Introduction & Background

Breast reduction surgery is a procedure designed to decrease the size of large breasts that may cause physical discomfort, emotional distress, or health problems. For many women, excessively large breasts can lead to a variety of issues, including back, neck, and shoulder pain, rashes, posture problems, and even difficulty in performing certain physical activities.

The decision to undergo breast reduction surgery is often motivated by a desire to improve physical health, self-esteem, and overall quality of life. The procedure may be performed for both cosmetic reasons as well as to address health concerns.

Causes of Excessively Large Breasts

Excessively large breasts may develop due to a variety of causes:

1. Genetic Factors: One of the most common causes of large breasts is heredity. If your mother or grandmother had large breasts, you are more likely to develop them as well.
2. Hormonal Changes: During puberty, pregnancy, and menopause, women undergo hormonal changes that can lead to breast enlargement. Conditions like polycystic ovary syndrome (PCOS) may also contribute.
3. Obesity: Overweight individuals may experience an increase in breast size due to the accumulation of fatty tissue. While fatty tissue is common in breasts, an increase in body fat may disproportionately enlarge them.
4. Medications: Certain medications, such as those used for hormone replacement therapy, antidepressants, or birth control, can increase breast size as a side effect.
5. Congenital Factors: Some women may be born with disproportionately large breasts, which can cause discomfort or emotional distress from an early age.

Indications for Breast Reduction Surgery

Breast reduction surgery is indicated when large breasts interfere with a person’s daily life, cause physical or emotional discomfort, or lead to health problems. Common indications include:

1. Chronic Pain: Persistent pain in the back, neck, or shoulders due to the weight of large breasts.
2. Postural Problems: The weight of large breasts can lead to slouched or hunched posture, which can cause muscle strain.
3. Breast-Related Skin Issues: Rashes or skin irritation underneath the breast, especially in the crease where the skin rubs together.
4. Difficulty in Physical Activity: Excessive breast size may make it difficult to engage in physical activities like running, yoga, or sports.
5. Emotional Discomfort: Feelings of self-consciousness or embarrassment about breast size can affect one’s body image and mental health.
6. Physical Limitations: Difficulty fitting into clothing or participating in activities due to the size of the breasts.

Symptoms of Excessively Large Breasts

People with excessively large breasts may experience several physical symptoms, including:

1. Back, Neck, and Shoulder Pain: The weight of large breasts can cause significant pain in the back, neck, and shoulders due to muscle strain and poor posture.
2. Headaches: Tension headaches can occur from the strain on neck muscles.
3. Breast-Related Skin Irritation: Constant rubbing between the breast and skin underneath can lead to chafing, rashes, or fungal infections.
4. Numbness or Tingling: Large breasts may place pressure on nerves, leading to numbness or tingling sensations in the arms or chest.
5. Difficulty Finding Well-Fitting Clothes: A large bust size can make it difficult to find clothes that fit comfortably, which can cause frustration and emotional distress.

Prevention Strategies for Large Breasts

While there are limited ways to prevent naturally large breasts, the following lifestyle strategies may help:

1. Maintain a Healthy Weight: Since excess fat can contribute to large breast size, maintaining a healthy weight may prevent further breast enlargement.
2. Exercise: Regular physical activity, especially exercises that strengthen the back, shoulders, and core, can help alleviate some of the discomfort associated with large breasts.
3. Proper Posture: Maintaining good posture can reduce the strain on the back and neck, preventing some of the discomfort associated with large breasts.
4. Early Intervention: If you notice your breasts growing disproportionately during puberty or another hormonal change, seek medical advice early to explore options for management or prevention.

Myths and Facts About Breast Reduction Surgery

Myth 1: Breast reduction is only for women.

• Fact: Men can also undergo breast reduction surgery if they suffer from a condition called gynecomastia, which causes excess breast tissue growth.

Myth 2: Breast reduction leaves noticeable scars.

• Fact: While some scarring is inevitable, modern surgical techniques minimize visible scarring, and the benefits often outweigh the cosmetic concerns.

Myth 3: Breast reduction can affect your ability to breastfeed.

• Fact: Most women can still breastfeed after a breast reduction, although it may depend on the extent of the surgery and individual circumstances.

Myth 4: Breast reduction is purely cosmetic.

• Fact: Many women undergo breast reduction for health reasons, including chronic pain, skin irritation, and physical limitations.

Myth 5: The procedure is very painful and requires long recovery.

• Fact: Most patients report moderate pain after surgery, but it can be managed with medication, and recovery typically takes a few weeks.

Treatments and Therapy for Large Breasts

Medication-Based Treatments

• Pain Relievers: Over-the-counter medications like ibuprofen or acetaminophen can help manage the pain associated with large breasts.
• Hormonal Treatment: In some cases, doctors may recommend hormone therapy to balance hormone levels and potentially reduce breast size.

Surgical Treatments

1. Breast Reduction Surgery: The most effective treatment for excessively large breasts. It involves removing excess tissue, fat, and skin to create smaller, more manageable breasts.
2. Liposuction: For some patients, liposuction alone can be used to reduce the size of breasts, especially if the enlargement is primarily due to fatty tissue.

Physical Therapy and Rehabilitation

• Post-Surgery Rehabilitation: After surgery, patients often undergo physical therapy to help with posture, flexibility, and strengthening exercises. This aids in faster recovery and helps prevent complications.

Lifestyle and Behavioral Interventions

• Ergonomic Adjustments: Proper posture and ergonomically designed seating at work or home can reduce strain on the back, neck, and shoulders.

Alternative and Complementary Medicine

• Massage Therapy: Gentle massage can help reduce tension in the muscles of the back and shoulders.
• Acupuncture: Some women report relief from pain through acupuncture, although its effectiveness for breast-related issues may vary.

Psychotherapy and Counseling

• Mental Health Support: For individuals emotionally affected by the size of their breasts, therapy can help improve self-esteem and body image.
• Support Groups: Joining a support group with other women undergoing breast reduction can provide comfort and advice.

Immunizations and Vaccines

• Preventive Care: Regular check-ups and maintaining overall health can help prevent infections, especially post-surgery. Vaccinations, including flu and tetanus shots, may be advised.

Stem Cell Therapy

• While still in experimental stages, stem cell therapy holds potential for helping with tissue regeneration and healing in post-operative recovery.

Gene Therapy

• Though gene therapy has been explored for various conditions, it is not yet applicable to breast reduction.

Top 20 FAQs About Breast Reduction

1. What is breast reduction surgery?

Answer:
Breast reduction surgery, or reduction mammoplasty, is a procedure that removes excess fat, tissue, and skin from the breasts to reduce their size. It is done to alleviate physical discomfort and improve appearance.

2. Who is a good candidate for breast reduction?

Answer:
Good candidates for breast reduction are individuals experiencing physical discomfort (e.g., back, neck, or shoulder pain), emotional distress, or difficulty with physical activities due to large breasts. They should be in good overall health, have realistic expectations, and be non-smokers.

3. How long does the surgery take?

Answer:
Breast reduction surgery typically takes 2 to 4 hours, depending on the complexity and the amount of tissue being removed. The procedure is usually done under general anesthesia.

4. What are the risks of breast reduction surgery?

Answer:
Some risks include infection, scarring, changes in nipple sensation, blood clots, and asymmetry. In rare cases, complications such as excessive bleeding or poor healing of incisions can occur.

5. Will I experience pain after the surgery?

Answer:
Pain and discomfort are common after breast reduction surgery but can usually be managed with prescribed pain medications. Most patients experience soreness and swelling, which typically subside within a few weeks.

6. How long is the recovery period?

Answer:
The initial recovery period lasts about 1 to 2 weeks, during which patients should avoid strenuous activity. Full recovery can take about 6 to 8 weeks, but it may vary depending on the individual.

7. Can breast reduction affect my ability to breastfeed?

Answer:
While most women can still breastfeed after breast reduction, there is a possibility of reduced milk production. The ability to breastfeed depends on the extent of the surgery and whether the milk ducts or nipple were affected during the procedure.

8. Are there non-surgical options for reducing breast size?

Answer:
Non-surgical options include weight loss, as excess body fat can contribute to large breasts. Some hormonal treatments or medications may also impact breast size, but they are not guaranteed to work.

9. How can I prepare for breast reduction surgery?

Answer:
Preparing for surgery involves a physical examination, blood tests, and medical imaging. Patients should avoid smoking, certain medications (like blood thinners), and may need to arrange for post-surgery care and transportation home.

10. What is the cost of breast reduction surgery?

Answer:
The cost of breast reduction surgery varies depending on location, surgeon’s experience, and the complexity of the procedure. On average, it can range from $5,000 to $10,000, but many insurance plans may cover it if it is deemed medically necessary.

11. Will the scars be visible after surgery?

Answer:
Scarring is a normal part of the healing process after breast reduction, but skilled surgeons can minimize the visibility. Scars are usually located around the areola, vertically down the breast, and along the breast crease. They fade over time but may be permanent.

12. Can men undergo breast reduction surgery?

Answer:
Yes, men can undergo breast reduction surgery, particularly if they have a condition called gynecomastia, where excess breast tissue develops due to hormonal imbalances. The procedure is similar to that of women but typically involves less tissue removal.

13. How soon will I see results after surgery?

Answer:
Patients usually see the results immediately after the surgery, with significantly smaller breasts. However, swelling and bruising may obscure the final outcome, which fully becomes visible after about 3 to 6 months.

14. What type of anesthesia is used during the procedure?

Answer:
Breast reduction surgery is typically performed under general anesthesia, meaning the patient will be asleep and pain-free during the procedure. In some cases, local anesthesia with sedation may be used, but this is less common.

15. Will my breasts return to their original size over time?

Answer:
Once the excess tissue is removed, the size of the breasts should remain stable. However, weight changes, pregnancy, or hormonal shifts can influence breast size over time.

16. Can I get a breast lift along with breast reduction?

Answer:
Yes, breast reduction surgery often includes a breast lift (mastopexy) to reposition the nipple and tighten the skin, enhancing the shape and appearance of the breasts. A lift can be done simultaneously with the reduction procedure for better results.

17. How should I care for my breasts after surgery?

Answer:
Post-surgery care includes wearing a supportive bra, taking prescribed medications, avoiding heavy lifting or strenuous activity, and following the surgeon’s guidelines for cleaning and dressing the surgical sites. Keeping follow-up appointments is also essential.

18. Can I return to work right after the surgery?

Answer:
Most patients can return to work within 1 to 2 weeks, depending on the type of work. If the job is physically demanding, a longer recovery period may be needed. Lifting, bending, or strenuous activities should be avoided during the initial recovery phase.

19. What happens if I gain weight after breast reduction?

Answer:
If you gain weight after breast reduction, your breasts may enlarge again since they contain fatty tissue. It’s essential to maintain a healthy weight to keep the results of the surgery. Regular exercise and a balanced diet can help maintain the outcome.

20. Is breast reduction covered by insurance?

Answer:
In some cases, breast reduction surgery is covered by insurance if it is deemed medically necessary. This typically requires proof of chronic pain, skin irritation, or other health issues related to the size of the breasts. Cosmetic breast reduction, however, is usually not covered.

Conclusion

Breast reduction surgery offers significant relief for individuals experiencing discomfort from excessively large breasts. It can provide both physical and psychological benefits by improving quality of life and boosting self-esteem. The procedure is highly effective in addressing chronic pain, postural problems, and emotional distress, with a relatively fast recovery time. However, it’s essential to understand the potential risks and carefully consider all treatment options.

The post What is Breast reduction & how its getting done? appeared first on MyMedicPlus.

Medical cannabis was found to exhibit an overall positive effect on maintaining nightime sleep in patients with chronic pain, but frequent use was associated with problems of both waking up at night and falling asleep, according to study findings published in the journal BMJ Supportive & Palliative Care.

Chronic pain is a debilitating condition affecting approximately 19% to 37% of adults in developed countries. Among those affected, there are high rates of comorbid insomnia, which causes symptoms such as difficulty initiating sleep, disrupted sleep, and early morning awakenings. Research on MC has exhibited positive, yet small effect sizes as a pain reliever, with further efficacy being reported on managing sleep.

“Research has demonstrated that the endocannabinoid system has a role in the regulation of sleep, including the maintenance and promotion of sleep,” said the study authors.

They note that many of the studies reporting a significant and positive impact of MC use on sleep are of poor quality due their small size and because the legal status of MC varies, warranting further examination on the growing popularity of MC to manage sleep problems and chronic pain.

The study authors examined the association between the use of whole plant cannabis and sleep problems among 128 patients with chronic pain (mean age, 61 ± 6 years; 49%, males), distinguished as MC users (n = 66) and nonusers (n = 62). Regression models tested the differences in sleep problems between the 2 study cohorts, with Pearson correlations between MC use measures (dose, length and frequency of use, number of strains used, tetrahydrocannabinol/cannabidiol levels) and sleep problems assessed among MC users. The results were adjusted for age, sex, pain level, and use of sleep and antidepressant medications.

Among the entire study cohort, 24.1% reported always waking up early and not falling back asleep, 20.2% reported always having difficulties falling asleep, and 27.2% reported always waking up during the night. Of the comparative study results, MC users were shown to be less likely to wake up at night than nonusers (mean: 4.59 vs 5.54; P = 0.018), with no further differences found in sleep measures between the groups.

In a final analysis of the MC users, Pearson correlations showed that frequency of MC use was the sole association with sleep issues, indicating the potential significance of tolerance among MC users. “Specifically, more frequent use was associated with more problems related to waking up at night and problems falling asleep,” said the study authors.

The researchers highlighted that limitations to the study, including MC administration and specific strain usage, may signal differential effects on sleep, warranting the need for future studies to examine this variability in more detail.

“These findings may have large public health impacts considering the ageing of the population, the relatively high prevalence of sleep problems in this population, along with increasing use of MC,” said the study authors.

The post Tolerance Complicates Sleep Benefit From Medical Cannabis Among Patients With Chronic Pain, Insomnia appeared first on MyMedicPlus.

The average cost for a woman with endometriosis both personally and for society is around A$30,000 a year, according to our research, published today in the journal PLOS ONE.

Most of these costs are not from medication, or doctors’ visits, although these do play a part. Rather, they’re due to lost productivity, as women are unable to work – or work to their usual level of efficiency – while experiencing high levels of pain.

Remind me, what is endometriosis?

Chronic pelvic pain is pain below the belly button that occurs on most days for at least six months. The most common identifiable cause is endometriosis. Endometriosis is the presence and growth of tissue (called lesions) similar to the lining of the uterus that’s found outside the uterus.

Women with the condition have a variety of symptoms, including non-cyclical pelvic pain (which is like period pain but occurs regularly throughout the month), severe period pain, pain during or after sexual intercourse, and severe fatigue. Gastrointestinal problems, such as severe bloating (often called “endo belly” by those who suffer from it) and pain with bowel motions, are also common.

Currently, surgery (a laparoscopy) is the only way to make a formal diagnosis of endometriosis – this is where a small camera is inserted into the pelvic/abdominal cavity to investigate the presence of endometriosis lesions.

Both medical and surgical treatments are commonly used for women with endometriosis. Medical therapies include non-steroidal anti-inflammatories (such as ibuprofen and naproxen), oral contraceptive pills and other forms of hormonal treatments.

While these medications can be effective for some, many women experience side effects and need to stop using them.

Surgery is the current “gold standard” of treatment, but despite successful surgery many women find their pain and symptoms can return within about five years after surgery.

How many women have it?

Around 7% of Australian women aged 25–29 and 11% of women aged 40–44 are likely to have endometriosis, which is similar to the worldwide estimate of one in ten women.

Delays in diagnosis are extremely common, and combined with needing surgery for a diagnosis, means many women suffer for years with chronic pelvic pain before being diagnosed with endometriosis later in life. This contributes to the difficulty in getting exact figures for how many women in Australia have endometriosis.

Worldwide estimates of chronic pelvic pain range from 5% to 26% of women. In New Zealand, it’s around 25% and is likely to be similar in Australia but we are lacking any up-to-date and reliable statistics on this.

What did our study find?

Endometriosis and chronic pelvic pain affect all aspects of women’s lives – social activities, romantic relationships and friendships, education, and work attendance and productivity.

We surveyed more than 400 women aged 18 to 45 who were either diagnosed with endometriosis or experiencing chronic pelvic pain. We asked about health-care costs (both out of pocket and funded), employment-related costs, and other costs related to childcare and household maintenance. We also asked about their pain levels.

We found the average cost for a woman with endometriosis was around A$30,000 per year.

Around one-fifth of this cost was in the health sector, for medications, doctors’ visits, hospital visits, assisted reproductive technology such as IVF, and any transport costs to get to these appointments. Of this, A$1,200 were out-of-pocket costs.

The bulk of the costs (over 80%) were due to lost productivity, either because of absenteeism (being off work) or presenteeism (not being as productive as usual because you’re sick). Women with endometriosis often use up all their sick leave and then often have to work when they are in severe pain.

Overall, if one in ten women aged 18 to 45 do have endometriosis, the total economic burden in Australia may be as high as A$9.7bn per year for endometriosis alone.

Pain scores had a very strong link with productivity costs. Women with the most severe pain had a 12-times greater loss of productivity, in terms of working hours lost, than those with minimal pain.

Overall, taking into account all costs (health sector, out-of-pocket, carers and productivity) women with severe pain have six-times greater costs (A$36,000) a year overall compared to those with minimal pain (A$5,700).

Finally, we also looked at the cost of illness not only of those women with a diagnosis of endometriosis, but also of those that had other causes of chronic pelvic pain, such as vulvodynia (pain, burning or discomfort in the vulva) and adenomyosis (growths in the muscular wall of the uterus).

We found the overall costs between the two groups – those with endometriosis and those with other types of pelvic pain – were very similar.

So what should we be doing?

The economic burden of endometriosis is at least as high as other chronic disease burdens such as diabetes. However, many women are not receiving the support they need.

We also need to prioritise funding for endometriosis research, which until recentlyhas attracted comparatively little research funding.

Plans are underway to increase awareness and education, and improve diagnosis and pain management. Unfortunately, there is no such plan for women with other forms of chronic pelvic pain.

Reducing pain, by even a modest 10-20%, could improve women’s quality of life and potentially save billions of dollars each year.

The post Endometriosis costs women and society $30,000 a year for every sufferer appeared first on MyMedicPlus.

The average cost for a woman with endometriosis both personally and for society is around A$30,000 a year, according to our research, published today in the journal PLOS ONE.

Most of these costs are not from medication, or doctors’ visits, although these do play a part. Rather, they’re due to lost productivity, as women are unable to work – or work to their usual level of efficiency – while experiencing high levels of pain.

Remind me, what is endometriosis?

Chronic pelvic pain is pain below the belly button that occurs on most days for at least six months. The most common identifiable cause is endometriosis. Endometriosis is the presence and growth of tissue (called lesions) similar to the lining of the uterus that’s found outside the uterus.

Women with the condition have a variety of symptoms, including non-cyclical pelvic pain (which is like period pain but occurs regularly throughout the month), severe period pain, pain during or after sexual intercourse, and severe fatigue. Gastrointestinal problems, such as severe bloating (often called “endo belly” by those who suffer from it) and pain with bowel motions, are also common.

Currently, surgery (a laparoscopy) is the only way to make a formal diagnosis of endometriosis – this is where a small camera is inserted into the pelvic/abdominal cavity to investigate the presence of endometriosis lesions.

Both medical and surgical treatments are commonly used for women with endometriosis. Medical therapies include non-steroidal anti-inflammatories (such as ibuprofen and naproxen), oral contraceptive pills and other forms of hormonal treatments.

While these medications can be effective for some, many women experience side effects and need to stop using them.

Surgery is the current “gold standard” of treatment, but despite successful surgery many women find their pain and symptoms can return within about five years after surgery.

How many women have it?

Around 7% of Australian women aged 25–29 and 11% of women aged 40–44 are likely to have endometriosis, which is similar to the worldwide estimate of one in ten women.

Delays in diagnosis are extremely common, and combined with needing surgery for a diagnosis, means many women suffer for years with chronic pelvic pain before being diagnosed with endometriosis later in life. This contributes to the difficulty in getting exact figures for how many women in Australia have endometriosis.

Worldwide estimates of chronic pelvic pain range from 5% to 26% of women. In New Zealand, it’s around 25% and is likely to be similar in Australia but we are lacking any up-to-date and reliable statistics on this.

What did our study find?

Endometriosis and chronic pelvic pain affect all aspects of women’s lives – social activities, romantic relationships and friendships, education, and work attendance and productivity.

We surveyed more than 400 women aged 18 to 45 who were either diagnosed with endometriosis or experiencing chronic pelvic pain. We asked about health-care costs (both out of pocket and funded), employment-related costs, and other costs related to childcare and household maintenance. We also asked about their pain levels.

We found the average cost for a woman with endometriosis was around A$30,000 per year.

Around one-fifth of this cost was in the health sector, for medications, doctors’ visits, hospital visits, assisted reproductive technology such as IVF, and any transport costs to get to these appointments. Of this, A$1,200 were out-of-pocket costs.

The bulk of the costs (over 80%) were due to lost productivity, either because of absenteeism (being off work) or presenteeism (not being as productive as usual because you’re sick). Women with endometriosis often use up all their sick leave and then often have to work when they are in severe pain.

Overall, if one in ten women aged 18 to 45 do have endometriosis, the total economic burden in Australia may be as high as A$9.7bn per year for endometriosis alone.

Pain scores had a very strong link with productivity costs. Women with the most severe pain had a 12-times greater loss of productivity, in terms of working hours lost, than those with minimal pain.

Overall, taking into account all costs (health sector, out-of-pocket, carers and productivity) women with severe pain have six-times greater costs (A$36,000) a year overall compared to those with minimal pain (A$5,700).

Finally, we also looked at the cost of illness not only of those women with a diagnosis of endometriosis, but also of those that had other causes of chronic pelvic pain, such as vulvodynia (pain, burning or discomfort in the vulva) and adenomyosis (growths in the muscular wall of the uterus).

We found the overall costs between the two groups – those with endometriosis and those with other types of pelvic pain – were very similar.

So what should we be doing?

The economic burden of endometriosis is at least as high as other chronic disease burdens such as diabetes. However, many women are not receiving the support they need.

We also need to prioritise funding for endometriosis research, which until recentlyhas attracted comparatively little research funding.

Plans are underway to increase awareness and education, and improve diagnosis and pain management. Unfortunately, there is no such plan for women with other forms of chronic pelvic pain.

Reducing pain, by even a modest 10-20%, could improve women’s quality of life and potentially save billions of dollars each year.

The post Endometriosis costs women and society $30,000 a year for every sufferer October 11, 2019 6.06am AEDT appeared first on MyMedicPlus.