What is a Designer Breast Reduction?

Dr. Rovelo has created the designer breast reduction as a way to fully customize every surgery to every individual patient.

Dr. Rovelo believes that a breast reduction is about more than just making the breast smaller.

It should also create a breast that has a beautiful shape and that will maintain its shape and position over time.

A designer breast reduction utilizes advanced techniques to achieve these goals.

In addition, the long term appearance of the breasts is improved by advanced scar management techniques and strategies.

This is more than just a functional Beverly Hills breast reduction procedure. 

What are the additional components of a Designer Breast Reduction?

Liposuction: Liposuction is frequently used with breast reductions to help shape and contour the sides of the breasts and the chest wall. This helps to narrow the breast and eliminate fullness in these areas. Liposuction does not eliminate the need for a surgical excision of breast tissue, but it can help to improve the overall contour.

Fat Grafting: Fat grafting starts by harvesting a patient’s own fat through liposuction techniques. The fat is then washed and directly injected back into the patient’s breast. This is typically done to restore volume in the superior portion of the breast. This area is prone to deflation and can sometimes appear empty after a breast reduction or lift. Fat grafting in this superior portion of the breast does not affect the overall size and will not make the breast larger, but it does allow for a more rounded and full appearance.

Breast Implant: Although it may seem counterintuitive to add an implant to a breast reduction, sometimes this is needed in order to create a fuller and more filled out appearance of the breast. This is particularly important in patients that have lost a significant amount of weight and have very loose skin. The breast augmentation implant is typically very small and does not contribute much volume or extra size to the breast, but it does provide fullness in the superior aspect of the breast and it creates a breast with an aesthetically pleasing shape and fullness.

Dermal Mesh: An absorbable dermal mesh is frequently used to provide additional soft tissue support to the breast. Weight loss and individual genetics can result in very loose skin that is prone to stretching out over time. In these patients, the breasts can start to descend and stretch out very early after surgery. The placement of a dermal mesh at the time of the breast reduction will help to strengthen the soft tissues of the breast, making them less susceptible to stretching. Over time, the mesh absorbs and disappears, but as it absorbs, the body replaces it with its own collagen and support structures. As a result, the soft tissues of the breast become stronger and less prone to stretching and descending over time.

Scar Management: When the incisions are fully healed, Dr. Rovelo will suggest a scar management program to improve and enhance the appearance of the surgical scars (minimal scarring). This includes the use of silicone scar products, as well as laser therapies to improve the color and redness of the scars. For problematic scars, microneedling and ablative laser therapies can also be utilized.

 What is a Designer Breast Reduction?

 Large breasts (macromastia) can contribute to symptoms of back, shoulder, neck, and physical pain.

 Macromastia can also lead to difficulty with exercise and feelings of self-consciousness.

A breast reduction is a breast surgery designed to reduce the size and volume of the breast.

It also places the breast tissue and nipple in a more youthful position on the chest wall.

Many breast reduction patients experience a huge improvement in their quality of life after breast reduction surgery – back and neck pain is relieved and they are able to exercise and move around with greater ease.

She also takes great pride in producing a beautiful breast that matches a patient’s unique body and desired breast size.

Who is a Good Candidate for a Beverly Hills Breast Reduction?

Breast reduction surgery can be performed at any age.

However, with rare exceptions, it is best to wait until the breast has fully developed and growth has stopped prior to proceeding with a reduction mammaplasty.

You may be a good candidate for a designer breast reduction surgery if you:

• Dislike the large size, or they are heavy (excessively large breasts), pendulous breasts.
• Experience embarrassment or feel self-conscious about the large size of your breasts
• Have symptoms associated with overly large breasts including back pain, shoulder grooving from your bra straps, constant pain, and shoulder pain.
• Recurrent rashes, infections, or skin irritation beneath the breast crease.
• Breast reductions are frequently covered by insurance if certain conditions are met.

Breast reductions in Los Angeles may be covered by insurance if certain conditions are met. As an out-of-network provider, Dr. Rovelo’s office will work with you to obtain insurance authorization, but there will be additional out of network fees associated with the procedure.

General considerations for insurance coverage require that the size of the breasts is directly contributing to physical pain, discomfort, and/or rashes under the breasts.

In addition, coverage typically requires that a certain amount of breast tissue be removed.

How much remaining breast tissue should be removed is determined by the Schnur Sliding Scale.

This scale calculates how much excess breast tissue needs to be removed by correlating the amount removed with the patient’s weight, or BSA (body surface area).

 If insurance is not paying for the breast reduction surgery, there is more flexibility in the amount that needs to be removed.

 In this situation, board certified plastic surgeon Dr. Rovelo will discuss with the patient her desired size and post-operative goals for symptom relief and aesthetic appearance.

How is Designer Breast Reduction Surgery Performed?

Breast reduction surgery can be performed using several different incision patterns.

•  The vertical reduction (“lollipop incision”) places the incision around the areola and down the midline of the inferior breast. Occasionally this incision is extended horizontally in the inframammary fold (IMF) for a short distance. This technique works well for patients that need a very small reduction in size and who do not have an excessive amount of extra skin or fatty tissue.
• The Wise pattern reduction (“anchor incision”) places the incision around the areola, down the midline of the inferior breast, and across the entire length of the inframammary fold (IMF). This technique is used for patients who require a significant reduction in breast size and who have a large amount of excess skin and tissue that needs to be removed. Although the incisions are long, a large portion of the incision pattern is hidden under the breast, while the visible portions tend to heal well.

How Long After a Designer Breast Reduction Will I Know My Size?

For most patients, it takes a few months after a breast reduction to arrive at your final size.

In the initial few weeks, there is a significant amount of swelling that makes the breasts appear larger and firmer than usual.

Over the next few weeks, this swelling will start to go down.

Usually, by 6 weeks, the breasts are close to their final size.

At this stage, it is recommended to be sized for an underwire (or non-surgical) bra.

The breasts will still continue to go down in size, but to a lesser degree, up until about 3 months post-operatively.

They will also become much softer and have a more natural feel and position on the chest wall.

Breast Reduction Scars & Excess Breast Tissue

 All breast reductions require incisions to be placed on the breasts.

These incisions typically go all the way around the areola (making it smaller in diameter), down the center of the breast and horizontally underneath the breast.

This is classically known as an anchor-pattern incision.

The horizontal incision that sits underneath the breast is typically not visible, but the incisions that go around the areola and down the center of the breast are visible.

A lollipop-pattern incision uses only the incisions around the areola and down the center of the breast.

This is typically reserved for patients that just need a breast lift (mastopexy) and is very rarely used for patients that require an actual reduction.

For the first few months, the scars will appear pink/red.

After 3-4 months, the red pigment will start to fade.

Over the course of the next year, the scars typically fade pretty well.

However, there are some scar treatments that can be initiated to improve the overall healing.

As soon as the incisions are fully healed (around 3-4 weeks), a silicone scar treatment in either a gel or an adhesive strip formulation is recommended.

There are also various laser and microneedling options for management of the scars.

Problematic scars can also be treated with injections and/or revision.

Designer Breast Reduction FAQs

Can you do a designer breast reduction with just liposuction?

Breast tissue is fundamentally different than regular fat.

It contains glandular tissue (milk ducts) and fibrous elements.

These more structural components make it difficult to remove volume through liposuction alone.

Older patients may have less of this structural tissue and may be able to have liposuction alone, but this would be an extremely rare case.

In addition to its limitations in volume removal, liposuction does not remove the extra skin that is left behind.

Similarly, it does not provide the breast lift that is inherent in a classic breast reduction.

Liposuction can be used as a supplemental procedure to a breast reduction.

It is not uncommon to require liposuction of the sides of the chest wall and armpit area.

This is not breast tissue, but liposuction of these areas results in a more harmonious and aesthetically pleasing breast shape.

How long should I wear my surgical bra after a designer breast reduction?

Surgical, or post-op bras are special bras designed to improve the healing after a breast reduction.

They typically have some compression (similar to a sports bra) that assists with decreasing swelling and improving post-operative comfort.

They button or zip up the front for ease of placement and easy access to any dressing changes that may be required.

Also, they do not have an underwire, in order to avoid too much compression on the incisions under the breasts.

It is generally recommended to wear a surgical bra the first six weeks after breast surgery.

This bra is typically applied right after surgery.

After 6 weeks, you can transition to a more traditional underwire bra.

Some patients find that they prefer to wear the post-operative bra for longer, or at night.

When can I sleep without a bra after breast reduction?

Never!

No but seriously, not that often.

Even after a reduction, breasts will continue to respond to time, age, and gravity.

These factors will be in effect even at night while you are sleeping.

In order to preserve the long term, desired results of your designer breast reduction, wearing either a regular underwire bra or a night-time sleeping bra is highly recommended.

Similarly, a good supportive bra should be worn most days.

Obviously, there are times when no bra or a light bralette may be preferred, but in general, a good supportive bra should be worn at all times to counteract the forces of gravity and to preserve your results.

Why Choose Dr. Rovelo for a Designer Breast Reduction Surgery in Beverly Hills?

 Dr. Rovelo is a board certified plastic surgeon and truly a breast reduction expert.

She listens to the patients and works with them to obtain a size that they desire and that is proportionate to their body.

She has an eye for what makes a breast beautiful, natural, and in harmony with the rest of the body.

Keeping these goals in mind, she spends extra time with you in a private consultation as well as the operating room to ensure that the final result is not only a smaller breast, but also a beautiful breast.

Dr. Rovelo is also very aware that a designer breast reduction surgery can result in a range of emotions, and she is there to support the patients throughout the entirety of their surgical journey.

How Old Do You Have to Be to Get a Designer Breast Reduction?

Breast reductions can be done as soon as breast development is complete and has stabilized (i.e. breasts are no longer growing).

In some patients, this can be as early as their mid-late teen years.

That being said, breasts may continue to have a slow amount of growth into late teen years, but this is usually not a substantial amount.

However, any weight gain or changes in hormone status (birth control, pregnancy, etc.) may cause the breasts to grow larger and a repeat or revision breast reduction may be required in the future.

What is a Teen Breast Reduction?

Teen breast reduction surgery is fairly common.

There are many reasons why teens may want to have a breast reduction.

Frequently, the size of their breasts make it difficult to play the sports that they enjoy playing.

The size of their breasts may also make it difficult to just do regular physical activities for their age.

There can also be feelings of self-consciousness and the physical and emotional burden related to the size of the breasts.

For these reasons, a teen breast reduction can provide dramatic improvements in overall physical and emotional well-being.

An ideal teen breast reduction patient has completed breast development, can verbalize why they wish to have a reduction, and is emotionally mature enough to understand the risks/benefits of a breast reduction surgery.

What is an Areola Reduction Surgery?

Areola reduction is typically included in a breast reduction surgery.

This is because the areolas are frequently enlarged in a ratio consistent with the size of the breasts.

Once the breasts are reduced, the areolas also require a reduction in order to maintain size symmetry and proportion.

The areola reduction is included in the pattern of the skin incisions.

What is a Heart Shaped Areola Reduction Surgery?

Can you make the areolas a different shape when reducing them?

Unfortunately, this is not a reliable option.

The areolas can be cut into different shapes, however the long term results are not ideal. 

Areola tissue is very thin, and it is prone to stretching over time.

When cut into a classic circle pattern, stretching is not that noticeable and relatively symmetric.

However, when cut into a different pattern, such as a heart, the stretching can be inconsistent and asymmetric and result in a very strange and unaesthetic shape that may be different between the two breasts.

What is a Nipple Reduction Surgery?

Nipple reduction frequently refers to changing the height/width of the nipple.

This is not typically addressed in a breast reduction.

Blood supply to the nipples is critical after a breast reduction, and combining a breast reduction with a nipple reduction may compromise the overall blood supply and healing.

If nipple reduction is desired, it would be best performed as a stand-alone procedure either before or ideally after a breast reduction.

This is a procedure that does not require general anesthesia and could be done as a local, in-office plastic surgery procedure.

How Do I Lose Belly Fat after Breast Reduction?

 It is not uncommon for patients to notice that their abdomen appears larger after a breast reduction.

This is not because the abdomen has actually become larger, but because the breasts are no longer covering it, and because the breasts have become disproportionately smaller, relative to the abdomen.

If this is a potential concern, fat reduction techniques such as liposuction and/or a tummy tuck can be added to a breast reduction procedure.

It is best to talk to your surgeon and determine if these are possible options when you pursue breast reduction surgery.

What are Designer Breast Reduction Risks?

A surgical procedure is associated with risks.

The risks associated with breast reduction include bleeding, infection, scarring, asymmetry, and need for revisional procedures.

Sensation to the nipple can be diminished or impaired.

 The ability to breast-feed or produce milk may be compromised.

On rare occasions, blood supply to the nipple is compromised and the nipple undergoes partial or complete loss.

 It is important to talk with Dr. Rovelo about the risks of your surgery and how the risks can be minimized to provide the best possible outcome.

What is the Recovery Time for a Designer Breast Reduction?

A designer breast reduction in Beverly Hills or Los Angeles is performed in the outpatient surgical setting, under general anesthesia.

Depending on the extent of the surgery or patient preference, some patients may choose to stay one night in an aftercare facility.

During the initial healing phase, patients will be seen on the first day after surgery and then again at 1 week after surgery.

 Light activity and return to work can resume after 1-2 weeks.

Heavy lifting and strenuous exercise may be resumed after 6 weeks.

Patients will need to wear a soft bra until healing is complete, typically 6 weeks.

How Much Does a Designer Breast Reduction Cost with Insurance?

Obtaining insurance coverage for a breast reduction can be difficult to navigate, even when insurance requirements have been met and you require the medically necessary procedure.

Once coverage has been obtained, patients are still responsible for all of their insurance co-payments and co-insurance amounts to the insurance provider.

 Dr. Rovelo and her office staff are accustomed to working with insurance companies and will be able to assist you with your coverage questions.

With years of experience, Millicent Rovelo MD is considered one of the best breast surgeons in Beverly Hills.

For questions on cost and realistic expectations, contact Dr. Rovelo for a designer breast reduction consultation in southern California today.