Breast Reduction
Breast reduction surgery, also known as “reduction mammaplasty,” is a procedure designed to relieve the stress of excess breast weight for females by reducing the size of the breasts.
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The breasts are reduced by removing fat, tissue, and excess skin. Many women with excessively large and heavy breasts experience pain in their necks and backs, difficulty performing routine activities or exercise, and frustration with fitting into certain styles of clothing. If you’re considering breast reduction surgery, consult a board-certified plastic surgeon. It’s important to understand what breast reduction surgery entails, including possible risks and complications as well as set realistic expectations.
Am I a candidate for a breast reduction?
If you answer “yes” to any of the following questions, a breast reduction may be right for you:
- Do you have strain and pain in your back and neck, deep shoulder grooves from bra straps or numbness and tingling in the arms caused by large breasts?
- Do you get chronic skin infections under the breast that are caused by moisture that collects under large breasts?
- Is it difficult to exercise due to discomfort or weight of significantly large breasts, thus restricting movements and performance in physical activities?
- Do you have a poor self-image related to large breasts or cosmetic problems such as stretch marks in your skin from heavy breasts or trouble finding clothes that fit? A breast reduction can also be done if you want to have smaller breasts. Surgery done for cosmetic reasons may not be covered by insurance.
The Benefits of Breast Reduction
Clothing Fits Better
Many styles of clothing do not cater to a larger bust line. Although the clothing and retail industry is coming around thanks to pop culture icons such as Rebel Wilson, Lizzo, Melissa McCarthy and Queen Latifah. But we are not all famous nor can we have the closet of a Hollywood star. So a breast reduction helps create a more balanced hourglass shape that will boost a woman’s confidence both in and out of the fitting room.
Reduces Back Pain
Heavy breasts can cause back and neck pain. The weight of your breasts even in supportive or sports bras cause indentations in the shoulders from the straps. This procedure will reduce the weight of overly large breasts and help eliminate the associated discomfort and pain. Which in turn permits ability to partake in exercise and other physical activities that improves your mind and health.
Improves Physical Ability
Large, heavy breasts often impede performance in athletics as well as routine physical activities. There are certain health conditions such as diabetes and heart problems related to obesity that can be mitigated by weight loss. A breast reduction can increase mobility and comfort to improve the overall quality of life for patients.
Eliminates Skin Irritation
Skin irritation can occur beneath the breasts when they are excessively large leading to bacterial or fungal infections. Breast reduction reduces the weight and lifts the breasts, so they no longer irritate the skin. This makes hygiene easier and more thorough to help prevent rashes and infections.
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Breast Reduction Options
Inverted T Pattern
- Ideal For: Severely sagging, pendulous breasts, or poor skin quality.
- Technique: A lollipop-shaped incision that also extends along the breast crease is used to remove excess skin and tissue.
- Benefit: Allows removal of large amounts of skin in vertical and horizontal directions Provides the most significant amount of skin and breast tissue reduction.
Vertical Pattern
- Ideal For: Large sagging and pendulous breast with healthy skin with good elasticity.
- Technique: A lollipop-shaped incision around the nipple and down to the breast crease is used to remove excess skin and tissue.
- Benefit: Eliminates horizontal scar, lifts low-hanging breasts and still allows tightening of the breast in a vertical and horizontal plane.
Circumareolar Pattern
- Ideal For: Minimal reduction and slight nipple asymmetry
- Technique: A doughnut-shaped area of skin around the areola is removed. Some areola can be removed to decrease the size and provide symmetry. Breast tissue is also able to be removed with this technique, but is minimal.
- Benefit: Produces inconspicuous scarring around the areola. Also limited to a small number of patients.
The Breast Reduction Process
Consultation
Once you fill out the online questionnaire, you will be contacted to confirm an appointment for a one-on-one consultation with the surgeon. You may also provide photos through our HIPAA compliant system and during your visit your surgeon can provide a personal 3D simulation using your own photos. This tool is a powerful education tool that helps identify what can and cannot be performed.
This appointment also includes an analysis of your health history, any medications you are taking, and what you desire to achieve with the procedure. Please have all of this information with you when you come to your appointment. All of which can be submitted electronically through our HIPAA compliant patient portal.
You will have a breast exam and a mammogram before the procedure to be as sure
as possible that you do not have cancer.
The surgeon will discuss the techniques that will best provide you with the results you desire and answer any questions you may have. Discuss the size and shape of breasts you want to have with your healthcare provider. If you are planning to have children and want to breastfeed, talk with your provider about this.
Preoperative Instructions
Your surgeon will review in detail all of the information you need to know prior to surgery.
Generally, patients should avoid nicotine products six weeks before surgery and stop taking anti-inflammatory medication (e.g., aspirin and ibuprofen) for at least two weeks before surgery. Some vitamins and supplements may also cause problems during or after surgery, so it is best to avoid them or to talk to your surgeon about potential side effects.
You may be asked to bathe using an antibacterial soap before your procedure.
Eating and drinking restrictions include:
- 8 hours before the procedure – stop eating heavy meals or foods, such as meat, fried foods, or fatty foods.
- 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
- 6 hours before the procedure – stop drinking milk or drinks that contain milk.
- 2 hours before the procedure – stop drinking clear liquids.
You may be asked to obtain blood tests and/or a mammogram.
Be sure to arrange for someone to drive you home and care for you for the first 48 hours after your procedure.
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During the Procedure
Breast reduction is performed with general anesthesia, in a surgery center or in hospital and takes approximately three hours to complete. An IV will be inserted into one of your veins. Based on the techniques agreed upon during your consultation, the surgeon will place the incisions as described above. Incisions are closed with absorbable sutures and covered with surgical tape. In most cases drains are not used but not uncommon. Liposuction and fat grafting are tools that help shape the breast and will be discussed during your consultation.
Recovery
After surgery, your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until you leave the surgical center. You may continue to receive fluids and pain medicines through an IV.
You will have to wear compression stockings to help prevent blood clots and reduce swelling in your legs. You will be advised to wear a loose fitting bra with mild compression to aid with breast swelling and to keep you comfortable. Breast swelling will typically subside after about three weeks but may last as long as 6 months.
Expect pain, bruising, and tenderness for which you will be provided pain medications as needed.
For the first few days after surgery you will need to get plenty of rest. Most patients are able to return to work in one-two weeks and resume regular exercise after about six weeks.
Your surgeon will give you more detailed information about what you can expect during your recovery.
Common Breast Reduction Concerns
Pain
Pain after breast reduction is minimal and can be managed with prescribed pain medication both narcotic and non-narcotic. An anesthetic can be injected to block the sensory nerves to reduce the use of narcotics and decrease the amount of pain you will have. You may be instructed to wear a compression bra, which will also help decrease pain and swelling.
Recovery
Swelling and bruising will be apparent for at least the first two weeks, after which time most patients feel comfortable returning to work. After six weeks, patients can resume exercise and regular physical activities.
Scars
Scars with breast reduction are significant and vary based on the size of the reduction. The larger the reduction the more scar burden you will have. These do fade over time. Typically, there will be a scar around the areola, a vertical scar from the areola to the breast crease, and a scar along the breast crease.
Duration of Results
The results of breast reduction will last a lifetime, and the breasts will continue to age naturally. Patients will experience lighter, more youthful breasts and increased comfort and confidence as a result of this procedure.
Breast Reduction FAQs
Q. Who are the best candidates for breast reduction surgery?
A. Typical candidates for breast reduction desire to reduce the size of their breasts either for aesthetic reasons or to relieve pain and discomfort. The best candidates are in good physical health and do not smoke.
Q. Is breast reduction covered by insurance?
A. Some health insurance providers will cover the cost of breast reduction if the patient has been treated in the past for pain and severe discomfort requiring narcotics. The patient has also experienced significant rashes requiring antifungals and antibiotics to treat.
Q. What are the risks of breast reduction surgery?
A. As with any surgical procedure, there are risks involved with breast reduction. Although rare, bleeding, infection, changes in skin sensation, asymmetry, or poor wound healing can occur. Follow-up visits with your surgeon will help to monitor and correct any complications.
Q. Will breast reduction affect my ability to breastfeed?
A. It is best for patients to be finished having children prior to breast reduction surgery if they plan to breastfeed. While breast reduction will not completely alter the ability to breastfeed, there is a chance it may limit it to some extent.
Q. When will final results be apparent?
A. Once swelling and bruising dissipate, final results are apparent. Swelling can last anywhere from a couple of weeks to six months after surgery. Scars will continue to fade over time, and protecting your scars from the sun will help prevent them from darkening.