Breast Reduction

Less is More: All About Breast Reduction

Breast reductions are unique to breast surgery in that they are not really a procedure driven by aesthetic trends. Breast reduction surgery is largely functional with an aesthetic bonus. Disproportionately large breasts cause back pain, shoulder pain, shoulder grooving, and can contribute to poor posture. When my patients experience a lightened load on their body plus an improved appearance of their breast they wonder why they waited so long to have the surgery. Reducing the size of the breast can make it easier to perform physical activity and help you achieve your fitness goals by removing a physical obstacle. 

GOALS OF A BREAST REDUCTION

1. Reduce the size + narrow the breast
2. Lift the breast to a more youthful position

Tissue Removal

Breast reduction surgery starts with removing excess breast tissue. The technique I use resects most of the excess volume along the inferior and lateral portions of the breast. This technique, called the superomedial pedicle, leaves breast tissue on the inner and upper portion of the breast in order to maintain shape and fullness where you want it. During this tissue removal the nipple areola complex remains attached to underlying tissue that is carefully preserved in order to maintain blood flow to the nipple. The breast looks like an origami project during the process and eventually is reconstructed and shaped into a smaller, narrower breast. 

Breast Lift

I get asked frequently if a breast lift is “included” with a reduction, and the answer is yes. It is standard procedure to lift the breast during the reshaping process. The breast mound and the nipple areolar complex will be lifted to a more youthful position on the chest. The proper position for the nipple in a breast with no implant is at the level of the inframammary fold (IMF or the crease between your breast and abdomen). 

INCISIONS

The incision and therefore your scars will be in the shape of an anchor, around the areola, vertically to your IMF, and then horizontally along the breast crease. Scar visibility in these areas vary in women because of the influence of DNA and compliance with postoperative instructions. The scars mature around 6 months to 1 year after surgery and are well tolerated by most women. 

SURGERY DAY

The surgical process is relatively easy. Our surgical center and clinic is contained in the same space at Highland Park Plastic Surgery Center where you will present for surgery and go home the same day just a few hours later. General anesthesia will be used to keep you comfortable and asleep during surgery. 

RECOVERY

Pain - many women recover from a breast reduction without need for narcotic pain medication, although I provide a prescription if needed. 

Bandages/surgical dressing - a compressive bra is required for 6-8 weeks after surgery

Limitations - you will be restricted from strenuous exercise for 2 weeks but encouraged to walk frequently, at 2-4 weeks you will gradually increase your activity, and at 6-8 weeks you will be released to full activity 

EXPECTED OUTCOMES 

Sensation

After a breast reduction women often have changes in sensation for two reasons. Some women experience improved sensation because the nerves in the breast are relieved from a state of constant weighted stretch they have been under. Most women will experience some loss of sensation because of nerves that are cut when removing breast tissue.

Asymmetry

When I perform breast reductions I adjust for asymmetries and plan my resection accordingly however breasts are never naturally symmetric and they will never be completely symmetric after surgery. 

WHO IS A GOOD CANDIDATE?

Weight Changes & Breast Reduction 

In order to maximize the investment you are making in your personal outcome it is important to be weight stable prior to signing up for a breast reduction. This helps ensure that you will not have breast volume changes after surgery that could affect your results. Weight gain or loss can affect the aesthetic outcome.

• Weight gain risks - you may need a secondary breast reduction in the future
• Weight loss risks - you may end up losing more breast tissue than desired if you lose weight after a breast reduction 

Pregnancy & Breast Reduction

If your breasts are disproportionate to your frame then you will likely be a good candidate for breast reduction even if you have planned pregnancies in the future. The benefit of a reduction often outweighs any downside of breast changes with/after pregnancy. As with weight changes, it is possible that after pregnancy you may need a secondary breast surgery to improve the appearance or reduce the size. 

Breastfeeding & Breast Reduction

Because of the change in blood supply and nerve function after breast reduction, there is a risk that breastfeeding will not be possible. The data on this shows that the breast resection pattern may have an affect on the capacity to breast feed, but that overall women have an average chance of being able to breast feed compared to other women.

Age & Breast Reduction

Macromastia is a medical condition in which there is a disproportionately large growth of breast tissue that can cause real physical and mental health concerns. The disproportionate size of the breasts can contribute to pain, interference with daily activities/exercise, and can draw unwanted attention from peers. In such cases it is appropriate to perform a breast reduction on an adolescent. Even in these cases it is best to wait until breast growth has plateaued and has been relatively stable for 12 or more months. 

If you are wondering if a breast reduction is the right surgery for you, come and see me for a private consultation.

As always, here's to choosing how we age, on our own terms!

Dr. Lindsey Tavakolian, MD