OverviewIf you feel your breasts are too large or heavy for the size of your body, you may be a good candidate for breast reduction surgery. (1) For many women, reducing the size of overly large breasts not only increases their self-confidence but provides relief from physical issues such as shoulder, back, and neck pain which oftentimes interferes with normal, everyday activities. (2) The overall goal of breast reduction surgery is to leave the patient with smaller, lighter, and more proportionate breasts. In many cases, a breast reduction will be combined with breast lift procedure to provide a more youthful and perkier look.
You might be a good candidate for breast reduction surgery if you are: (3)
- In good overall health with no major medical issues
- Well informed about the procedure and what to expect
- Emotionally stable
- Experiencing back, shoulder or neck pain associated with overly large breasts
- Having difficulty finding dresses or tops that fit
- Uncomfortable with your appearance because of the size of your breasts
You may not be a good candidate if you are:
- Unhealthy, or have medical issues making you unfit for the procedure
- Pregnant, breastfeeding or plan on having children in the future
- Not realistic about the expectations, particularly regarding the expected scars and recovery period
- History of irregular mammograms
To see if you’re a candidate, schedule a consultation with a plastic surgeon. They can make the final decision on whether or not breast reduction is right for you.
What to Know Beforehand
- You might not be able to get the exact cup size you want. How much your breasts can be reduced depends on your size, breast composition, and goals. During your consultation, your plastic surgeon will help you determine the best plan and give you a realistic idea of what you can expect. Most breast reduction patients go down one to two cup sizes.
- You’ll get a breast lift, too. The procedure is actually a twofer: Your surgeon will remove excess tissue and skin to make your breasts smaller, and then move the nipples up in position to give them a lift.
- You’ll have scars, which is a common concern among patients. (11) Fortunately, there are ways to reduce the appearance of scarring during and after surgery. Most scars generally fade within a year after surgery.
- There’s a chance you’ll have decreased nipple sensation. (12) This is caused by disruption of the nerves that innervate the nipple. In some cases, women may experience increased nipple sensation that is caused by agitated nerves.
- It could affect your ability to breastfeed later. If you plan on breastfeeding, make sure to discuss this with your surgeon. (4)
- Insurance might be a battle. Breast reduction may be considered a cosmetic technique by your insurance carrier, especially if only a small amount of tissue is removed.
- You want to make sure your breasts are done growing before having a reduction. Breast reductions are generally not recommended for teenagers, as the surgery can affect normal development. However, teenagers who rapidly develop large breasts may struggle with physical and psychological problems as a result.
- You may have to lose weight before undergoing surgery. Many surgeons will recommend that overweight women try to lose weight before a breast reduction surgery. In some cases, losing weight is associated with shrinking breast tissue, which could make the surgery unnecessary.
- Your breasts won’t be perky forever. Breast reduction surgery can provide a lift, but as recovery progresses your breasts will fall somewhat. In addition, as you age your breasts will drop somewhat
- You might need to buy new clothing. Breast reduction surgery may affect how your clothing fits.
Types of Incisions
- Donut Incision – Also known as a circular incision, this entails an incision around the areola.
- Anchor Incision – Also known as an inverted T, this is a set of three incisions. The first is a circular incision around the areola. The second is a vertical incision from the areola to the crease in your breast. The third is a horizontal incision in the breast crease.
- Lollipop or Keyhole Incision – This is made around the border of the areola and then from the lowest point on the areola down to the breast crease.
There is another option that may be suitable for some women called a “No-Scar” or “Scarless” breast reduction. (8) This procedure involves a series of small incisions that provide access for a small cannula that removes fat via liposuction. This option is usually for those who have minimal sagging and primarily extra fatty tissue in the breast. Studies have shown positive results with select patients. (9) Scars will fade in the year following your surgery, and skilled surgeons can take steps to minimize the visibility of scars. If you are concerned about scarring, make sure to discuss it with your surgeon during your initial consultation.
Which Option is Best for You?
- The size and composition of your breasts before surgery
- Your ideal breast size following the surgery
- The desired shape of your breasts post-surgery
They key to getting the breast reduction results that you want is good communication and understanding between you and your plastic surgeon.
- Your surgeon will use a surgical marker to identify the incision site(s)
- Anesthesia is administered
- An incision is made that will allow the surgeon to access the excess breast tissue without disrupting the subareolar parenchyma (the tissue that connects the nipple to the chest wall)
- Glandular and/or fat tissue is removed, and the remaining breast tissue is shaped
- The still-attached nipple is re-positioned to a higher position on the chest
- Excess skin is removed, and loose skin is tightened
- The incisions are closed with layered sutures that will support the newly shaped breasts
Risks and Complications
- Decrease or loss of sensation in the nipples or breasts
- Asymmetrical results (one breast or nipple may appear larger or smaller than the other)
- Problems with breast-feeding
- Allergic reactions to anesthesia, surgical tape, or drugs used during the procedure
- Long recovery time
How Long Will Results Last?
Cost of Breast Reduction
- Surgeon’s fee
- Anesthesia fees
- Hospital or surgical facility costs
- Medical tests
- Post-surgery garments
- Prescriptions for medication
On average, breast reduction costs between $6,500 and $12,000. This does not include additional expenses that may be involved such as any medical tests that must be done prior to surgery (e.g. mammogram) surgical garments and pain medications. Many women who consider breast reduction also have other cosmetic procedures done at the same time such liposuction, breast lift and abdominoplasty surgery to enhance the overall results. If additional procedures are performed at the same time, this could also increase your overall cost. If you’re paying out of pocket, ask your plastic surgeon if they offer any financing plans to make the procedure more affordable.
Q: How can I minimize scars from breast reduction surgery? A: Around 3 weeks after your surgery you can start applying a silicone scar therapy treatment, which has been shown to improve the appearance of scars over time. Avoiding sun exposure and tanning beds is important to prevent permanent color changes.
Q: Will a breast reduction really help my back and/or neck problems? A: Large breasts are a well-known cause of back and neck pain, and surgical reduction can provide substantial relief. (6) If you are not sure that your breasts are the source of your back or neck pain, it may be worth making an appointment with an orthopedist or a spine surgeon before undergoing the surgery.
Q: How long after surgery are breasts swollen? A: In most cases, swelling will resolve within a few weeks after the surgery, although minor swelling may persist for several months. If you are concerned that you have abnormal swelling, contact your surgeon immediately.
Q: How long does bruising last after surgery? A: Bruising typically disappears within 2-3 weeks after surgery.
Q: Will chest exercises lift and reduce my breasts? A: If you are overweight, exercise may reduce the size of your breasts. However, chest exercises alone will not lift or reduce breasts.
Q: Can breast tissue grow back after breast reduction surgery? A: While uncommon, breast tissue may grow back after surgery. Growth of breast tissue is often related to hormonal changes (pregnancy, menopause) or weight gain.
How to Choose Your Surgeon
In order to achieve the desired results, it is important that you take the time to choose your surgeon wisely. The surgeon you select, and the recommended surgical approach has an impact on patient satisfaction. Look for a surgeon who has extensive experience specifically with breast reduction surgery. Make sure that your surgeon is board-certified and is a member of one or more of the following organizations:
- American Board of Plastic Surgery
- American Society of Plastic Surgeons
- The Aesthetic Society
Although board-certification and membership in one or more of these organizations does not guarantee a successful outcome, surgeons must meet stringent criteria in order to achieve membership and board-certification. You can be confident that you are working with a highly trained, experienced surgeon who will help minimize risks associated with breast reduction surgery.