Breast Reduction > Procedures
Also known as reduction mammaplasty, breast reduction
removes excess breast fat, glandular tissue and skin to achieve a
breast size in proportion with your body and to alleviate the
discomfort associated with overly large breasts.
Beauty for life:
 Enhancing
your appearance with breast reduction surgery
Overly
large breasts can cause some women to have both health and emotional
problems. In addition to self image issues, you may also experience
physical pain and discomfort. The
weight of excess breast tissue can impair your ability to lead an
active life. The emotional discomfort and self-consciousness often
associated with having large pendulous breasts is as important an issue
to many women as the physical discomfort and pain. Also
known as reduction mammaplasty, this procedure removes excess breast
fat, glandular tissue and skin to achieve a breast size in proportion
with your body and to alleviate the discomfort associated with overly
large breasts. Is it right for me?Breast
reduction is a highly 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. Breast reduction is a good option for you if:
 You are physically healthy
You have realistic expectations
You don’t smoke
You are bothered by the feeling that your breasts are too large
Your breasts limit your physical activity
You experience back, neck and shoulder pain caused by the weight of your breasts
You have regular indentations from bra straps that support heavy, pendulous breasts
You have skin irritation beneath the breast crease
Your breasts hang low and have stretched skin
Your nipples rest below the breast crease when your breasts are unsupported
You have enlarged areolas caused by stretched skinBack to Top What to expect during your consultationThe
success and safety of your breast reduction procedure depends very much
on your complete candidness during your consultation. You’ll be asked a
number of questions about your health, desires and lifestyle.  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 biopsiesYour surgeon may 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 breast reduction and any risks or potential complications
Discuss the use of anesthesia during your breast reductionBack to Top
Preparing for surgery
 Prior
to 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 surgery
Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleedingSpecial instructions you receive will cover:
What to do on the day of surgery
Post-operative care and follow-upYour
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 helpIf
your breast reduction procedure is performed on an outpatient basis, be
sure to arrange for someone to drive you to and from surgery and to
stay with you for at least the first night following surgery. Back to Top Procedural Steps:What happens during breast reduction surgery?Breast
reduction 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 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. Step 1 - AnesthesiaMedications
are administered for your comfort during the surgical procedure. The
choices include intravenous sedation and general anesthesia. Your
doctor will recommend the best choice for you. Step 2 - The incisionIncision options include:
A circular pattern around the areola 
The incision lines that remain are visible and permanent scars, although usually well concealed beneath a swimsuit or bra.
A keyhole or racquet-shaped pattern with an incision around the areola and vertically down to the breast crease 
An inverted T or anchor-shaped incision pattern 
Step 3 - Removing tissue and repositioningAfter
the incision is made, the nipple-which remains tethered to its original
blood and nerve supply-is then repositioned. The areola is reduced by
excising skin at the perimeter, if necessary. Underlying
breast tissue is reduced, lifted and shaped. Occasionally, for
extremely large pendulous breasts, the nipple and areola may need to be
removed and transplanted to a higher position on the breast (free
nipple graft). Step 4 - Closing the incisionsThe
incisions are brought together to reshape the now smaller breast.
Sutures are layered deep within the breast tissue to create and support
the newly shaped breasts; sutures, skin adhesives and/or surgical tape
close the skin. Incision lines are permanent, but in most cases will
fade and significantly improve over time. Step 5 - See the resultsThe
results of your breast reduction surgery are immediately visible. Over
time, post-surgical swelling will resolve and incision lines will fade.
Satisfaction with your new image should continue to grow as you recover. Back to Top Important facts about the safety and risks of breast reductionThe
decision to have breast reduction surgery is extremely personal and
you’ll have to decide if the benefits will achieve your goals and if
the risks and potential complications are acceptable. Your
plastic surgeon and/or 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. The 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 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 fluctuationsWhere will my surgery be performed?Breast
reduction 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 homeIf
you experience shortness of breath, chest pains, or unusual heart
beats, seek medical attention immediately. Should any of these
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
procedures and another surgery may be necessary. Be carefulFollowing
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. 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. Back to Top My recovery When
your procedure is complete, dressings or bandages will be applied to
the incisions. An elastic bandage or support bra may be worn to
minimize swelling and support the breasts as they heal.A small, thin tube may be temporarily placed under the skin to drain any excess blood or fluid that may collect.
You will be given specific instructions that may include:
How to care for your surgical site(s) following surgery, medications to
apply or take orally to aid healing and reduce the risk of infection,
specific concerns to look for at the surgical site or in your general
health, and when to follow up with your plastic surgeon. Be sure to ask
your plastic surgeon specific questions about what you can expect
during your individual recovery period.
Where will I be taken after my surgery is complete?
What medication will I be given or prescribed after surgery?
Will I have dressings/bandages after surgery? When will they be removed?
Are stitches removed? When?
When can I resume normal activity and exercise?
When do I return for follow-up care?Back to Top The results will be long-lasting The
results of breast reduction surgery will be long-lasting. Your new
breast size should help relieve you from the pain and physical
limitations experienced prior to breast reduction.
Your better proportioned figure will likely enhance your self image and boost your self-confidence. However, over time your breasts can change due to aging, weight fluctuations, hormonal factors and gravity. Back to Top How much will breast reduction surgery cost?Cost
is always a consideration in elective surgery. Prices for breast
reduction can vary widely. A surgeon’s cost for breast reduction may
vary based on his or her experience as well as geographic office
location. Many plastic surgeons offer patient financing plans, so be sure to ask. Cost may include:
Surgeon’s fee
Hospital or surgical facility costs
Anesthesia fees
Prescriptions for medication
Post-surgery garments, and
Medical testsBreast
reduction surgery is generally considered a reconstructive procedure
and may be covered by health insurance when it is performed to relieve
medical symptoms. Many insurers define breast reduction surgery as reconstructive based on the amount of tissue that will be removed. However,
pre-certification is required for reimbursement or coverage. Each
insurance policy varies greatly. Carefully review your policy to
determine coverage.  Your satisfaction involves more than a fee
When
choosing a plastic surgeon for breast reduction, remember that the
surgeon’s experience and your comfort with him or her are just as
important as the final cost of the surgery. Back to Top Words to know
Areola: Pigmented skin surrounding the nipple.
Breast reduction: Also known as reduction mammaplasty, the surgical removal of breast tissue to reduce the size of breasts.
General anesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness.
Hematoma: Blood pooling beneath the skin.
Intravenous sedation: Sedatives administered by injection into a vein to help you relax.
Liposuction: Also called lipoplasty or suction lipectomy, this procedure vacuums out fat from beneath the skin’s surface to reduce fullness.
Local anesthesia: A drug injected directly to the site of an incision during an operation to relieve pain.
Mammogram: An x-ray image of the breast.
MRI: Magnetic Resonance Imaging; a painless test to view tissue similar to an x-ray.
Reduction mammaplasty: The surgical removal of breast tissue to reduce the size of breasts.
Sutures: Stitches used by surgeons to hold skin and tissue together.Back to Top Questions to ask my plastic surgeonUse this checklist as a guide during your consultation
Are you certified by the American Board of Plastic Surgery?
Are you a member of the American Society of Plastic Surgeons?
Were you trained specifically in the field of plastic surgery?
How many years of plastic surgery training have you had?
Do you have hospital privileges to perform this procedure?
If so, at which hospitals?
Is
the office-based surgical facility accredited by a nationally- or
state-recognized accrediting agency, or is it state-licensed or
Medicare-certified?
Am I a good candidate for this procedure?
What will be expected of me to get the best results?
Where and how will you perform my procedure?
What surgical technique is recommended for me?
How long of a recovery period can I expect, and what kind of help will I need during my recovery?
What are the risks and complications associated with my procedure?
How are complications handled?
How will my ability to breastfeed be affected?
How can I expect my breasts to look over time?
After pregnancy? After breastfeeding?
What are my options if I am dissatisfied with the outcome?
Do you have before-and-after photos I can look at for this procedure and what results are reasonable for me?Back to Top
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