Background:

Breast reduction, also called reduction mammaplasty, is designed to relieve the physical discomfort often associated with very large breasts and to enhance the overall appearance of the breasts. The procedure removes excess breast tissue and skin, making breasts smaller and firmer. The areola (the pigmented skin surrounding the nipple) may be reduced and repositioned. Breast reduction can be performed at any age, but plastic surgeons usually recommend waiting until breast development has stopped.

Technique:

Individual factors and personal preferences will determine the specific technique selected to reduce the size of the patient’s breasts. The most common method of reducing the breasts involves three incisions: One is made around the areola; another runs vertically from the bottom edge of the areola to the crease underneath the breast; the third incision is horizontal beneath the breast and follows the natural curve of the breast crease. After the surgeon has removed excess breast tissue, fat and skin, the nipple and areola are shifted to a higher position. The areola, which in large breasts usually has been stretched, also is reduced in size. Skin that was formerly located above the nipple is brought down and together to reshape the breast. Lipoplasty may be used to improve the contour under the arm. Usually, the nipples and areolas remain attached to underlying mounds of tissue, and this allows for the preservation of sensation. The ability to breast-feed may also be preserved by this method, although this cannot be guaranteed. In some instances, it may be possible to avoid the vertical incision that runs from the bottom edge of the areola to the breast crease or the horizontal incision underneath the breast.

Benefits:

• Breasts will be more proportional to rest of the patient’s body, and clothes will fit better. Breast reduction often makes a dramatic change in appearance as well as physical comfort. The level of patient satisfaction from breast reduction is among the highest of any plastic surgery procedure.


• Significant complications from breast reduction are infrequent.


• It is often possible to return to work within one or two weeks, depending on your job. Resumption of most normal activities, including some form of mild exercise, is often possible after several weeks.

Other Considerations:

• Every surgery carries some risk. Potential complications include reaction to anesthesia, bleeding, infection and poor healing.


• Patient may be instructed to wear a support bra for a few weeks, until swelling and discoloration of breasts diminishes.


• Diminished sensation in the nipple and areola areas usually is temporary. However, it may take weeks, months or even more than a year before sensation returns to normal. Permanent loss of sensation in the nipples or breasts may occur rarely.


• Incisions will initially be red or pink in color, and will remain that way for a number of months following surgery.


• Incision lines will be permanently visible, more so in certain individuals than others. The incisions for breast reduction are in locations easily concealed by clothing.


• Following reduction, sometimes the breasts may not be perfectly symmetrical or the nipple height may vary slightly. If desired, minor adjustments can be made at a later time, but patients should remember that natural breasts usually show some variation.


• Revisionary surgery is sometimes helpful in certain instances where incisions may have healed poorly.