Breast Reduction

Overview

Overly large breasts can cause health and emotional problems for some women. In addition to self-image and emotional issues, women may experience physical pain and discomfort, and the weight of excess breast tissue can impair their abilities to complete normal daily activities. 

A breast reduction, also known as reduction mamlasty, is a surgical procedure that removes excess breast tissue through incisions made on the breasts. In addition to the reduction, the procedure also uplifts the breasts to give you a size that’s in proportion with your body, thereby alleviating the discomfort associated with overly large breasts.

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Who Is a Candidate?

Breast reduction is a highly individualized procedure. It can be a good option for you if you are physically healthy, but are bothered by the feeling that your breasts are too large. Breast reduction also can be a good option if you are experiencing:

• Back pain
• Neck pain
• Shoulder pain
• Have indentations from your bra straps across your collar bone
• Have rashes underneath your breasts

Breast reduction can help you comfortably resume your normal activities of daily living, but you must be willing to accept permanent scars on the breasts.

Risks

In addition to the risks associated with anesthesia, other risks can include scarring, infection, and changes in nipple or breast sensation, which may be temporary or permanent. 

From a cosmetic standpoint there may be breast contour and shape irregularities, and there may be a need for future surgical revisions. The decision to have breast reduction surgery is extremely personal and you’ll have to weigh your goals against the potential risks and complications. When breasts are made smaller, other areas, such as the abdomen, may appear larger.

Not every person is a candidate for this procedure, and your risks may be greater or different than those of other patients. Your plastic surgeon will review all potential risks and complications with you prior to the surgery.

Before the Procedure 

The success and safety of your breast reduction procedure depends on your complete honesty during your initial consultation with the plastic surgeon. You’ll be asked a number of questions about

• Your health
• Desires
• Lifestyle, including your reasons and expectations for the surgery, and desired outcome

You will have to provide a detailed medical history including:

• Medical condition(s)
• Drug allergies
• Use of current medications

Notify your doctor of any previous surgeries or family history of breast cancer, and provide the results of any mammograms or previous biopsies. As part of the preparation, your surgeon will:

• Examine your breasts
• May take detailed measurements of their:
• Size
• Shape
• Skin quality
• Placement of nipples and areolas
• Take photographs for your medical record

In addition, women 35 years of age or older will need to have a baseline mammogram if you have not had one in the past. 

Some of the specific instructions you’ll receive about preparing for surgery include:

• Smoking cessation
• Medications to avoid
• When to take your prescribed medications
• Proper washing techniques
• Restrictions regarding eating and drinking the night before surgery

Procedure Details

Breast reduction usually is performed through incisions made on the breasts with surgical removal of the breasts:

• Excess glandular tissue
• Associated excess fat tissue
• Excess skin

In some cases, liposuction may be used in conjunction with the surgery to remove excess fat. In rare cases where the large breast size is primarily due to fatty tissue and excess skin is not a factor, liposuction alone may be used for breast reduction. For women with very large breasts, the nipples may need to be taken off and sewn back on as skin grafts.

There are several factors that help to determine the surgical technique used for your breast reduction, including:

• Breast anatomy
• Composition
• Amount of reduction desired
• Your surgeon's preferences

Several incision options are available, and your surgeon will discuss each in detail with you. Incision lines are permanent but will fade and significantly improve over time, and usually are hidden beneath a swimsuit or bra.

Type of anesthesia

Your doctor will recommend the best type of anesthesia for you, but local anesthesia along with intravenous sedation or general anesthesia can be used.

Where Will the Surgery Be Performed?

Breast reduction surgery usually is done in a hospital as outpatient surgery and you must be driven to and from the hospital by a friend or family member. Some patients may be required to spend a night in the hospital.

This is considered major surgery and following your physician's instructions is important to the procedure's success. 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.

Short-term Recovery

When the procedure is complete, dressings or bandages will be applied to the incisions, and an elastic bandage or support bra may be worn to minimize swelling and support the breasts as they heal. You will be given specific instructions about caring for the surgical site and which medications to take or apply directly on the breasts to aid with healing and reduce the risk of infection.

Anticipated Results

The results of breast reduction surgery will be long lasting. Your new breast size should help relieve the pain and physical limitations you had experienced prior to the breast reduction. Your breasts generally will have a better shape, are uplifted, and are more proportional with your physique. Over the course of time, your breasts may slightly change due to aging, weight fluctuations, hormonal factors, and gravity.