Breast Reduction

Patients see me for breast reduction surgery primarily because of neck pain, back pain, shoulder pain, or rashes underneath the breast.

It's a very common operation for me, and I'm pleased to say that generally, our patients are highly satisfied with their results and relief of symptoms.

Here are some things you should know if you are considering breast reduction surgery:

1) Insurance may cover it

As you can imagine, each insurance company and plan is different, but largely there is coverage for breast reduction surgery if symptoms are well documented by your primary care doctor as well as explained to your surgeon.

Most companies have a minimum amount of tissue that needs to be removed in order for the reduction to be considered medically necessary. What this means is your surgeon has to remove that much breast tissue from each breast at a minimum.

Some insurance companies require a trial of physical therapy beforehand.

At our practice, we submit information to your insurance company to see if they will provide us with prior approval for surgery. As long as you're medically safe to undergo the surgery and your surgeon thinks it's a reasonable choice.

2) What does the consult look like?

You typically will meet either myself, one of my partners, or one of our advanced practice providers who will determine if you are medically a good candidate to undergo breast reduction surgery. We will do breast measurements and evaluate how much breast tissue you currently have.

We will then calculate how much breast tissue has to be removed based on the scale that most insurance companies use. This scale is called the Schnur Scale and uses your body surface area, which is calculated from your height and weight, to determine how much breast tissue should be removed at a minimum.

We will talk with you about what this may look like on your own chest, and we would like to get a good sense of what breast size you are hoping to be.

3) Can I pick a cup size?

Cup sizes are tricky because they vary greatly among various designers and companies. What's helpful for us is to know if you're looking to be on the smaller side of the spectrum or remain on the larger side. There's a maximum amount of breast tissue we can remove while still keeping the skin and your nipple alive, and there's typically a minimum amount of tissue that we have to remove in order to meet insurance criteria. Within these two parameters, there is some wiggle room where we can remove more tissue if you'd like us to or less if you'd like to remain on the larger side.

4) What does surgery look like?

At our practice, we always operate at a facility that's attached to the hospital. Most patients go home the same day of surgery, which is the safer place to be immediately following surgery to minimize the risk of infection.

On the morning of surgery, your surgeon will meet you and mark your breasts while you're seated upright. This gives us the best opportunity to plan the operation for how your breasts will ultimately look.

Surgery usually takes between two and three hours from the time your surgeon gets started. It's done under general anesthesia, which means you're completely asleep during the surgery, and you'll have to follow anesthesiologist guidelines on eating or drinking the night before so that anesthesia can be provided safely.

Recovery in the recovery room takes an additional couple of hours, and then you would go home safely with somebody who would be able to keep an eye on you overnight.

5) What is recovery like?

When you wake up from surgery, you'll have tape on your incisions to help with scarring (let us know if you have an adhesive allergy and we can choose a different dressing). You'll have a surgical bra that you can exchange for a front-fastening sports bra, which most patients find to be comfortable to wear. I don't use drains as part of surgery.

From the day of surgery up until two weeks, the expectation is that you go for short leisurely walks multiple times per day.

At four weeks after surgery, you are typically healed well enough to clean up around your home.

By six weeks, most patients can go to the gym and are safe to use any of the equipment there.

At your final appointment at about 12 weeks post-surgery, most of the swelling should have reduced, and you could be formally fitted for new bras at your preferred bra store.

6) What risks of surgery should I know about?

It's very important to know what the risks of surgery are to see if this is the right choice for you.

With any surgery, there is a risk of bleeding and infection. These are relatively uncommon in breast reduction surgery; however, they do happen on occasion.

By far the most common complication we see is healing difficulties. This could happen to upwards of half of all patients who undergo breast reduction surgery. Most of the time, this is very minor and just means that the incision is taking a little longer to heal. Sometimes this can require revision surgery, but this is rare.

Other complications include asymmetries, which are universal, but usually not big differences that require intervention.

One or both nipples may go numb after surgery. There's a low but real risk that one or both nipples may not survive surgery at all. This is called nipple areolar necrosis, and it may need to be addressed with a second surgery, and you may need reconstruction.

Younger patients who may be interested in breastfeeding in the future should know that having breast reduction surgery may prevent you from being able to nurse.

Overall, breast reduction surgery is one of the most common plastic surgeries that we perform. We enjoy doing it because patients are generally very happy with their results and the relief of symptoms that they are able to achieve.