Breast Reduction

What is breast reduction surgery?

 

Breast reduction, also known as reduction mammaplasty, is a procedure to remove excess breast fat, glandular tissue and skin to achieve a breast size more in proportion with your body and to alleviate the discomfort associated with excessively large breasts (macromastia).

Disproportionately large breasts can cause both physical and emotional distress for patients. Patients with macromastia may experience physical discomfort resulting from the weight of their breasts. The resulting pain can make it challenging for some patients to perform common physical activities. Along with the physical ailments of macromastia, some patients may suffer from emotional distress or more significant mental health problems as a result of their large breasts.

Although breast reduction is often performed to address medical issues, patients who do not have the symptoms of macromastia but are unhappy with the size of their breasts can still pursue breast reduction as an aesthetic procedure. Patients choosing to undergo breast reduction surgery for cosmetic reasons may cite any number of factors, including social stigmas and wardrobe concerns.


Case Study

After researching the basics about breast reduction, many patients want to know what to expect before breast reduction surgery.

Prior to breast reduction surgery, you may be asked to:

  • Get lab testing or a medical evaluation
  • Take certain medications or adjust your current medications
  • Get a baseline mammogram before surgery and another one after surgery to help detect any future changes in your breast tissue
  • Stop smoking well in advance of breast reduction surgery
  • Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding

Special instructions you receive will cover:

  • What to do on the day of surgery
  • Post-operative care and follow-up

Your plastic surgeon will also discuss where your procedure will be performed. Breast reduction surgery may be performed in an accredited office-based surgical center, outpatient/ambulatory surgical center or a hospital.

You'll need help

If your breast reduction procedure is performed on an outpatient basis, be sure to arrange for someone to drive you to and from surgery and stay with you the following night.

Breast reduction surgery is usually performed through incisions on your breasts with surgical removal of the excess fat, glandular tissue and skin.

In some cases, excess fat may be removed through liposuction in conjunction with the excision techniques described below. If breast size is largely due to fatty tissue and excess skin is not a factor, liposuction alone may be used in the procedure for breast reduction.

The technique used to reduce the size of your breasts will be determined by your individual condition, breast composition, amount of reduction desired, your personal preferences and the surgeon's advice.

Specialist

The success and safety of your breast reduction procedure highly depends on your complete candidness during your consultation. You'll be asked a number of questions about your health, desires and lifestyle.

During your breast reduction consultation be prepared to discuss:

  • Why you want the surgery, your expectations and desired outcome
  • Medical conditions, drug allergies and medical treatments
  • Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs
  • Previous surgeries
  • Family history of breast cancer and results of any mammograms or previous biopsies

Your plastic surgeon will also:

  • Evaluate your general health status and any pre-existing health conditions or risk factors
  • Examine your breasts, and may take detailed measurements of their size and shape, skin quality, placement of your nipples and areolas
  • Take photographs for your medical record
  • Discuss your options and recommend a course of treatment
  • Discuss likely outcomes of your breast reduction procedure and any risks or potential complications
  • Discuss the use of anesthesia during your procedure for breast reduction

Disclaimer

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.

Your plastic surgeon and/or plastic surgery staff 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.

Possible breast reduction surgery risks 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; talk to your doctor if you are planning to nurse a baby
  • 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.

Where will my surgery be performed?

Breast reduction procedures may be performed in your plastic surgeon's accredited office-based surgical facility, an ambulatory surgical facility or a hospital. Your plastic surgeon and the assisting staff will fully attend to your comfort and safety.

When you go home

If you experience shortness of breath, chest pains or unusual heartbeats, seek medical attention immediately. Should any of these breast reduction complications occur, you may require hospitalization and additional treatment.

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 surgical procedure and another surgery may be necessary.

Be careful

Following your physician's instructions is key to the success of your surgery. It is important that the surgical incisions are not subjected to excessive force, abrasion or motion during the time of healing. Your doctor will give you specific instructions on how to care for yourself and minimize breast reduction surgery risks.

Be sure to ask questions: It's very important to address all your questions directly with your plastic surgeon. It is natural to feel some anxiety, whether excitement for the anticipated outcome or preoperative stress. Discuss these feelings with your plastic surgeon.

Frequently Asked Questions About This Procedure

DO I NEED SOMEONE TO DRIVE ME TO AND FROM THE APPOINTMENT?

No, however you are welcome to bring a family member or friend for support if you wish.

HOW DO I KNOW IF I AM A GOOD CANDIDATE FOR THIS PROCEDURE?

Breast reduction is an individualized procedure and you should do it for yourself, not to fulfill someone else’s desires or to try to fit any sort of ideal image. Ideal candidates are healthy, nonsmokers, who feel the size of their breasts are limiting their daily life. You are also an ideal candidate for a reduction if you experience back, neck and shoulder pain caused by the weight of your breasts.

WILL INSURANCE PAY FOR MY BREAST REDUCTION?

If you are thinking about having a breast reduction, contact your insurance company. Some insurance companies cover some or all the costs of breast reduction surgery if surgery is being done to relieve back pain, skin problems, or other medical problems caused by large or heavy breasts.  If this is something you feel you are a candidate for please let us know and we can discuss this with you and if appropriate prepare the submission paperwork with you at your visit.

IF INSURANCE DOES NOT COVER IT, HOW MUCH DOES A BREAST REDUCTION COST?

This is something that will be specific to each case and each procedure. Typically, the cost of a breast reduction varies, depending on several factors, and can range anywhere from $5,000 to$10,000.

HOW LONG DO I NEED TO WAIT TO SCHEDULE MY BREAST REDUCTION SURGERY?

Typically, we perform our breast reductions in Paoli Hospital Operating Room or the Surgery Center.  They are always on a Wednesday morning or Thursday afternoon.   We always ensure we schedule surgery around your schedule and when it makes sense for you to have such an operation.

ONCE WE SET A DATE, WHAT SHOULD I DO TO PREPARE FOR THIS PROCEDURE?

We will provide detailed instructions unique to each patient, but typically we ask all breast reduction patients to get a baseline mammogram. We also ask patients to stop smoking in the weeks before and after, and stop taking blood thinning medications prior to the procedure.

WHAT SHOULD I WEAR TO THE PROCEDURE?

Wear something loose and comfortable.

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