What is a Breast Reduction?
Large breasts (macromastia) can contribute to symptoms of back, shoulder, and neck pain. Macromastia can also lead to difficulty with exercise and feelings of self-consciousness. A breast reduction is a 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 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.
Dr. Rovelo treats breast reduction as more than just a functional procedure. She also takes great pride in producing a beautiful breast that matches a patient’s unique body and desired breast size.
Who is a candidate for a Breast Reduction?
Breast reduction 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 surgery.
You may be a candidate for a breast reduction if you:
- Dislike the large size of your breasts
- Experience embarrassment or feel self-conscious about the large size of your breasts
- Have symptoms associated with large breasts including back pain, shoulder grooving from your bra straps, recurrent rashes or infections under your breasts
Breast reductions are frequently covered by insurance if certain conditions are met. General considerations for coverage require that the size of the breasts is directly contributing to pain, discomfort, and/or rashes under the breasts. In addition, coverage typically requires that a certain amount of breast tissue be removed. How much tissue should be removed is determined by the Schnur Sliding Scale. This scale calculates how much 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, there is more flexibility in the amount that needs to be removed. In this situation, Dr. Rovelo will discuss with the patient her desired size and post-operative goals for symptom relief and aesthetic appearance.
How is Breast Reduction 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 moderate reduction in size and who do not have an excessive amount of extra skin or breast 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 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.
All surgery 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 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.
Breast reduction is performed in the outpatient surgical setting, under general anesthesia. Depending on the size of the breast reduction, surgery may take between 3-5 hours. Depending on the extent of surgery, some patients may choose to stay one night in an aftercare facility. Patients may have drains placed after surgery. Patients will be seen on the first day after surgery and then again at one 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.