Breast Reduction

You may be a good candidate for breast reduction if you have one or more of the following conditions:

• Breasts that are too large in proportion to your 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 your breasts.
• Skin irritation beneath your breasts.
• Indentations in your shoulders from tight bra straps.
• Restriction of physical activity due to the size and weight of your breasts.
• Dissatisfaction or self-consciousness about the largeness of your breasts.

Breast reduction can be performed at any age, but plastic surgeons usually recommend 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 feel that they can address any subsequent changes later. If you plan to breast-feed in the future, you should discuss this with your plastic surgeon.

During the consultation, you will be asked about your desired breast size as well as anything else about your breasts that you would like to see improved. This will help us to understand your expectations and determine whether they realistically can be achieved.

How will I be evaluated for breast reduction surgery?

The doctor will examine your breasts, taking measurements and perhaps photographs for your medical record. The size and shape of your breasts, the quality of your skin, and the placement of the nipples and areolas will be carefully evaluated.

You should come to the consultation prepared to discuss your medical history. This will include information about any medical conditions, drug allergies, medical treatments you have received, previous surgeries including breast biopsies, and medications that you currently take. It is important for you to provide complete information.

You should tell us if you plan to lose a significant amount of weight, particularly if you have noticed that your breasts become smaller with weight loss. We may recommend that you stabilize your weight before having surgery.

Fortunately, significant complications from breast reduction are infrequent. Every year thousands of women undergo successful breast reduction surgery, experience no major problems and are pleased with the results. Anyone considering surgery, however, should be aware of both the benefits and the risks.

I understand that every surgical procedure has risks, but how will I learn more so that I can make an informed decision?

The risks and complications are carefully explained either by the doctor or one of the nurses in the office during your initial consultation or at your preoperative appointment.

Some of the potential complications that may be discussed with you include bleeding, infection and reactions to anesthesia.

Following reduction, sometimes the breasts may not be perfectly symmetrical or the nipple height may be slightly varied. If desired, minor adjustments can be made at a later time. Permanent loss of sensation in the nipples or breasts may rarely occur. Revisionary surgery is sometimes helpful in certain instances where incisions may have healed poorly. In the unlikely event of injury to or loss of the nipple and areola, they usually can be satisfactorily reconstructed using skin grafts.

You can help to lessen certain risks by following the advice and instructions given to you both before and after surgery.

Our goal and that of the entire staff is to make your surgical experience as easy and comfortable for you as possible.

Your breast reduction surgery will be performed in our freestanding ambulatory facility.

A general anesthetic is administered, so that you will be asleep throughout the procedure. When surgery is completed, you will be taken into a recovery area where you will continue to be closely monitored. Gauze dressings will be placed on your breasts and covered with an elastic bandage or surgical bra.

Depending on your age, or if you have a history of breast cancer in your family, we may recommend a baseline mammogram before surgery and another mammographic examination some months after surgery. This will help to detect any future changes in your breast tissue. Following breast reduction, you will still be able to perform breast self-examination. Breast reduction surgery will not increase your risk of developing breast cancer.

If you are a smoker, you will be asked to stop smoking completely six weeks in advance of surgery. Aspirin and certain anti-inflammatory drugs can cause increased bleeding, so you should avoid taking these medications for two weeks before surgery. We will provide you with additional written preoperative instructions.

We perform breast reduction surgery as an outpatient procedure. Regardless, you will need someone to drive you home and to stay with you for the next day or two.

The day after surgery, you will be encouraged to get out of bed for short periods of time. After several days, you will be able to move about more comfortably. Straining, bending and lifting must be avoided, since these activities might cause increased swelling or even bleeding. You may be instructed to sleep on your back to avoid pressure on your breasts.

A return visit to the office is scheduled upon your discharge from the recovery area. When you return to the office in a day or two, we will take down your dressings and if necessary give you dressing instructions. You will be instructed to wear a support bra for a few weeks, until the swelling and discoloration of your breasts diminishes. Generally, stitches will be removed in stages over a period of approximately three weeks, beginning about one week after surgery.

You may notice that you feel less sensation in the nipple and areola areas. This usually is temporary. It may, however, take weeks, months or even more than a year before sensation returns to normal. Your breasts may also require some time to assume a more natural shape. Incisions will initially be red or pink in color. They will remain this way for many months following surgery.

Breast Reduction FAQ’s

After breast reduction surgery, it is often possible to return to work within just a couple of days, depending on your job. In many instances, you can resume most of your normal activities, including some form of mild exercise, after several weeks. You may continue to experience some mild, periodic discomfort during this time, but such feelings are normal. Severe pain should be reported to our office.

Any sexual activity should be avoided for a minimum of one week. After that, care must be taken to be extremely gentle with your breasts for at least the next six weeks.

Unless you gain or lose a significant amount of weight or become pregnant, your breast size should remain fairly constant. However, gravity and the effects of aging will eventually alter the size and shape of virtually every woman’s breasts. If, after a period of years, you become dissatisfied with the appearance of your breasts, you may choose to undergo a breast “lifting” procedure to restore their more youthful contour.

Insurance coverage is sometimes available for breast reduction surgery. Many factors determine your eligibility, including the specific terms of your insurance policy and the amount of breast tissue to be removed. A letter of predetermination may be required by your insurance company prior to surgery. Unfortunately, at this time, the doctor does not accept insurance reimbursement for this type of surgery. Our office will be happy to assist you in getting reimbursed by providing any necessary information to you such as ICD and CPT codes and copies of your records. We do not correspond with the insurance companies for you.

Individual factors and personal preferences will determine the specific technique selected to reduce the size of your breasts.

The most common method of reducing the breasts involves three incisions. One incision is made around the areola. Another runs vertically from the bottom edge of the areola to the crease underneath the breast. The third incision follows the natural curve of the breast crease.

After the doctor 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. Liposuction 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.

What are some variations to the common breast reduction technique?

There are many variations to the design of the incisions for breast reduction. The size and shape of your breasts, as well as the desired amount of reduction, are factors that will help determine the best technique for you.

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.

Occasionally, the doctor performs liposuction only to reduce the breast size. Candidates for this technique are usually younger and have nipples that are already in a higher, or pointing forward or up position.

Rarely, if your breasts are extremely large, the nipples and areolas may need to be completely detached before they are shifted to a higher level. In such a case, you will need to have made the decision to sacrifice sensation and the possibility of breast-feeding in order to achieve your desired breast size.

You will return to our office for follow-up care at prescribed intervals, at which time your progress will be evaluated. We typically follow our patients until they are six months out from surgery. Some patients will be followed for up to 18 months.

Please remember that the relationship with your plastic surgeon does not end when you leave the operating room. If you have questions or concerns during your recovery, or need additional information at a later time, you should contact us.

Dr. Dhaval Patel is an accomplished Double Board Certified Aesthetic & Reconstructive Plastic Surgeon, who is skillful enough to restore your youthfulness which has been lost with the effects of aging & gravity. He is the man behind the famous Chicago Institute of Plastic Surgery.