Breast Reduction Surgery

By Jerome Edelstein, MD

Breast reduction offers an ideal method of correction for not just reducing breast size, but also for resolving asymmetry, and for lifting the breast. Breast reduction has an extremely high success rate, leaving patients pleased with their results.

Since every woman’s body is different, our Plastic Surgeons must adapt their surgical approach to each patient in order to provide them with the best possible reduction results.

The specific techniques used to accomplish the reduction are determined by a combination of factors. These include breast composition, physical condition, and personal goals involving size and shape.

However, the treatment always follows the same general guidelines. In every reduction, the goal is to reduce volume and weight, tighten the skin (so it can better reshape and support the breast), and reposition the nipple/areola so it sits higher on the chest. The main surgical aim of reducing size is accomplished through incisions being made to the breasts that allow for the removal of excess glandular tissue, fat and skin. If a patient’s breast size consists mainly of fatty tissue and not excess skin, it may be possible for your surgeon to perform the reduction through liposuction alone. In other cases they may advise coupling surgical tissue excision with liposuction.

Depending on the surgical approach most appropriate to the patient, your surgeon may choose to make one of several different incision types. In most cases, the incision will be shaped like a keyhole or racquet, a circle surrounding the areola (the pigmented area around the nipple) and the vertical line running down to the breast crease. Another incision type is the anchor incision, which is similar to the incision above, with the addition of another incision along the crease under the breast. Patients will still be able to conceal their scar beneath a bra or swimsuit top.

Once the incision has been created, your surgeon repositions the nipple and areola, delicately moving the structure without damaging its link to the underlying blood supply and nervous system. If the areola needs to be reduced in size it can be made smaller by cutting away skin from its perimeter. Women with extremely large breasts may rarely require nipple/areola removal and transplant (a technique called the free nipple graft) in order to move these structures to a higher position. During this stage of surgery, the underlying breast tissue is reduced, shaped and lifted as necessary.

After the underlying tissue and skin has been altered, your surgeon begins to close the incisions in a manner that further reshapes the breast. Internal stitches, placed deep within the tissue, help to shape and support the breasts. Once this has been accomplished, further sutures, surgical tape and/or skin adhesives are used to close the outer incisions.Breast Reduction RecoveryThe incisions created during the reduction procedure, while permanent, will fade and become far less noticeable with time. Drains are never used. The surgical wounds themselves require several weeks to fully heal. During the first two to three weeks, patients should expect some bruising and swelling. Numbness may affect the skin covering the lower half of the breast and the nipple for three or fourth months as well.

Patients are typically provided with medication to help manage discomfort during the first seven days of recovery. After one week, most women find that they are able to return to their normal activities. More strenuous exercise should be limited for three to four weeks.