Breast Procedures Breast Reduction

Breast Reduction

  • Best Candidates:
    Women who are seeking to reduce their breast size for physical relief and an improved appearance
  • Length of Procedure:
    2 to 4 hours
  • Inpatient/Outpatient:
    Usually outpatient
  • Anesthesia:
    General or local with sedation
  • Results:
    Permanent
  • Procedures in 2015:
    100,825 (source: American Society of Plastic Surgeons)

Breast Reduction

Women with overly large and heavy breasts can experience medical problems, have trouble performing physical activities and feel awkward and self-conscious. Thousands of women each year choose breast reduction for physical relief as well as for cosmetic reasons. The procedure results in breasts that are smaller, lighter and more firm and shapely.

The procedure information contained in this article will give you a good introduction to breast reduction. Schedule a consultation with a Top Plastic Surgeon to receive a medical examination and discuss your options for breast enhancement.

Breast Reduction Overview

Women with very large breasts can experience medical problems that include neck, back and shoulder pain, headaches, breathing difficulties, circulation problems and irritation due to bra straps digging in to the skin. They may also feel self-conscious and feel that their breasts are out of proportion to the rest of their body. The majority of women who undergo breast reduction successfully achieve relief of their physical symptoms, an improved appearance, a boost to their self-image and an increase in self-confidence.

How Breast Reduction is Performed

During breast reduction surgery, or "reduction mammaplasty," excess volume is removed from the breasts, and the breasts are then lifted and reshaped. The procedure results in breasts that are smaller, lighter, firmer and in better proportion to the rest of the body. The size of the areola (the darker skin surrounding the nipple) can also be reduced.

The length of the procedure varies depending on the technique used, and usually takes from 2 to 4 hours. Breast reduction is usually performed as an outpatient procedure in your surgeon's surgical suite, in an outpatient surgery center or in a hospital. More extensive breast reduction procedures sometimes require an overnight hospital stay. Breast reduction surgery is usually performed under general anesthesia, which lets you to sleep throughout the procedure.

Liposuction can be used in conjunction with breast reduction to remove excess fat from the armpits. Liposuction is also used to suction fat from the breasts, but can result in increased sagging if the excess skin is not removed.

Anchor-Shaped Breast Reduction

Though breast reduction techniques may vary, the most common method involves an anchor-shaped incision that begins above the areola, extends downward to either side of the areola and then curves to each side of the breast. Excess fat, glandular tissue and skin are removed, and the nipple and areola are moved to a new position higher on the breast. The skin on both sides of the breast is then brought together to give the breast its new shape. Stitches are placed around the areola, along a line extending downward from the areola and along the crease where the breast meets the chest.

Concentric ("Doughnut") Breast Reduction

Women who have smaller breasts and less sagging may be candidates for a concentric breast reduction. During this procedure, circular incisions are made around the areola in the shape of a doughnut, excess breast volume is removed and the areola and nipple are moved upward to their new position. Though this method has the advantage of lessened scarring, your surgeon may be limited in the amount of breast volume that can be removed.

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Best Candidates

The best candidates for breast reduction are women who are bothered by large, sagging breasts and are seeking physical relief and improvement in their appearance.

Generally, the best candidates for breast reduction are women:

  • Who are in good overall health except for symptoms caused by unusually large breasts.
  • Are well-informed about treatment options and have realistic expectations.
  • Who want to improve their appearance and relieve the physical symptoms caused by overly large breasts.

Breast reduction is not recommended for women who think they may breastfeed in the future because the surgery removes many of the milk ducts that open at the nipples.

If you believe that you may be a good candidate for breast reduction, a qualified plastic surgeon can evaluate your circumstances, explain anything about the procedure you don't understand, answer all of your questions and help you decide if the procedure is right for you.

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Breast Reduction Risks

Any surgery carries some degree of risk. Complications experienced by breast reduction patients are infrequent and usually minor when the procedure is performed by a qualified plastic surgeon. To minimize your risk, be sure to follow all of your plastic surgeon's instructions both before and after the procedure. Contact your surgeon's office immediately if you experience any symptoms you believe may indicate a complication.

The most common risks associated with breast reduction surgery include:

  • Small sores around the nipples
  • Pain, swelling or bruising beyond normal levels
  • Excessive bleeding
  • Numbness (usually temporary)
  • Asymmetry
  • Infection
  • Adverse reaction to anesthesia
  • Dissatisfaction with results

The scars left by breast reduction are permanent and noticeable, though they will be concealed beneath your bra or swimsuit. The scars may be red and uneven for several months, but will eventually fade to faint lines. Your surgeon will make the incisions so that the resulting scars are as subtle as possible. Smokers are at an increased risk of wider scars due to decreased blood flow to the skin and underlying tissues.

Small sores can develop around the nipples in some patients, and are treated with antibiotic creams. Numbness around the nipples usually subsides quickly but can be permanent if the breasts are very large and the areolas and nipples have to be completely detached from their nerves and blood vessels before being moved to their new position. Rarely, the nipples may be uneven or other characteristics of the breasts may be mismatched.

Since breast reduction removes many of the milk ducts behind the nipple, breast reduction is usually not recommended for women who may breastfeed in the future.

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Breast Reduction Costs

You should be provided with complete information on costs and financing options at the initial consultation with your plastic surgeon. The total fee for breast reduction can vary depending on the region of the country, the extent of the procedure and your needs as a patient.

Health insurance will often cover the cost of breast reduction if the procedure is deemed to be a medical necessity. Ask your insurance company if it has any eligibility requirements, such as a specific amount of breast tissue that has to be removed, and what documentation is required, such as a letter from your surgeon.

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Breast Reduction Consultation

If you decide that you might benefit from a breast reduction, the first step is to locate a qualified plastic surgeon and schedule a consultation. During this meeting, you will be examined by the doctor and discuss your options in detail. Be sure to ask any questions that you have and openly discuss your expectations for the procedure.

The surgeon will examine your breasts and note their size, shape and the degree of sagging. He or she will also assess the characteristics of your skin and any other physical factors that could affect the surgery procedure. Your breasts will probably be photographed to provide a basis of comparison for your post-surgery result and possibly to provide documentation for an insurance claim.

Much of the discussion will be about your goals and expectations for the new size and shape of your breasts. The surgeon should fully address all of your questions and offer advice on how to achieve your desired results. He or she should give you the full details of the procedure, including the technique that will be used and where the nipple will be positioned. You should also cover costs and financing, risks, possible complications and the details of the recovery process. Be sure to ask for before and after photos of some of the surgeon's recent breast reduction patients.

Be prepared to discuss your overall health and medical history. Bring a list of all of your current medications — prescription, over-the-counter and herbal — and any vitamins that you take. Also remember to bring a list of previous surgeries.

As the consultation concludes, you may wish to schedule your procedure, take some time to think or seek a second opinion. If you decide to proceed with the procedure, your plastic surgeon will provide you with specific instructions on how to prepare for your breast reduction. These instructions will include guidelines for eating, drinking, and medications and vitamins to take or avoid before and after surgery.

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Breast Reduction Recovery

Prepare your home by taking things that you have to reach up for (for example, items on a high shelf or cupboard) and put them on a countertop or table. Stretching for items over your head will be uncomfortable for about a week after surgery. Stock up with foods that are light on the stomach, and have comfortable clothes ready, including loosely-fitting shirts that open in the front. You will also need a couple of cotton sports bras without underwire or post-surgical bras to provide comfort and support for the first few weeks after surgery.

Your plastic surgeon will provide you with specific instructions to follow after breast reduction surgery. To help ensure a smooth recovery, always follow his or her instructions on taking your medications, caring for your breasts and resuming your normal activities.

You may feel some pain in the first few days after surgery and soreness in the breasts for a couple of weeks when you move around. Tingling or shooting pains may occasionally be experienced during the next few months. Mild to moderate swelling and bruising is normal and should subside within a few weeks. Contact your plastic surgeon's office immediately if you experience any severe swelling, bruising or pain that is not controlled by your pain medication.

Your breasts will be bandaged after surgery to provide support and protection. Keep the dressings as clean and dry as possible until they are removed in a few days. The stitches will be removed in 1 to 3 weeks. The scars may be red and bumpy for several months before fading to thin white lines. Any numbness in the breasts and nipples usually goes away after a few weeks, but may last longer and is sometimes permanent.

Always follow your surgeon's advice on when you can resume your normal activities. You should be up and around within a couple of days, and most women can return to work or resume most normal activities within a week or two. More vigorous physical activity and any heavy lifting should be avoided for at least 6 weeks to give the breasts time to heal.

It may take 6 months or more to see your final results as the breasts settle into their new size and shape. Breastfeeding may not be possible after breast reduction since many of the milk ducts behind the nipple are removed.

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