Many patients come to our board-certified plastic surgeon, Dr. David L. Durst, to consider breast reduction. This procedure is much more common than you might think. Patients who consider breast reduction have years’ worth of trouble as a result of their breasts being too big. When Dr. Durst talks to you, he will ask about your symptoms. Often these include problems with your back and your neck. They may also include problems with rashes underneath the breasts, difficulty finding bras that fit, and the reality that some activities just simply are not possible when your breasts are too big. If that is the situation, most patients can find significant improvement with the breast reduction procedure.
Another component of overly large breasts can be some droopiness in almost every situation. When Dr. Durst examines you, he will take measurements and determine whether your current bra size is out of proportion with your ideal size based on your frame. He will also catalogue your symptoms. At that time, he will make a recommendation about the breast reduction that would be most beneficial to you.
Breast Reduction Procedure
The operation involves a surgical procedure performed at the hospital or Surgery Center, typically with an overnight stay. Incisions will be designed on the breast to allow the breast to be lifted and tightened at the same time as being reduced in size. Many patients need reduction of at least 50% to get down to a “normal” size. The surgical techniques used in breast reduction surgery vary according to a patient’s needs and anatomical structure, but some of the different approaches available include:
Vertical or “Lollipop” Breast Reduction
Vertical breast reductions can be beneficial for women with a mild amount of breast sagging and excess skin. This technique involves making a lollipop-shaped incision that encircles the areola – the dark-pigmented area surrounding the nipple – and extends down the center of the breast, through which excess skin and breast tissue can be removed for more shapely and proportionate breasts. While this can be an effective technique for those with a moderate amount of excess breast tissue, if you have a substantial amount of excess breast tissue or are experiencing severe breast and nipple droopiness, a full breast reduction may be more appropriate.
Full or T-Pattern Breast Reduction
A full breast reduction best serves women with more significant amounts of excess skin and breast tissue. Typically reserved for cases of severe breast droopiness, this approach requires an anchor-shaped incision that encircles the areola, extends down to the breast crease, and continues horizontally under the breast crease for an upside-down “T” pattern. This will allow a substantial amount of skin and breast tissue to be removed so that the breasts will appear tighter and higher on the chest wall.
Breast Reduction through Liposuction
Liposuction can also be utilized to reduce the size of breasts; however, it should be noted that this technique only removes fatty tissue and cannot remove glandular breast tissue. Additionally, excess skin is not removed, so breasts with moderate droopiness will likely still exhibit some of those qualities after the procedure. While breast reduction through liposuction has its limitations, it can be very effective for women with little to no breast sag, as well as in some cases of gynecomastia in men.
Breast Reduction Recovery
After surgery, a special bra will be worn for about six weeks, and most patients take about two weeks off work. Daily activities can generally be resumed after a couple of days, but patients should avoid strenuous exercise for about three weeks. The final results should reveal themselves gradually over time and, while the breasts may appear larger at first, the swelling should slowly dissipate. The soreness generally will be mild and easily controlled with prescriptions that Dr. Durst will provide for you. Some patients seek breast reduction even in their teenage years just because they are simply way too big. Even in this group, future childbearing is certainly possible, but whether breast-feeding would be possible in the future can be difficult to determine.
Will my Insurance Cover Breast Reduction?
Often breast reduction is covered by insurance. Many people now know that the insurance companies are getting tighter with the approval process for various procedures. It is important for patients to have “documentation” in their medical record to assist with the insurance approval process. This basically means that you should ask your primary doctor to catalogue your symptoms in the medical record and make recommendations of nonsurgical treatment that might be helpful. After a period of time when these symptoms have not been alleviated by conservative methods, the approval from insurance often will not be difficult to obtain. It is important though, to specifically ask your doctor to write down your symptoms in their record, then refer you to Dr. Durst for a surgical evaluation.
Dr. Durst frequently hears that the only thing that his patients wished that they could do differently about their breast reduction was to have had it years earlier. Consistently one of the most satisfying procedures in plastic surgery, Dr. Durst would be happy to talk with you about breast reduction and evaluate your situation.