What can transform a good tennis player into a world class competitor literally overnight? More practice, performance enhancing drugs, better training, a new coach? No, none of these, at least not overnight! How about breast reduction surgery?? Such was the case for tennis superstar Simona Halep whose recent breast reduction surgery was followed by a dramatic improvement in her game. Halep’s impressive, straight-sets victory over Sloane Stephens at the French Open was just the latest big win in the 22-year-old Romanian’s meteoric rise the past year. Simona was named the WTA’s Most Improved Player for 2013 when she won the first six singles titles of her career. She attributes this new found success in part to surgery she had five years ago.
Why would a woman consider a breast reduction procedure? In contrast to a woman who has breasts that she considers too small, there is the woman who truly suffers from breasts that are too large. In her case there is often embarrassing attention from others, an inability to fit into clothing, limitation of physical activity, pain of the back-shoulder-neck regions, painful shoulder grooving at the site of the bra straps, rashes and/or infections of the skin in the crease beneath the breasts, etc.
What does such a procedure involve? A typical patient undergoes a 2 ½ hour operation at which time the breasts are reduced in size , lifted, and the areola-nipple is reduced in diameter and lifted. The resultant scar generally encircles the areola, passes down to the fold beneath the breast, and then is placed in the fold beneath the breast. Some surgical reduction techniques may allow for the avoidance of the scar beneath the breast, although these are associated with a higher revision rate. Over the course of a year the scar generally flattens and fades to the point that it is not particularly noticeable. To aid in this change, many patients will wear silicone tape for 3 months after surgery and some may require steroid injections or laser treatments if the scars remain thickened.
How long is required for recovery? Most patients are able to go home the day of surgery with little discomfort. Drains may be used for a couple of the days, and the patient is then able to shower. In my practice only a few sutures require removal after 2 weeks, at which point patients are able to resume driving, return to a desk job, and perform light activities. By 4 weeks patients begin cardiovascular exercise, and by 6 weeks all activities are permitted.
Can complications occur? With any operation there is the potential for problems, but most of these can be successfully treated. There may be an inability to nurse, a decrease or loss of nipple sensation, unattractive scarring, partial regrowth of the breasts, and even a loss nipple tissue due to lack of an adequate blood supply.
Who is a candidate for breast reduction surgery? As long as one is in relatively good health, surgery can be considered. I have had patients in their 80’s who have successfully undergone surgery. For many of these women their only regret is that they waited so long to have surgery! Young women should generally be of a stable breast size for 1 year before surgery, although disabling symptoms may be a reason to override this criteria. Smokers should avoid all nicotine-containing products for 2 weeks before and after surgery.
A family history of breast cancer is not a contraindication to surgery. The tissue removed is always checked for any signs of breast cancer and mammograms are just as effective in detecting breast cancer after surgery as they were before. Interestingly a woman’s chances of developing breast cancer are decreased by the surgery.
Although your tennis game may not improve to “Wimbledon-status,” a woman who undergoes breast reduction can generally expect a marked improvement in her symptoms. In some cases a portion of the surgery may be covered by health insurance, although any liposuction of the fat on the side of the chest is considered to be cosmetic surgery and is not covered.
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George Sanders, M.D.
