Women with excessively large breasts may wish to consider breast reduction surgery either for purely aesthetic concerns or in order to alleviate physical discomfort due to their breast size. Whereas some women are unhappy with the cosmetic appearance of their chest, others may want to lessen symptoms such as back pain, neck pain and headaches, or improve poor posture – all of which may be attributed to the enlarged size of their breasts. These symptoms may have a significant negative impact on their daily activities and ability to engage in physical exercise. For women who suffer from any of these issues, breast reduction surgery may be an option. This procedure, also called reduction mammaplasty, consists of the following:
- removal of excesss fat and glandular tissue from enlarged breasts;
- lifting and repositioning low nipples and areolas; and
- tightening loose skin envelope.
These elements result in smaller, more shapely breasts that are more comfortable and in better proportion to the rest of the body. Primary consideration is given to preserving sensation and bloody supply to the nipples. This may limit the amount of size reduction that is achievable safely without compromising sensation and function of the nipples. Breast reduction surgery often includes procedures performed in other cosmetic breast surgery operations, namely breast lift (mastopexy) and nipple and areola surgery.
In addition to causing pain and other unpleasant symptoms, large breasts may also draw unwanted attention that can affect a woman’s self-esteem and make her uncomfortable with her appearance. Breast reduction surgery can help patients regain confidence and enjoy an improved self-image by creating a new body they are more comfortable with and proud of. Numerous plastic surgery studies have corroborated the positive outcomes of the surgery, including many physical and psychological benefits in patients who have undergone breast reduction surgery.
In some women, only one breast may be significantly enlarged relative to the other, resulting in noticeable asymmetry. Although most women have some degree of asymmetry in terms of shape, size, and overall appearance of their breasts, occasionally the imbalance has a markedly negative effect on their self- image and ability to find suitable clothing. Performing breast reduction surgery only one one breast aims to improve breast symmetry and overall aesthetic balance.
Prior to your breast reduction procedure, Dr. Hutchinson will meet with you to discuss your goals and expectations for surgery, as well as to inform you of the details of your chosen procedure. This discussion is important in helping patients achieve the precise results they desire. Each procedure is fully customized for each individual patient.
Candidates for Breast Reduction
Ideal candidates for breast reduction surgery are women who are generally in good health and have oversized breasts that cause them medical problems, low self-esteem, physical or social discomfort, or frustrations with the size of their breasts. Younger patients in their adolescence may also consider breast reduction surgery once they have finished puberty. Special considerations are taken into account when performing breast reduction in teenagers. In some patients with significant breast asymmetry, breast reduction may be performed only on one breast in order to improve symmetry. Women must not be pregnant or breastfeeding while undergoing this procedure.
It is important for patients to understand the potential benefits of and risks associated with breast reduction, and to have realistic expectations in order to be satisfied with the results of their surgery. Patients who have undergone prior breast reduction surgery and who are seeking a revision, due to suboptimal results, excess scarring, or recurrent breast enlargement, may also safely undergo additional breast reduction. For these patients, breast reduction revision options are limited due to prior scars and breast tissue removed during the previous operation(s).
Breast Reduction Procedure
Breast reduction surgery is performed under general anesthesia and usually takes about 1.5 to 2 hours, depending on choice of technique and each patient’s individual case. There are several different types of incisions that may be used for this plastic surgery procedure. Dr. Hutchinson will determine the best type for you after evaluating your breasts and discussing your goals and expectations.
- Traditional Breast Reduction Surgery – This technique involves an inverted “T” or anchor-shaped incision and is ideal for women with extremely large breasts, although scarring is usually more apparent. Excess skin, fat, and breast tissue is removed from the sides and upper aspect of the breast, the nipples are lifted, and the areolas reduced as needed.
- Vertical Incision Breast Reduction – Also known as short-scar or limited incision breast reduction, this technique involves incisions that extend only around the areola and down to the breast crease for a lollipop shape. The vertical incision technique creates perky, shapely breasts and results in significantly less scarring than the traditional method. The method also allows for excess breast tissue and skin to be removed, and for nipples to be lifted and areolas reduced. Excess breast tissue is removed from the sides and bottom of the breasts, and the remaining breast tissue is reshaped internally to provide long lasting results. Ideal patients for short-scar breast reduction are women who wish to obtain a moderate decrease in breast size and younger patients such as adolescents with enlarged breasts who wish to reduce breast size and are primarily concerned about limiting scarring on their breasts.
- “Scarless” Breast Reduction – “Scarless” breast reduction uses liposuction techniques to reduce the size of the breast using tiny incisions which result in minimal, imperceptible scarring. Since liposuction removes primarily fatty tissue in the breast, patients who benefit most from this technique have a significant amount of breast fat relative to glandular tissue, minimal excess skin, well positioned nipples, and appropriately sized areolas. There are no incisions around the nipple or areola, so this method of breast reduction is limited to removal of breast fat and does not provide significant lifting of the nipples or reduction of the areolas. Skin reduction occurs as a secondary process following breast liposuction, and relies on the patient’s skin elasticity to shrink and produce the final result. This technique is ideal for women who desire a moderate breast reduction and have excellent skin tone, and is also commonly used on men with enlarged breasts to remove excess breast tissue from the chest (gynecomastia correction).
Recovery from Breast Reduction
After breast reduction plastic surgery, patients will likely experience soreness, swelling and bruising for several days. Patients usually wear a surgical bra for the first few weeks after surgery. Physical activity should be limited for one week, while exercise and other strenuous activity should be avoided for at least two weeks.
Patients will return for their first follow up appointment with Dr. Hutchinson within the first week after surgery. Sutures are absorbable and do not need to be removed, and drains are not routinely used. It is important to see Dr. Hutchinson for regular follow-up visits to ensure that your breasts are healing properly.
Results of Breast Reduction
The results of breast reduction surgery are noticeable immediately after the operation and will continue to improve over time. Some swelling and bruising are normal and will gradually subside. Scars will continue to fade with time and can usually be concealed by clothing.
Breast reduction has repeatedly been demonstrated to produce excellent outcomes with long lasting benefits in reducing or eliminating symptoms due to excessive breast size, and these effects are permanent. Most breast reduction patients are delighted with their results and the improvement in their quality of life after surgery. In addition to better physical status, patients also benefit from greater psychological and emotional well-being.
Risks of Breast Reduction
Although breast reduction is considered extremely safe for most patients, there are certain risks associated with any surgical procedure. Some of these risks include bleeding, infection, unsightly scars, loss of sensation, wound healing problems, and inability to breastfeed. The vast majority of patients, however, undergo this procedure with no serious complications.
Dr. Hutchinson will discuss these and other risks with you prior to surgery, as well as answer any questions you may have to ensure that you feel comfortable with your decision.
The Breast Reduction Patient’s Frequently Asked Questions
Q: Am I a good candidate for breast reduction surgery?
A: Once your breasts have completed their development, you may benefit from breast reduction surgery if you experience any of the following:
- think that your breasts look too big, feel too heavy, or are disproportionately large relative to your body frame
- don’t feel comfortable in clothing or can’t find clothing that fits properly
- are constrained in your activities (including sports and physical exercise) because your breasts are too large
- suffer from symptoms such as back pain, neck pain, shoulder pain, or headaches due to your large breasts
- get rashes under or between your breasts, a medical condition called intertrigo
- have shoulder grooves from your bra straps due to excessive weight of your breasts
- need to wear special bras to provide sufficient support for your breasts
- have poor posture, are hunched over, or have spine curvature (scoliosis) due to the weight of your breasts
- have asymmetric breasts with one breast significantly larger than the other, and would like better symmetry
Q: What should I expect during my breast reduction consultation?
A: Your initial consultation with Dr. Hutchinson includes the following:
- a comprehensive in-person discussion with Dr. Hutchinson when she will obtain your medical history and you will have time to explain what bothers you about your breasts and what results you hope to achieve with surgery
- after your conversation, you will be seen in a private examination room where she will perform a detailed physical examination and assess your unique physical characteristics
- she will also take medical photographs which provide additional information when discussing your surgery
- following your examination, Dr. Hutchinson will discuss surgical options, determine the best customized surgical plan for you to achieve your goals, and review your medical photographs with you
- Dr. Hutchinson will also provide you with specific details regarding the bespoke operation she creates for you as each patient’s plan is based on individual features and desired outcome
- she will also inform you of what is required from you before and after your surgery to ensure a successful operation and smooth recovery
- you will be given ample time to ask any questions you have in order to feel comfortable with your decision
- you will also have an opportunity to schedule your surgery once you have decided to proceed
Q: What cup size will I be after my breast reduction surgery?
A: Bra cup size is variable between brassiere manufacturers and is not entirely reliable as a measurement of breast size either before or after breast reduction. In order to help you understand what results can be achieved with breast reduction surgery and what is the best possible option for you, Dr. Hutchinson will discuss with you specific details of your current breast size and physical characteristics. Factors that may impact your results include the following:
- your current breast size, including:
- breast volume
- amount of breast sagging (“ptosis”)
- weight of the breasts
- amount of fat and glandular breast tissue
- position of your nipples
- size and shape of areolas
- skin characteristics, such as:
- amount of excess skin
- skin quality (elasticity and tone)
- breast scars from prior surgery
- breast asymmetry or differences between the breasts in terms of:
- breast volume, shape, and width
- breast sagging (“ptosis”)
- nipple position
- areola size and shape
Q: How should I prepare for my breast reduction surgery?
A: Dr. Hutchinson provides her patients with detailed and precise instructions to be followed prior to surgery, which include the following:
- Dr. Hutchinson will make recommendations for each patient including:
- breast imaging including mammogram, sonogram, and/or MRI as necessary
- requirements for medical clearance and bloodwork prior to surgery
- patients should be active participants in optimizing their wellness, including:
- maintaining a healthy lifestyle, diet, and weight
- avoiding smoking
- not taking medications that can increase risk of complications
Q: What should I expect after my breast reduction surgery?
A: Every patient will have her own personal experience and recovery after breast reduction, although some common aspects of their post-operative course include the following:
- changes are immediate and results long lasting
- some discomfort, swelling, and bruising are normal in the first few days after surgery
- you should wear the surgical brassiere provided after surgery
- it is essential you refrain from strenuous physical activity after surgery and closely follow the detailed instructions provided by Dr. Hutchinson
- most patients who were suffering from symptoms such as neck or back pain due to their large breasts will experience improvement or complete resolution of symptoms after breast reduction, and these effects are often permanent