Breast Reduction

Breast reduction removes fat, glandular tissue and skin from the breasts, giving a woman smaller, better shaped breasts. It is especially helpful for women who experience back and neck pain, skin irritation, breathing problems and indentations in the shoulders from bra straps resulting from large breasts.

The most common technique involves an anchor-shaped incision that encircles the areola, extends downward and follows the natural curve of the crease beneath the breast. Liposuction may be used to remove excess fat from the armpit area.

This procedure is usually performed under general anesthesia and patients usually stay overnight in the hospital. Most patients are up and around in a day or two, but your breasts will ache occasionally for several weeks. Most women can return to work (if it is not too strenuous) in about two weeks.

Of note, this procedure is commonly covered by insurance if you meet certain criteria.

Procedural Steps

First, Anesthesia is induced

Medications are administered for your comfort during the surgical procedure. This procedure is usually done under general anesthesia.

Incision options

The incison lines that remain are visible and perminant scars develop, although they are usually will concealed beneath a swimsuit or bra.

Removing tissue and repositioning

After the incision is made, the nipple (which remains tethered to its original blood and nerve supply) is then repositioned. The areola is reduced by excising skin at the perimeter, if necessary.

Underlying breast tissue is reduced, lifted and shaped. Occasionally, for extremely large pendulous breasts, the nipple and areola may need to be removed and transplanted to a higher position on the breast (free nipple graft).

Closing the incisions

The incisions are brought together to reshape the now smaller breast. Sutures are layered deep within the breast tissue to create and support the newly shaped breasts; sutures, skin adhesives and/or surgical tape close the skin. Incision lines are permanent, but in most cases will fade and significantly improve over time.

Recovery time for breast reduction

Many patients have questions about recovery from breast surgery.

When your breast reduction procedure is complete, dressings or bandages will be applied to the incisions. A support bra may be worn to minimize swelling and support the breasts as they heal.

A small, thin tube may be temporarily placed under the skin to drain any excess blood or fluid that may collect.

You will be given specific instructions for breast reduction recovery that may include: how to care for your breasts following breast reduction surgery, medications to apply or take orally to aid healing and reduce the risk of infection, specific concerns to look for at the surgical site or in your general health, and when to follow up in the office.

Breast reduction risks and safety information

The decision to have breast reduction surgery is extremely personal. You will have to decide if the benefits will achieve your goals and if the risks of breast reduction surgery and potential complications are acceptable.

At your consultation, we will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks or potential complications.

The risks of breast reduction and breast reduction complications include:

• Unfavorable scarring
• Infection
• Changes in nipple or breast sensation, which may be temporary or permanent
• Anesthesia risks
• Bleeding (hematoma)
• Blood clots
• Poor wound healing
• Breast contour and shape irregularities
• Skin discoloration, permanent pigmentation changes, swelling and bruising
• Damage to deeper structures - such as nerves, blood vessels, muscles, and lungs - can occur and may be temporary or permanent
• Breast asymmetry
• Fluid accumulation
• Excessive firmness of the breast
• Potential inability to breastfeed
• Potential loss of skin/tissue of breast where incisions meet each other
• Potential, partial or total loss of nipple and areola
• Deep vein thrombosis, cardiac and pulmonary complications
• Pain, which may persist
• Allergies to tape, suture materials and glues, blood products, topical preparations or injectable agents
• Fatty tissue deep in the skin could die (fat necrosis)
• Possibility of revisional surgery

You should know that:

• Breast reduction surgery can interfere with certain diagnostic procedures
• Breast and nipple piercing can cause an infection
• Your ability to breastfeed following reduction mammaplasty may be limited.
• The breast reduction procedure can be performed at any age, but is best done when your breasts are fully developed
• Changes in the breasts during pregnancy can alter the outcomes of previous breast reduction surgery, as can significant weight fluctuations

The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single breast reduction procedure and another surgery may be necessary.