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Breast Reduction

While breast augmentation is one of the top plastic surgeries performed annually, breast reduction surgery is also very popular. This procedure may be performed for cosmetic or reconstructive purposes, but often provides relief to many women by alleviating the physical problems associated with overly large breasts, such as breast, neck, back, and shoulder pain. Breast reduction, or reduction mammoplasty, can improve a patient’s quality of life in several areas, and has a high rate of satisfaction.

What is a breast reduction?

Breast reduction surgery is a procedure to remove excess breast fat, glandular tissue, and skin in order to alleviate the discomfort and achieve a breast size that is more in proportion with the patient’s body. Excessively large breasts, or macromastia, can cause both physical and emotional difficulties for patients. They can also make common physical activities a challenge. While breast reduction surgery is often performed to address these types of issues, it is also an option for patients who do not have obvious symptoms of macromastia but are still unhappy with the size of their breasts.

If you have experienced one or more of the following symptoms, you could be a good candidate for reduction mammoplasty:

  • Breasts that are too large in proportion to your body size
  • Back, neck and shoulder pain caused by heavy breasts
  • Grooves in your shoulders caused by tight bra straps
  • Poor posture due to breast size
  • Heavy breasts that droop significantly
  • Breasts that are not equal in size (one is significantly larger than the other)
  • Trouble sleeping due to breast discomfort when lying down
  • Frequently occurring rashes or infection affecting the skin underneath your breasts
  • An inability to participate in athletic or physical activities due to the size of your breasts
  • Feelings of self-consciousness regarding breast size

A breast reduction can offer tremendous relief by alleviating these uncomfortable symptoms, and will also enhance the shape and appearance of your breasts while improving the comfort and fit of your clothing.

Types of breast reductions

There are several different surgical techniques that can be used when performing a breast reduction. Breast anatomy, the type and amount of tissue to be removed, and the desired outcome will all be considered when choosing the correct method for your case. These various techniques include:

A breast reduction can sometimes be performed using liposuction alone. This is a less invasive procedure, with minimal scarring and lasting results. However, it will only achieve optimal results in certain patients. Generally, these patients will have good skin elasticity, little to no sagging to correct, macromastia due largely to excess fatty tissue, and will desire a slight to moderate reduction in breast size.

Vertical or “Lollipop”
For patients in need of a moderate reduction in breast size who have more noticeable sagging, a vertical breast reduction can be a good option. This procedure involves two incision sites: one made around the edge of the areola, with the second incision running vertically from the bottom of the areola to the inframammary fold or the crease beneath the breast. This incision pattern allows surgeons to remove excess fat, skin, and breast tissue, then reshape the new smaller breast internally, lifting the breast into a more youthful position.

A vertical breast reduction does leave some scarring on the breast, but it is limited to the area below the nipple and is easily hidden beneath a bra or bikini top.

Inverted-T or “Anchor”
The inverted-T breast reduction uses three incisions: one around the edge of the areola, one vertically from the areola to the breast crease, and one made along the crease underneath the breast. This technique allows for the maximum degree of tissue removal and reshaping, and is often used for patients in need of a more significant breast size reduction, particularly if there is also considerable sagging or asymmetry to correct.

Scarring from this type of breast reduction is similar to a vertical reduction, with another thin scar running along the crease beneath the breast. With proper care, all breast reduction scars will typically fade considerably over time, and can easily be concealed by clothing, including bras and bikini tops.

Recovering from a breast reduction

Breast reduction surgery is typically an outpatient procedure. General anesthesia or intravenous sedation with local anesthesia will be administered before the surgeon begins. Once the excess breast tissue, fat, and skin has been removed, the remaining breast tissue and skin will be reshaped and closed with dissolvable sutures.

After spending a brief time in supervised recovery, you will be able to continue your recovery at home. Your chest will be bandaged, and you may be sent home in a surgical bra. There will be considerable soreness the first few days after your procedure, and your surgeon may prescribe pain medication to help keep you comfortable during this time. Ice packs placed gently on top of the bandages can also help alleviate any discomfort you may be feeling.

Your natural healing rate and the extent of the surgery performed will determine how much time you need to recover from your breast reduction procedure. You will be able to get up and walk around the same day of surgery, although you should have a trusted adult with you for the first 24 hours. While you may be permitted to shower a few days after surgery, you may need help getting dressed since you won’t have a full range of motion in your chest and shoulders at first.

Most patients are able to drive and return to a desk job within the first week after surgery, and once they are no longer taking prescription pain medication. You will likely need to wait at least 3-4 weeks before resuming exercise to ensure the incisions heal properly and reduce the risk of infection.

Within 2-3 months, you’ll be able to enjoy the final results of your breast reduction, but you may continue to notice subtle changes for 6-12 months post-surgery. Many women are able to successfully breastfeed after reduction mammoplasty.