Breast Reduction: 9 Things Doctors Want You to Know
Medically Reviewed By William C. Lloyd III, MD, FACS
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Insights from Breast Reduction SurgeonsIf you have large breasts, breast reduction surgery is an option to alleviate the pain and discomfort you may be experiencing in your back, neck, and along your shoulders. Other reasons for breast reduction include when the size of your breasts limit your activities or you are unhappy with how your breasts look. Here are things experts want you to know about this surgical procedure and how breast reduction can help women improve their quality of life. -
1. “A breast reduction isn’t the same thing as a breast lift.”Some women who visit a plastic surgeon ask for a breast reduction when what they really want is a breast lift. “There’s a lot of colloquial misuse of the terms,” says Marc Everett, MD, a board-certified plastic surgeon in New York City. “There is a little bit of a difference between breast lift and breast reduction in that every breast reduction is a breast lift, but every breast lift is not a breast reduction.” Only a small amount of breast tissue is removed in a lift and these are generally done to help sagging breasts.
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2. “There is always some scarring left after breast reduction surgery.”Surgery always leaves some sort of scar, but plastic surgeons work hard to minimize them for the best possible outcome. “Of course, we try to do techniques that limit scars, for a nice cosmetic closure,” explains C. Bob Basu, MD, a plastic surgeon in Houston, Texas. “But scars are going to form.” The size of breast reduction scars depends on the type of surgery. For example, if only a moderate amount of tissue is removed, there might only be some scarring around the nipple. For larger breasts, there may be scars along the side of the breast too.
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3. “Breast reduction surgical complications are not common.”Complications related to breast reductions are not common. “I tell people the risk of surgery is going to be 2 to 4%,” says Craig A. Vander Kolk, MD, the director of cosmetic medicine and surgery at Mercy Medical Center in Baltimore, MD. “All surgeries have risk of bleeding, infection, and scarring; and the incision can break open. You can have numbness to the nipple, you might not be able to breastfeed, but those are few and far between. I tend not to dwell on that because 95% of people are happy after the surgery, and it’s unusual to have major complications.”
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4. “Check the fine print on your insurance policy.”Although you may want a breast reduction to help get rid of your back pain and help you feel better about yourself, your insurance company may not agree it’s necessary. “Don’t assume, even though the insurance company tells you, oh yes, it’s a covered benefit,” Dr. Basu says. “In fact, I would prepare patients to do their homework of what the costs are. Financing options are very popular for patients now, then you can always investigate the insurance route. Maybe you have a Cadillac plan that will cover it.” Check with your insurance company to get pre-authorization (if it is covered) and avoid any unpleasant surprises.
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5. “Don’t ask for a specific bra cup size.”Women have been trained to think of breast size as bra cup size, but every fashion designer is different and someone with a C cup with one fashion line may be a B or a D in another. But cup size also depends on the patient herself. “There are limitations [to what can be done], and cup size is the worst thing a patient can focus on,” says Dr. Basu. “Not only does cup size vary by designer, but cup size also varies on chest wall rib cage diameter.” It is still important to be clear about your goals for surgery including what breast size and appearance you want to achieve and other symptoms you want to ease.
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6. “Breast reduction surgery requires planning.”When you visit a plastic surgeon for a breast reduction, there is more than meets the eye. Your surgeon makes decisions about how and where to make the incisions and how much breast tissue can be removed. And there is a limit as to how much breast tissue can be taken. “There is a limit to the size that you can leave somebody [to still] have sensation in the nipple,” explains Dr. Vander Kolk. It’s important to maintain blood flow through the remaining breast tissue to your nipples to keep them alive; this will allow you to be able to breastfeed and to have sensation.
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7. “Some things are out of the surgeon’s control.”When assessing breast size there are things that surgeons can’t control, such as skeletal bony anatomy of the thoracic rib cage. “So, if somebody has a very wide chest with a wide sternum and they want to be a B cup, that just may not be anatomically possible and that’s where the ‘wish pic’ discussion comes into play,” says Dr. Basu. “I think it’s very important for patients to understand there are limitations of what any surgeon can do based on their baseline anatomy.” Wish pics are photos of breasts that the patients feel might be a good fit for them.
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8. “Women can have breast reductions before pregnancy.”Women can choose to have a breast reduction regardless of age. “You have the women who have had early massive growth of their breasts in the teenage years and either they’re in their late teenage years, usually more into their 20s,” explains Dr. Everett. “This group is usually not married yet or they are [married] but it’s before children. They see their breasts as something that has been a hindrance to their social development and physical comfort for the years leading up to the point at which they seek consultation.”
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9. “Older women can have the surgery too.”It’s common for older women to ask about breast reduction surgery. “They just never sought any sort of medical attention [for their large breasts] and they get into that 50s to early-60s range where, socially, it’s not something that’s as important to them; and they’re really just tired of the discomfort of carrying large breasts around,” says Dr. Everett. The years of having heavy breasts, pulls on the neck and back, and causes problems with their posture. These women tend to seek breast reduction to improve their health and quality of life.
Breast Reduction: 9 Things Doctors Want You to Know
