Breast reduction surgery can be a big help to patients who are seeking relief from physical symptoms caused by the excessive weight of large breasts, including neck, shoulder, and back pain. Following breast reduction, the breasts are usually more proportional to the rest of the body, and most patients report a significant improvement in their physical health. Dr. Charles Hsu, a plastic surgeon in Beverly Hills, incorporates a breast lift into all of his breast reduction procedures for the best results.
Best Candidates for Breast Reduction
Breasts that are too large in proportion to the body frame
Heavy, pendulous breasts with nipples and areolas that point downward
One breast is much larger than the other
Back, neck, or shoulder pain caused by the weight of the breasts
Skin irritation beneath the breasts
Indentations in the shoulders from tight bra straps.
Restriction of physical activity due to the size and weight of the breasts.
Dissatisfaction or self-consciousness about the largeness of the breasts
Dr. Hsu will start the consultation by asking the patient why they want a breast reduction and what specific concerns they have about their breasts. Dr. Hsu will take measurements of the breasts during the physical examination, and if the patient is over 40, a recent mammogram will need to be provided. Dr. Hsu and the patient can then plan the breast reduction surgery, including what techniques will be used and the amount of breast tissue that will be removed. Patients who are planning to breastfeed after the surgery need to tell Dr. Hsu this during the consultation.
Breast reduction surgery takes about 3-4 hours with the patient under a general anesthetic. During surgery, Dr. Hsu will make the appropriate incision, remove the breast tissue, raise the breast and nipple, and then suture everything into place. For the thinnest, most inconspicuous scar, Dr. Hsu uses a special technique with several layers of dissolvable sutures.
There are two incision patterns and techniques that Dr. Hsu will use during a breast reduction surgery:
The anchor incision is made around the perimeter of the areola, then extends vertically down the breast crease, and continues horizontally along the breast crease. This technique leaves the most scarring, so it is for women with big pendulous breasts with severe degree of sagging who will not be helped sufficiently by less invasive techniques. This incision is often used for a breast reduction in conjunction with a breast lift.
The lollipop incision, also known as a keyhole incision, is made around the perimeter of the areola and then goes vertically down to the breast crease. This technique leaves less scarring and it is suitable for women with a moderate degree of excess breast tissue and sagging.
Recovery and Post-Op
Once the breast reduction surgery is complete, Dr. Hsu will apply bandages to the breast and secure the breasts with a surgical bra. The bandages and surgical bra must be worn for at least the first week. Patients may continue to experience some mild, periodic discomfort during the first two weeks, but such feelings are normal and light activities may be performed. Any sexual activity should be avoided for a minimum of one week. Patients should be very careful to avoid pressure on the chest for at least 4-6 weeks and come to all follow-up appointments.
From Dr. Hsu
“I find breast reduction surgery very satisfying because it can dramatically improve a patient’s quality of life. Most patients, by the time they come to see me for breast reduction surgery, have had years of chronic neck pain, back pain, and shoulder pain caused by excessive weight from very heavy breasts. In some severe cases, patients can have shoulder strap grooving and even nerve problems in their hands and arms related to this!
I like to include a significant breast lift when I perform this breast reduction procedure. There is almost always an excess of both skin as well as breast tissue, and so during the procedure I will almost always elect to place the nipple and areola in a higher position on the new breast to maximize its aesthetic appearance.”
Frequently Asked Questions
Is Breast Reduction covered by Insurance?
For patients who want to have their breast reduction procedure covered by insurance, the insurance companies will usually provide some reimbursement if they decide that the surgery is needed for functional reasons. If a certain amount of tissue is removed, insurance companies will most often require the specimen to be weighed. Dr. Hsu can send this information to the insurance company to maximize the chance that insurance will reimburse the patient for some of the costs.
What is the best age to get Breast Reduction?
Breast reduction can be performed at any age, but Dr. Hsu usually recommends waiting until breast development has stopped. Childbirth and breast-feeding may have significant and unpredictable effects on the size and shape of your breasts. Nevertheless, many women decide to undergo breast reduction before having children and then address any subsequent changes later.
What happens to the Nipple and Areola?
After the excess breast tissue, fat and skin have been removed, the nipple and areola are shifted to a higher position. The areola, which has usually been stretched, is also reduced in size. Skin that was formerly located above the nipple is brought down and together to reshape the breast. Usually, the nipples and areolas remain attached to underlying mounds of tissue, and this allows for the preservation of sensation. The ability to breastfeed may also be preserved by this method, although this cannot be guaranteed.