Breast Reduction

Excessively large, heavy breasts can cause a variety of medical and cosmetic problems. They alter posture, leading to chronic neck, upper back and shoulder pain. Tight bra straps cut into the shoulder, causing deep grooves. Persistent moisture in the breast crease under the breast creates an environment for skin rashes and irritation. Jogging and active sports become difficult and uncomfortable. Finding clothes that fit well is difficult. Breast reduction is designed to remove the drooping, heavy breast tissue and to reshape and reposition the breast to a more youthful location on the chest.

The Vertical Scar Reduction/Lift technique is one technique performed by the doctors in Akron, OH. Breast enhancement using this procedure, also known as a Vertical Reduction Mammaplasty, combines a breast reduction with a lift and results in more projection, a smaller scar, and higher, younger looking breasts. Women who choose this procedure are also less likely to experience breast sagging over time.

What are some of the most common benefits of Breast Reduction?

A breast reduction is very effective at eliminating the symptoms produced by heavy breasts. The fact that the procedure also produces a breast lift and a more shapely, youthful appearance is an added benefit. The outcome is not only a new look, but also a new outlook.

What will happen at the initial consultation?

Having a breast reduction in Akron, Ohio is a very personal decision, and we want to make sure all of your questions and concerns are addressed. The consultation will begin with a complete medical history and exam. You should tell your doctor if you have symptoms of neck pain, back pain, shoulder pain, or skin irritation; any history of scarring; any history of breast surgery or breast disease; any family history of breast cancer, and the results of your mammograms. Click here to Request Your Consultation at Crystal Clinic Plastic Surgeons.

Are you a candidate?

You may be a good candidate for breast reduction if:

  • Your breasts are large and pendulous, usually a “D” cup or larger
  • You have symptoms of chronic headache, neck pain and/or upper back pain
  • You have deep grooves in your shoulders from wearing a tight bra to support the weight of your breasts
  • You have chronic skin irritation in the crease under your breast
  • You restrict your physical activity because of the size and weight of your breasts
  • You are willing to accept incisions on your breasts
  • You are self-conscious about the large size of your breasts.

If you are planning to lose a significant amount of weight or you may want to become pregnant in the future, you should mention this to your doctor before your breast reduction surgery. You will be asked about the changes you would like to make in your breast size, breast shape, nipple location, size of the areola and anything else related to the appearance of your breasts. This will help us understand your expectations and determine whether they can realistically be achieved.

The examination will evaluate the size and shape of your breasts, the size and location of your nipples and areolas (the colored skin around the nipple), the quality of your skin and the proportion of your bustline to your body. Other options available will be discussed. You can see photos of recent patients before and after surgery. Patient references are available upon request. The estimated costs of your plastic surgery procedure will be explained. Photographs will be taken for your medical record. A letter of medical necessity along with a photograph will be provided to your insurance company upon your request and permission. Issues that will be discussed at that time include the following:

Incisions

There are several techniques and incisions used for breast reduction. The particular technique for you will depend on the size and shape of your breasts, the extent of drooping and the size of your areola. The following are incisions used for reduction mammaplasty:

Reduction mammaplasty patient shown before surgery with oversize, heavy breasts and shoulder indentations caused by tight bra straps.

Incisions are made in the breast to define the area of excision and the new location for the nipple. Breast tissue, fat and skin in the light shaded areas are then removed. Skin is removed from the darker shaded area, and the nipple is elevated.

Skin formerly located above the nipple is brought down and together to reshape the breast.

The postoperative patient shown with resultant scars around the areola, extending vertically down the breast and horizontally along the crease underneath the breast where, for the most part, the horizontal scar is hidden.

Reduction mammaplasty patient shown before surgery with oversize, heavy breasts and shoulder indentations caused by tight bra straps. Incisions are made in the breast to define the area of excision and the new location for the nipple. Breast tissue, fat and skin in the light shaded areas are then removed. Skin is removed from the darker shaded area, and the nipple is elevated.

Skin formerly located above the nipple is brought down and together to reshape the breast. The postoperative patient shown with resultant scars around the areola, extending vertically down the breast and horizontally along the crease underneath the breast where, for the most part, the horizontal scar is hidden.

Inverted-T–This is the most commonly used incision. The incision is located around the areola, down the center of the breast from the areola to the breast crease and horizontally along the breast crease.

Vertical or Anchor–This incision incorporates the incision around the areola and the vertical component from the areola to the breast crease. The horizontal component is limited or occasionally avoided altogether. This more limited incision is used for smaller reductions.

Around the Areola (Circumareolar)–The incision is around the perimeter of the areola-skin junction. This incision is used rarely for breast reductions, but commonly for breast lifts.

Free Nipple Grafts–In the majority of breast reductions, the nipple and areola are left attached to the underlying breast tissue and transferred to the new site as a single unit. In some women with massively enlarged breasts, the nipple and areola have to be removed from the underlying breast tissue and replaced at the new site as a “graft.” This results in a nipple that has less sensitivity.

Minimal Scar Breast Reduction/Lift Procedure – Traditionally, incisions for a breast lift or breast reduction include a long scar along the entire crease under the breast. Crystal Clinic Plastic Surgeons uses short scar techniques on breast lifts and breast reductions. A short scar technique known as Vertical Mammaplasty makes it possible to eliminate that long incision, while also producing a rejuvenated, more youthful breast shape.

Liposuction in Breast Lift and Breast Reduction Procedures

Liposuction is commonly used as a tool to re-shape the breast by removing fat in the area under the arm and the area around the bottom breast crease. Occasionally, liposuction of the breast is performed to reduce the weight of the breast or to assist in re-shaping.

Will my medical insurance cover a Breast Reduction?

Because heavy breasts cause symptoms, breast reduction surgery is considered medically necessary to correct a functional problem. Most health insurance companies cover the costs of the procedure if the surgery is deemed medically necessary. You should check with your health insurance company prior to surgery and obtain written confirmation that they will cover the procedure.

In women who have had a mastectomy for breast cancer, a breast reduction is often necessary on the normal breast in order to obtain symmetry. According to federal law, your health insurance must cover the costs for breast reconstruction, including a breast reduction on the normal breast.

Risks and Limitations

Women who undergo breast reduction surgery are generally very pleased to have relief of symptoms and a shapely, new figure. However, as with any surgical procedure, there are potential risks from anesthesia, bleeding or infection. Fortunately, in breast reduction surgery these complications are infrequent. The following are other potential risks of a breast reduction:

  • Scars–Breast reduction surgery involves incisions. Some people make inconspicuous scars while others make more prominent scars. Occasionally, especially in women of color, the scars can be raised and painful. These are known as keloids or hypertrophic scars. There is no way to know if you are one of those people unless you’ve had a past history of this occurring. However, there are several ways to intervene to help prevent and treat prominent scars if they occur.
  • Breast-Feeding–In the majority of breast reductions, the nipple remains attached to the milk-producing breast tissue. Theoretically, breast-feeding will still be possible. However, your ability to breast-feed may be limited.
  • Breast Asymmetry–While our goal is to make your breasts perfect in size and shape, this may not occur. Revision surgery is rarely needed (less than five percent), but is an option if necessary.
  • Loss of Nipple Sensitivity–This is usually temporary and improves over several weeks. Rarely, it can be permanent. Many women with very large breasts have decreased nipple sensation to start with.
  • Nipple Death–This very uncommon complication may occur if the blood supply to the nipple is insufficient or the nipple becomes excessively engorged with blood.
  • Weight Loss–The breast is composed of a combination of milk-producing breast tissue and fat. In most women, losing weight will result in losing volume in the breasts.
  • Liposuction–Liposuction has been used to reduce the size of breasts by removing the fat component of the breast. This approach has limited effectiveness; it will reduce the weight of the breast and may give slight lifting. Liposuction is often used with the minimal scar breast reduction/lift procedures.

How is a Breast Reduction surgery performed?

The goal of Crystal Clinic Plastic Surgeons and the Crystal staff is to make your surgical experience as easy and comfortable for you as possible. A mammogram will be recommended if you have not had one within the past year. You will be asked to stop smoking and avoid certain vitamins and drugs that can cause bleeding, such as aspirin, ibuprofen and vitamin E. Additional preoperative instructions and prescriptions to be used postoperatively will be provided. For convenience, we recommend that you have your prescriptions filled several days prior to the procedure. Breast reduction surgery is usually performed with an overnight stay or as an outpatient. If your surgery is performed on an outpatient basis, you should arrange for someone to take you home and stay with you the first night.

Your procedure will be performed in an outpatient surgery center or hospital. Your doctor will see you before the procedure, sometimes even the day before the procedure, and place ink marks on the skin. General anesthesia is used for almost everyone. Antibiotics will be administered at the time of surgery. The procedure takes two to five hours. The procedure consists of making the incisions around the areola, down the middle of the breast and along the breast crease. Excessive breast tissue, fat and skin are removed, and the remaining breast tissue is contoured. After each breast is addressed individually, they are examined for symmetry. Dissolvable stitches are used to close the incisions. Rarely, small drain tubes are placed. Your breasts will be wrapped in gauze dressings or a surgical bra.

Following surgery, you will be taken to the recovery area where you will continue to be closely monitored. Pain medications are administered to keep you comfortable. You will be permitted to go home after a few hours unless you have planned to stay overnight.

What can I expect after Breast Reduction surgery?

You will be allowed to shower the day after surgery. You can expect to be sore for a few days. You will be asked to wear a special bra for the first two to three weeks. Swelling and bruising will gradually resolve over six weeks. Scar management techniques will begin 10 days after the surgery.

By three to four days you should be able to lift normal-weighted objects, drive and lift your arms above your head. You may return to work one to two weeks after surgery. Activities that require extensive use of the arms and chest, including repetitive lifting, should be limited for four to six weeks. You may resume sexual activity after two weeks, but you should be gentle with your breasts for the next four to six weeks. At six weeks you should be back to your normal activities. The scars may be red or pink for several months, but should gradually improve.

You will have prescribed pain medication and your need for this will become less and less over two weeks. It is not uncommon to have intermittent, shooting pains that gradually resolve completely within two months. You may have decreased nipple sensation, and this will gradually improve over a few months.

What is the long-term outcome for most people?

Breast reduction surgery is very gratifying. The symptoms are gone. You have a more youthful shape to your breasts. Your clothes fit better, and you feel better about the way you look. However, despite wanting breast reduction for years, some women may experience “the blues” for a few weeks until they adjust to their new body image.

Unfortunately, breast reduction does not stop the effects of gravity and aging on your breasts. If you gain weight, your breasts will get bigger. If over time you become dissatisfied with the appearance of your breasts, you may want to consider a revision. We recommend an annual follow-up to make sure you remain satisfied with your result. For future comparison, you should have a mammogram nine to 12 months after the procedure.