. It should be understood, that there is an absolute increase of breast tissue as well as skin, which needs to tackled, and surgery is the only option Procedure Breast reduction involves an actual removal of excess breast tissue as well as skin, and shaping the breast to a more aesthetic and shapely figure as per the pre-operative discussions with the patient. Commonly this involves two types of procedures. One is a wise pattern with inverted ‘T' scar pattern; the other is vertical short scar pattern. The latter technique is now well established, has a smaller scar, but takes significantly more time to give the final breast shape The ‘T' scar technique This involves a scar on the breast in the shape of an inverted T.

The advantages of the technique is this technique is easier to teach and more predictable results the final shape is immediately visible after surgery, with little changes in the long term period there is little potential of scar spreading The disadvantages of this procedure is long scar ( though the scar is hidden below the breast, so is visible only on lying down there is chance of tissue breakdown along the junction of the limbs of the inverted T(this is not common, and though there is rapid healing) The vertical short scar technique The procedure involves only a vertical scar without the horizontal component. As a result of which the skin excision is limited to the region around the areola (upper part).

This procedure has been popularized by Dr Ruth Graf (Brazil)(with whom the author has trained with) The advantages of this procedure is shorter scar The disadvantages of this procedure is that more difficult to teach it takes almost 6 months to show the final breast shape there may be need to revise the surgery in almost 30% of patients the skin shaping is as not as good, because lesser skin is removed from the lower half of the breast chances of scar stretching in the region of the areola Possible problems with breast reduction The patient will be required to stay in the hospital for 1 day after the surgery.

The possible problems associated with the procedure are lactation ability is lost on most patients. Ability to feed is the exception in most cases sensibility of breast tissue will take almost 6 months to recover chances of asymmetry are there in large reductions, some tissue loss is possible, however this does not majorly effect the final result like any procedure, there may be chances of seroma or a hematoma formation Results Breast reduction is an extremely satisfying procedure, because the results are predictable to a large extent in the preoperative period. How much tissue needs to be removed is decided, and therefore the patient has a clear picture of what her breasts are going to look like after surgery. There is a need to wear specially designed pressure garments to support the breast tissue for a period of 3 weeks.