What is the goal of breast reduction?

Breast reduction surgery is performed to address chronic symptoms associated with large breasts and improve breast aesthetics. 

• Reduce the excessive weight of enlarged breasts
• Alleviate symptoms caused by enlarged breasts
  • Chronic back, neck and shoulder pain
  • Rashes underneath breasts
  • Shoulder groove marks from bra straps (not always reversible)
  • Improve posture
• Raise nipple height
• Improve breast symmetry

Patient satisfaction is very high with this procedure despite incurring significant scars in the process.

Who is a candidate for breast reduction?

Breast reduction can be performed at any age although there are two main groups that seek treatment. Women between fifteen and thirty represent the largest group. Older women who have developed large breasts as a result of weight gain or postmenopausal changes also are candidates. Both groups are effectively treated by breast reduction surgery.

When should breast reduction be performed?

• Breast size should be stable prior to surgery – typically once periods are stable in younger patients
• Weight should be stable prior to any surgery – losing weight after a breast reduction can have an impact on your final outcome

How is a breast reduction done?

Breast reduction surgery removes skin from the lower part of the breast, and breast tissue is then removed mostly from the outer part of the breast, less from the center, and least from the inner aspect. The diameter of the areola is reduced. Contrary to a common misconception the nipple and areola are not typically disconnected from the breast during surgery. Drains are placed prior to final skin closure to draw off fluid produced as a byproduct of the procedure.

What are the different options available?

There are two main breast reduction methods – both types involve removing skin from the lower part of the breast in order to avoid visible scars above the nipple.

• Anchor scar pattern – results in a scar around the areola, one extending vertically down to the crease under the breast, and a scar in the crease itself. Useful in most types of reductions
• Lollipop or Vertical scar pattern – results in a scar only around the circumference of the areola and vertically down to the crease under the breast. There is no scar in the crease itself. Not as good for very large reductions
• Free Nipple Graft - A variation of the anchor pattern method where the nipple and areola actually are completely removed from the breast and implanted in the proper location at the end of the procedure. The nipple and areola has a near normal appearance after surgery but no sensation. This method is rarely required.

What size will my breasts be after surgery?

It is not possible to accurately predict final cup size following surgery. The emphasis is not to pursue a specific cup size but rather to remove enough tissue to relieve symptoms, raise the breasts as much as possible, and create the best possible shape

Where is the surgery performed and how long does it take?

Breast lifts are performed on an outpatient basis in either an ambulatory surgery center or hospital of your choice. The procedure takes about three hours. Including implants adds at least another hour and a half. All surgery is performed entirely by Dr. Sirota.

What type of anesthesia is used?

General anesthesia is required during a mastopexy.

What are the risks associated with a breast reduction?

The general risks of any surgical procedure still apply in breast reduction surgery. These include but are not limited to risk of bleeding, infection, blood clots and anesthesia related risks. In addition, there are risks specifically associated with breast reduction surgery that patients must be aware of:

• Altered nipple sensation – this can be anywhere from an increase, to a decrease, to a loss (though complete loss of sensation is rare) and may be temporary or permanent
• Loss of nipple or skin tissue – smokers are at increased risk of this happening
• Delayed healing and excessive scarring can occur following a breast lift, but all are quite rare

Why is smoking so harmful for surgery?

• Smoking severely reduces blood supply to the breast tissue and skin
• It delays healing and can be responsible for skin or nipple loss, wound infection, bad scars, and other complications that may require corrective surgery
• It is essential to stop smoking completely for at least one month before surgery
• Nicotine containing patches and gum are equally harmful.

What is the recovery like?

• The pain associated with a breast reduction tends to be mild and mostly along the incision line
• Many women describe the sensation as similar to swelling during their period
• A front opening surgical bra is typically worn during the recovery period
• Bras with underwires are avoided for at least six weeks
• Heavy lifting and high impact aerobics should be avoided for at least six weeks to allow time for incisions to fully heal

What happens to the tissue that is removed?

Breast tissue removed at surgery is routinely submitted for microscopic examination. The hospital pathology department studies the tissue in detail and issues a report. Significant abnormal findings are fortunately rare.

Does insurance cover breast reduction?

Insurance coverage of breast reduction surgery is highly variable, depending in part on the insurance company, the type of policy, and the severity of the condition. The more complete the documentation of disabling symptoms before surgery, and the greater the amount of tissue removed at surgery, the more likely that insurance coverage will be approved. The final decision is ultimately at the discretion of the insurance company, however. Preapproval is mandatory today if benefits are to be expected.