What are the Indications for Breast Reduction?

Breast Reduction is performed when the breasts are too large. Male breast enlargement is termed Gynecomastia, and male breast reduction is called Gynecomastia Reduction Surgery.

For women, the term for large breasts is Macromastia or sometimes Gigantomastia. Reduction Mammoplasty, or Reduction Mammaplasty, is the medical term for female breast reduction surgery, but it is usually referred to as simply breast reduction surgery.

There are many reasons why Breast Reduction Surgery is performed. Breast reduction is performed frequently for women with one or more of the following symptoms:

Breast Reduction Before and After Pictures (Reduction Mammoplasty)

Results shown are specific to each patient and individual results will vary

Breast Reduction Surgery and Breast Development

Breast Reduction Surgery and Breast Development

Breast Reduction Surgery is a cosmetic plastic surgery procedure that reduces, tightens and lifts the breast to diminish your physical discomfort and embarrassment, and increase your physical activity. The Reduction Mammoplasty does this in two ways. It reduces the amount of weight on the chest and the torque on the back by reducing breast tissue mass. Also, it firms and tightens the breasts by removing the excess breast skin and lifting the the breast tissue.

The timing of Breast Reduction Surgery depends on your health and your age. Since the Reduction Mammoplasty is elective surgery, it is important that you are in good health. If you have pre-existing medical problems, they should be well controlled, and Dr. Mele may ask you to see your doctor prior to surgery to be certain that the conditions are optimal for a safe and predictable breast reduction.

Follow-up After Breast Reduction

After surgery, it is important to follow-up with your Plastic Surgeon. They will provide you with additional information and instructions, which will further enhance your experience and results. Vigorous physical activity may be limited for several weeks after your Breast Reduction, so be certain to review which activities need to be avoided and for how long. Pain medications are usually only needed for a few days after surgery, and many patients suffering from chronic neck and back pain prior to Reduction Mammoplasty feel better as soon as they wake-up.

If you are interested in learning more about Breast Reduction in the San Francisco Bay Area, call our Walnut Creek Plastic Surgery office today at (925) 943-6353 to schedule a consultation.

Breast Reduction Videos

Breast Reduction Surgery (Reduction Mammaplasty)

If you are having physical symptoms from large breasts, like breast pain, neck pain, back pain, shoulder rutting, a chronic rash, or recurrent infections beneath your breasts, your health insurance may cover breast reduction surgery. Check your policy or contact your health plan to see if you qualify and what restrictions may apply. Some health plans have begun to exclude breast reduction as a covered procedure, and HMO plans will require you to see one of their doctors to qualify. Documentation of your symptoms and all attempts to relieve them is important. A letter from your primary care doctor or other doctors who have treated the problem, records of physical therapy, chiropractic care and medications taken can help with the approval process.

Inverted-T, Keyhole or Anchor Breast Reduction

This is the most frequently performed breast reduction surgery in the United States. It is similar to the breast lift of the same name; however, unlike a lift, breast tissue is removed. Removing breast tissue allows for a reduction in size and weight, resulting in a reduction of symptoms. While individual results vary, often relief is felt immediately, in the recovery room, directly after surgery. An Inverted-T breast reduction can be used for any size breast, no matter how large. I advise all my breast reduction patients that breast feeding may not be possible after breast reduction surgery. The inverted-T technique preserves a wide inferior base, providing the greatest chance of preserving lactation for women who can’t wait until after childbirth.

Vertical Breast Reduction

A vertical breast reduction is similar to an inverted-T breast reduction. It lacks the horizontal inframammary fold (IMF) incision, so less reduction of the inferior breast skin is possible. For long pendulous breasts, an inverted-T approach may provide a more predictable cosmetic result.

Horizontal Breast Reduction

A horizontal breast reduction is similar to an inverted-T breast reduction. It lacks the vertical incision, which runs from the lower pole of the areola to the IMF. It is best for the very ptotic (saggy) narrow breast. The nipple needs to be very low (before surgery) in order to eliminate the vertical scar.

Periareolar Breast Reduction

For breast that are starting relatively smaller, with excellent skin tone, sometimes both the vertical and horizontal scars can be eliminated. A periareolar lift is limited in the amount of lift it can provide, but in carefully selected patients, it can provide adequate lift with minimal scars. Since the incision is periareolar, the amount of lifting is limited, similar to a periareolar breast lift.

Liposuction (“No Scar” Breast Reduction)

The ultimate breast reduction would have no scars. For women with excellent skin tone and nipples near the optimal position, liposuction may be an option. Liposuction does not lift the breast so, liposuction for breast reduction works best with perky breasts. Liposuction can provide about one cup size reduction. The amount of reduction is limited by the amount of fat in the breast. Larger reductions can lead to a deflated appearing breast.

Are My Nipples Removed?

The nipple and areola are not usually removed from the breast when Breast Reduction is performed. The exception to this is the free nipple graft. For extremely large reductions, when there are problems with areolar circulation, and in cases where limiting surgery time is important, sometimes a free nipple graft is utilized. It is much like a skin graft, so it allows for the widest possible range of nipple placement. The down side is loss of nipple sensation. I rarely recommend free nipple grafts for my female breast reduction patients.

Free nipple grafts are more frequently used for gynecomastia reduction of very large male breasts. Since no extra breast tissue needs to be preserved beneath the nipple graft, the result is a flatter, more masculine chest.

Breast Reduction Video Presentation

Breast Reduction Insurance Coverage

Sometimes insurance will cover Breast Reduction Surgery that is done to relieve physical symptoms like shoulder rutting, neck and back pain, pain in the breasts, chronic rashes, or a history of recurrent infections under the breasts. Some health plans have completely stopped covering breast reduction surgery. Please check with your insurance company to see what is covered and what is necessary for approval. If you have an HMO plan, you will need to see an HMO doctor. Document your symptoms and what you are doing do treat them. A letter from other doctors you have seen about your symptoms, physical therapists, chiropractors, and a list of medications including the dose and frequency can help when seeking prior authorization for Reduction Mammoplasty.

Breast Reduction Recovery and Follow-up

Breast Reduction is an outpatient procedure. If you are healthy, you can go home the same day. If you have high blood pressure, or other medical problems, you may advised to stay overnight. Post-operative discomfort is most often described as pressure, and is usually well controlled with rest, ice and medications as needed. Follow-up visits are initially weekly, and decrease in frequency as you heal. Specific instruction will be provided tailored to your recovery, including scar reduction therapy.

Schedule Your Breast Reduction Consultation Today

If you are considering Reduction Mammoplasty, the best first step is an in-person consultation with an experienced, Board Certified Plastic Surgeon. Call our office today (925) 943-6353 to schedule your personal Breast Reduction Consultation today.

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