Breast Reduction

Breast reduction reduces the size of the breasts while lifting the nipple-areola complex by removing excess skin, fat and glandular tissue. This procedure, also known as reduction mammoplasty, is often performed on a woman who has already had children, is overweight or has a predisposition for large breasts. A breast reduction provides a breast size of better proportion while relieving women of physical discomforts and allowing them to participate in a broader range of activities that would have otherwise been impaired.

Am I a Good Candidate for a Breast Reduction? 

A GOOD CANDIDATE for breast reduction includes:

• Patients who feel their breasts are too large for the frame of their body
• Women who have difficulty breathing, poor posture and/or numbness in the chest area due to the weight of the breast tissue
• Any women with breasts that are so heavy that the nipples and areolas point downward
• A woman with one breast that is much larger than the other
• Women with neck, shoulder and back pain caused by the weight of the breasts
• Women who suffer from skin irritation beneath the breast crease
• Any women limited in physical activities, or the ability to lead an active life, because of the size of their breasts

The following patients are NOT GOOD CANDIDATES for breast reduction:

• Patients whose breasts have not finished developing
• Women who intend to have more children and/or breastfeed their current children
• Women with undiagnosed lumps, masses, wound healing disorders or clotting disorders
• Women with unrealistic expectations regarding what the procedure can, and cannot, do

How is Breast Reduction Performed?

Breast reduction surgery starts with the surgeon using a surgical marker to indicate where the incisions will be placed since the shape of the breasts change once the patient is on her back. The patient is usually placed under general anesthesia but intravenous sedation may also be an option. Breast reduction surgery generally requires three incisions. However, the incision pattern will depend on the size of the breasts, how much they sag and where the nipple-areola complex is positioned. The surgeon removes excess fat and skin with either a scalpel or liposuction depending on the condition of the breasts and the patient’s desired breast size. The remaining fat and skin will be restructured to create a more youthful breast shape. Then, the surgeon will move the nipple-areola complex to a higher position. If the patient wishes to have a smaller areola, the surgeon can create a new areola size. Small drainage tubes are placed within the incision to collect excess fluid. The incisions will be closed with layered sutures.

Alternative Technique

In some cases, the breasts are so large that the nipples and areolas may need to be completely detached before they are shifted into a higher position. However, this can cause a lack of sensation to the breasts and possibly void the ability to breastfeed.

Performed with Liposuction

Liposuction under the arms can be performed, in conjunction with a breast reduction, to provide better contour.

What is the Cost of Breast Reduction?  

Breast reduction surgery can cost between $7000 and $12,000. If breast reduction is being performed for aesthetic purposes, it will be an out-of-pocket cost for the patient. If the procedure is deemed medically necessary to help relieve back pain from overly large breasts or health issues from keeping the area under the large breasts clean, many health insurance companies will cover some, or all, of the cost.

Recovery and Downtime

After breast reduction surgery, the patient will experience altered sensations, numbness, swelling and bruising for several weeks or months. Surgical dressing will cover the incision wounds and a compression garment will be placed around the breasts. The compression garment will help minimize the swelling and support the newly sculpted breast tissue. This garment will be worn 24 hours a day for several weeks except when showering. The patient will have some discomfort during the RECOVERY process but this can be managed with pain medications. Patients should sleep on their backs, at an incline, to keep the torso elevated. The drainage tubes will be removed a few days after surgery when the fluid has finished draining.

Most women can resume work after 10 to 14 days of DOWNTIME. Patients should avoid heavy lifting or strenuous activities for several weeks. During the first menstrual cycle, after the procedure, the breasts may be tender and swell slightly. For several months, some patients experience sporadic breast pains during menstruation.

Results

Breast reduction surgery involves a significant disruption of the tissue and nerves. Therefore, it can take up to a year for all the swelling to dissipate and for the final results to become apparent. After most of the swelling has subsided, patients will be able to see improvements and the physical discomforts should be alleviated. While the surgeon will make every attempt to make the incision scar less noticeable, some techniques cannot hide a scar. The scar may appear red and lumpy for several months. In fact, it can take a full year for a scar to settle down before fading to a thin, pale line. Women who smoke have a tendency to develop wider scars over time. Breast reduction results are permanent but the breast shape can change due to weight fluctuations, aging, gravity and hormones.

Limitations for Breast Reduction

The limitations for breast reduction surgery include:

• The type of incision pattern regarding the size of the breast
• Extremely large breasts may be limited to a complete nipple-areola detachment
• Saggy, fibrous breast tissue may not be treated solely with micro-incisions and liposuction
• Liposuction of fatty, non-fibrous breasts can only remove up to one cup size

Risks of Breast Reduction

Some common risks of breast reduction include:

• Bleeding
• Infection
• Hematoma
• Seroma
• Asymmetry
• Scarring
• Blood clots
• Damage to the underlying structures
• Inability to breastfeed
• Temporary or permanent changes in sensation

Considering Breast Reduction Surgery

When considering breast reduction surgery, the patient should schedule a consultation with a board-certified surgeon who specializes in breast reduction. The surgeon should be willing to personally meet with the patient and take the time to listen to her concerns and goals. The doctor will conduct a breast exam to see if the patient is a good candidate for breast reduction. Before and after photos of the surgeon’s own patients should be examined and the surgeon should be able to describe the surgical technique he, or she, will be using. For the best possible outcome, patients should have a good understanding of the procedure, recovery and risks of breast reduction.

Written by Cosmetic Town Editorial Team - SP

Based on an exclusive interview provided by Dr. Chris Livingston in Houston, TX