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Breast Reduction

Medical Terms: Breast Reduction=Reduction Mammaplasty, Macromastia=excessively large breasts

Breast Reduction surgery is one of the most life-changing cosmetic procedures performed by Dr. Brown. Women who have naturally large breasts from puberty or adult-onset have difficulty in daily life finding clothes, bras, and swimwear that fit properly and look attractive. In addition, with the weight on the chest and associated sagging issues, back pain, neck pain, shoulder pain, and bra strap grooving into the shoulders become daily problems. Disproportionately large sized breasts interfere with certain activities, including jogging and many other types of exercise and fitness activities. Many women also do not like the unwanted attention that larger breasts may bring, and find themselves wearing special “minimizer” bras and oversized clothing to hide their breasts. Larger breasts can also make a person look heavier with a more matronly silhouette. For these reasons, breast reduction surgery is a very common cosmetic procedure which decreases the size of the breasts while providing an uplift to the breast and nipple. The amount of size reduction is based on patient preference, while also maintaining a well-contoured and naturally proportioned size for the individual. Results are almost always dramatic and life changing.

There are several different techniques for breast reduction surgery. For moderate degrees of macromastia with good overlying skin tone, a short-scar technique, termed a Vertical Breast Reduction is utilized. Skin is tightened around the areola, the nipple/areola are raised and made smaller, and tissue is removed from the lower central aspect of the breast. A powerful breast lift results from lower pole breast tissue tightening, and a resulting in a “lolli-pop” type of scar configuration results on the breast skin from this procedure. For more severe degrees of macromastia and associated sagging, A Full Breast Reduction is performed, in which breast tissue is removed from the periphery of the breast, and breast reshaping and skin tightening is performed in all dimensions. Scars are the trade off with breast reduction surgery, but hide in bras and the majority of revealing clothing styles and swimsuits. Women find that their smaller, perkier breasts are well worth the trade-off of inconspicuous scars. Symptoms of back, neck, and shoulder pain quickly resolve after breast reduction surgery. Women look healthy, fit, and well proportioned and are able to begin various types of fitness activities and exercise with ease.

Who is a Candidate?

  • Women with large, pendulous breasts desiring a decrease in bra size as well as a lift of the breast tissue and nipple
  • Women with sagging (ptotic), heavy, or matronly breast shape and appearance
  • Individuals who are uncomfortable or self conscious about the size of their breasts
  • Women who want to wear bathing suits, slim clothing styles, and bras that look good and fit properly
  • Patients with difficulty exercising, back pain, neck pain or shoulder pain from the weight of the breasts
  • Individuals with breast asymmetry in volume and/or nipple position, or enlarged areola
  • Patients must be non-smokers and healthy, ideally of stable weight

Goal of Surgery:

  • Size reduction, as well as lifting of the breast tissue and nipple
  • Decreased areola size as needed for more pleasing proportions
  • Improvement of breast asymmetry, realizing that perfect symmetry is unrealistic
  • Breast skin tightening
  • Relief of back pain, neck pain, and other discomforts related to large breasts
  • Improvement of self-image. Ability to wear bathing suits, tank tops, dresses and other attractive clothing styles
  • Youthful shape and contour, a more fit, less matronly silhouette

Procedure Description:

  • The surgery is done under general anesthesia as an outpatient and takes about 2-3 hours
  • Incisions are made around the natural contour of the breast. Around the nipple, down the lower half of the breast and underneath the breast fold. The Vertical Reduction technique avoids the skin and tissue take out under the lower breast fold. The nipple is not cut off. It remains attached to underlying blood vessels, nerves, and ducts. Larger reductions may be more at risk for temporary or long-term sensation changes.
  • Excess breast tissue, fat, and skin are removed. The resected volume is sent for pathological analysis. The nipple-areola complex is then moved to a more superior location. The nipple itself is not removed; the skin around the nipple is removed to obtain an approximate 4 cm nipple areola diameter. The nipple still remains attached to underlying blood vessels and nerves
  • Breast cup size cannot be guaranteed, as all bras fit differently. A certain amount of breast tissue must be preserved to ensure blood supply and proper healing to the overlying skin and nipple. Nevertheless, the results are usually dramatic
  • Permanent scars result after the procedure, but fade over 1 year. Everyone heals differently and at different rates

Postoperative Course:

  • The breasts are dressed in gauze and a sports bra
  • Drainage tubes are used in about 70% of cases, depending on the extent of your procedure
  • All sutures are absorbable. Small external knots will be trimmed in the office between 1 and 2 weeks
  • You can return to non-physical work in 1-2 weeks. No exercise, lifting, or strenuous activity for 4 weeks. Regular walking is encouraged immediately and may be continued. Gradual resumption of fitness activities begins as tolerated in 4 weeks
  • You must sleep on your back until your incisions are healed, 3-4 weeks
  • Bra support (usually a sports bra initially followed by a shapely underwire bra) is required day and night for 8 weeks, long-term use is encouraged during the day. The recommended underwire style almost never affects the healing incisions. The bra shapes and supports the breasts as they are healing
  • Expect mild bruising and swelling, and potential unusual appearance right after surgery, which may take a several months to resolve. Expect improvements in shape and contour for up to 6 months
  • The scars take at least one year to mature and fade. No tanning of the scars or breast skin for up to 1 year after surgery

Other Options:

  • Body contouring surgery can often be done in healthy individuals. Many patients simultaneously undergo liposuction or abdominoplasty

Breast reduction surgery is a commonly performed procedure by Dr. Brown. Women of all ages from puberty on upwards may have disproportionately large breasts which interfere with lifestyle. Dr. Brown has performed successful breast reduction surgery on women within the age ranges of 16-80 years old. For women who may become pregnant after breast reduction surgery, there may be a 30% chance of inability to breast-feed. Younger women describe improvements in self-esteem, ability to succeed in various sports and fitness activities, and ability to be comfortable in bikini tops and cute clothing styles without unwanted attention. Older individuals do remarkably well after breast reduction surgery and report significant improvements in quality of life after the procedure. They often mention that they wish they would have had the surgery done earlier in life to enjoy the daily benefits of having well-proportioned and non-pendulous breasts. Symptoms such as back, neck, shoulder pain, and bra strap grooving are typically resolved after breast reduction surgery. Preexisting musculoskeletal back problems and poor posture can also be improved with surgery. Besides the improvements in quality of life after breast reduction, Dr. Brown focuses on a beautiful cosmetic appearance of the breasts from surgery. Age-appropriate superior pole fullness and an attractive cleavage are desired with well-positioned and proportionately sized nipple/areola. Complete treatment of sagging issues with reduction of lateral breast/chest fullness, and improved symmetry and shape are also important in achieving an ideal cosmetic enhancement. Breast Reduction surgery is one of the most satisfying and rewarding cosmetic surgical procedures performed by Dr. Brown.

For More Information and descriptive diagrams of the Breast Reduction, click here.