Breast Reduction

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What Is Breast Reduction?

Breast reduction, also known as reduction mammaplasty, is the plastic surgical procedure that reduces the size of the breasts. The operation has a 50-year history and has undergone a number of evolutionary changes. Today, breast reduction is one of the most common procedures performed in the United States and is a large part of our practice.

Am I a Good Candidate for Breast Reduction Surgery?

Women seek breast reduction surgery for a number of reasons. The most common reason is chronic neck, back, and shoulder pain.

The pain has often been treated with pain medicines and physical therapy without relief. The larger size of the breast is refractory to diet and exercise. Many women seeking breast reduction are unable to purchase properly fitting bras, and this only exacerbates their symptoms. These women are also unable to find properly fitting clothing. Often many women complain of rashes beneath the breasts that are unresponsive to medical treatment. Surgery is their final and last option.

Many women seek breast reduction surgery for both medical and cosmetic reasons. Often these women have larger breasts but also desire the beneficial cosmetic effects of the surgery. This includes a smaller, lifted, higher, “perkier” breast. Conceptually the breast reduction and breast lift operations are very similar. The main difference is that in breast reduction breast tissue is removed, where in a straight breast lift breast tissue is repositioned, and none is removed.

Many women report immediate improvement in their chronic pain symptoms right after surgery. Despite recovering from the surgery itself, many women report immediate significant improvement in neck, back, and shoulder pain.

Many patients report that they can even breathe better after surgery. Our surgeons have many patients who have subsequently lost a significant amount of weight after the procedure. These women say that reducing the size of the breasts has unburdened their whole upper bodies and has allowed them to significantly increase their physical activity level. This side is one of the most important beneficial side effects of breast reduction surgery. Not only does it improve or cure upper body chronic pain, but improves the overall health of our patients.

How Old Do You Have to Be for Breast Reduction?

There is no minimum age for undergoing breast reduction surgery; however, it is typically best to wait until the breasts have finished developing before altering them with surgery. For this reason Dr. Zemmel and Dr. Reddy often recommend waiting until the age of 18 to get a breast reduction. Some teenagers may exhibit a more pressing need to reduce their enlarged breasts, though, and in these cases a reduction procedure may be advised before the patient turns 18.

What Can I Expect During My Breast Reduction Consultation?

Your consultation with our surgeons will last 30 to 45 minutes, and will consist of an interview and a full exam. They will learn of your goals and desires regarding the surgery, as well as review your medical history to make sure you are medically fit for surgery. You will be asked about all of the different ways having large breasts is difficult for you. Please mention any neck pain, back pain, shoulder pain, rashes beneath the breasts, and grooving or cuts from bra straps. Also please mention any prior medicines used to treat the chronic pain and any physical therapy you may have received. Your surgeon will then perform a full breast exam and take a number of measurements:

The total mass of breast tissue that will be removed from each breast will then be estimated. For insurance-based cases, Dr. Zemmel or Dr. Reddy will submit a letter on your behalf to your insurance carrier for preauthorization. Once authorization has been obtained, your surgery will be scheduled. Women seeking a cosmetic breast reduction will be provided a full quote with a listing of all of the fees necessary for the procedure.

How Can I Prepare for My Breast Reduction Surgery?

After your surgery has been scheduled, you will return to the office to meet with your surgeon for a preoperative visit. During your second consultation, your surgeon will go over the entire procedure in detail once again. He will also perform another examination and go over what your expected outcome will be. The type of incision used, the final position of the areola, and your approximate final cup size will be discussed. Your surgeon will also discuss in detail the risks, benefits and alternatives to the procedure and your recovery period.

You will receive a packet containing your prescriptions, pre-operative instructions, and post-operative instructions. We advise you to fill the prescriptions before surgery. You will be given a list of medications, vitamins, and herbal supplements to avoid 2 weeks before surgery. Please review this list and follow all instructions in detail.

How Is the Breast Reduction Procedure Performed?

There are several techniques for breast reduction surgery, and in properly selected patients, they all can give excellent results. Our plastic surgeons tailor their approach to each patient and do not use a “one size fits all” approach.

All breast reduction techniques use a pattern of skin incisions to allow your surgeon access inside the breast. The second step is removal of breast tissue and skin. This reduces the size and gives overall new shape to the breast. This is followed by lifting of the nipple and areola and then closure of the incisions. The net effect is to produce a smaller, higher, “perkier” breast and to relieve the burden of large breasts on your upper body.

Vertical Breast Reduction

Women who have a moderate amount of excess breast tissue to be removed and a relatively small amount of excess skin and nipple ptosis (sagging) may be a candidate for this technique. This procedure requires an incision around the areola and a vertical incision down the center of the breast giving a lollipop scar pattern. The benefit of the technique is that does not require the horizontal incision underneath the breast, and therefore, recovery is slightly easier. The strength of the lift is not quite as powerful as a full reduction. In women with significant sagging of the breasts and a very low nipple/areola, a full reduction pattern (Wise pattern) may be necessary to optimize size and shape.

Wise Pattern Breast Reduction

For women who have a large amount of excess breast tissue and skin to be removed a full breast reduction incision pattern, or Wise incision pattern will be necessary. This procedure calls for an incision around the areola, a vertical incision, and a horizontal incision under the crease of the breast. This incision pattern is known as the “upside down T” or the anchor pattern. A full reduction pattern will allow your surgeon to remove a maximum amount of skin and breast tissue and give you the most power lift and reshaping possible.

Breast Reduction Using Liposuction

Liposuction is the non-invasive surgical procedure where fatty tissue between the skin and muscle layers is removed through tiny incisions. This technique has been used to reduce the size of the breasts in both men and women. The goal of a liposuction breast reduction is to remove excess fatty and breast tissue and allow the skin to redrape over the remaining tissue. This will give a smaller breast with improved shape. This procedure is also especially useful in men with breast enlargement (gynecomastia) and is the preferred choice of our surgeon for the treatment of enlargement of the male breast.


Chimere Hendrickson

November 20, 2013


Will I Need a Breast Lift with My Breast Reduction?

Most breast reduction procedures involve some degree of lifting, as well. This is because as excess tissue is removed, the remaining breast tissue is tightened and the nipple/areola is typically raised to a higher position on the chest. If you are unhappy with the amount of sagging you have in addition to your enlarged breast tissue, you should mention this to your surgeon during your consultation, and they can help you understand how a breast reduction can address this. If additional lifting is desired to help you achieve your aesthetic goals, this can be incorporated into your surgical plan to help you achieve a reduced and more youthful-looking breast appearance.

How Long Is the Recovery from Breast Reduction Surgery?

Many breast reduction patients are admitted overnight to the hospital for observation. This allows our doctors and nurses to closely monitor your initial recovery and progress. Your post-operative pain will be well controlled with intravenous medicines; you will receive medicine for nausea if necessary and be made as comfortable as possible.

Your surgeon will then see you the next morning to change your bandages and discharge you when ready. At home you will rest and relax and frequently move about. Expect to perform light activities of daily living 2 or 3 days after surgery. You may shower 2 days after surgery. Your breasts will be tight and swollen for approximately 1 week after surgery. Many women compare it to engorgement with milk during pregnancy and breastfeeding. Most women do very well and have very little difficulty during the first week. During the second week, you will begin to feel more normal as the postoperative soreness resolves. Most women take 10 to 14 days off from work to recover.

When Will I See My Breast Reduction Results?

During the first couple of weeks, your breast will feel tight and swollen. This usually resolves rapidly after the first week. You will notice that your result will evolve over time. Your breast will initially be high and tight, and over a few weeks time, they will settle and become more rounded. You will notice your breasts taking on a more natural teardrop shape over time. Over the next several months your breast will continue to soften and you scar will lessen.

Are There Any Risks Associated with Breast Reduction Surgery?

The risks of breast reduction surgery include, but are not limited to, bleeding, infection, damage to other tissue structures, tissue loss, thickened scars, nipple loss, loss of nipple sensation, and breast asymmetry. Although complications are very rare, they occasionally happen, and our surgeon and team take every precaution to reduce the risk of complications. If complications do occur, your surgeon will make every effort to correct the problem.

What Will My Breast Reduction Scars Look Like?

Using the latest breast surgery techniques, Dr. Zemmel and Dr. Reddy take great care to minimize the prominence of the resulting scars. While some scarring is inevitable, the location of the incision can often be concealed around the outer edge of the areola or along the natural crease of the breast. Patients who require larger volumes of breast tissue to be removed may require an additional scar that runs from the areola to the lower pole of the breast. When wearing a bra or bikini top, the scars from breast reduction surgery should not be visible. In addition, the prominence of any visible scarring should continue to fade over time.

How Much Does Breast Reduction Cost?

On average, cosmetic breast reduction surgery typically costs around $10,000 and $12,000, but this number will vary. Since each breast reduction surgery is custom-tailored by your surgeon, there is no fixed cost for the procedure. The price of breast reduction can be influenced by a variety of factors—such as the incision type, the volume of breast tissue removed during surgery, and the overall complexity of the procedure. The experience of the plastic surgeon, anesthesiologist fees, hospital or surgical facility fees, as well as the geographic location of the practice may also be factored into the total cost of breast reduction. When comparing potential breast surgeons and inquiring about cost, be sure to ask what is included in the price you are quoted. Dr. Zemmel and Dr. Reddy recommend patients spend some time conducting research to find the best breast surgeon for their needs.

In many cases, the cost of breast reduction is covered by the patient’s health insurance provider, as long as the procedure is considered medically necessary (not just cosmetic). Patients may still be responsible for co-payments or plan deductibles. Regardless of health insurance, any patient may take advantage of our plastic surgery financing options. Qualifying patients can benefit from flexible payment plans with low monthly installments through third-party lenders such as CareCredit®. To learn more about these financing options, please contact a member of our staff today.

*Average breast reduction cost taken from the American Society of Plastic Surgeons (ASPS) 2018 statistics.

Will the My Breast Reduction Cost Be Covered by Insurance?

The cost of breast reduction surgery is often covered by health insurance providers; however, the procedure typically must be deemed medically necessary to qualify. The eligibility requirements that are set for coverage will vary for each insurance company. In general, a patient must demonstrate significant long-term physical symptoms including back, shoulder, and neck pain. Often patients have rashes beneath the breast, which are unresponsive to treatment with topical medications. Each of the major insurance carriers requires the surgeon to submit your height, weight, and an estimate of the amount of breast tissue removed. In most cases, this tissue must weigh about 1 to 4 pounds to be considered a medical problem. Pictures from below the neck level will also be submitted to show the degree of breast enlargement, bra strap grooving, and rash if present. It may take several weeks to obtain preauthorization from your insurance carrier. Once our office has obtained approval, then your surgery will be scheduled.

We recommend that you contact your insurance company to learn about the specifics of your policy regarding breast reduction coverage. Understanding the criteria you must meet will help you navigate the preauthorization process more easily. At this time we accept payment for breast reductions from the following insurance carrier:

If you learn you have been denied coverage, you can send an appeal to have your insurance provider reevaluate your case. As part of this process, it can be helpful to write your own letter explaining the extent of your symptoms and how they affect your quality of life. You may also want to gather letters from any other health care providers you have worked with to address your symptoms, such as a general care doctor, physical therapist, chiropractor, orthopedist, or dermatologist. Your surgeon can submit these letters along with scientific research about the long-term benefits of reduction surgery for addressing your specific needs.

Visit our specialty website to learn more about breast reduction and insurance coverage.

Is Breast Reduction Without Surgery Possible?

While exercises can help reduce overall body fat, this does not guarantee the breasts will be significantly reduced in size. This is because the breasts are composed of both fatty and glandular tissue. Excess fat in the breasts can often be reduced with weight loss, but glandular tissue can only be removed via surgical intervention. Breast reduction surgery is the most effective method of obtaining a significant reduction in breast size.

Additional FAQs About Breast Reduction

How Do I Shower After Breast Reduction Surgery?

In the first couple days after your procedure, you should only take a sponge bath and not wash your incisions. You should be able to shower 2 to 3 days after your breast reduction. Your surgical bra can be removed as you shower, and you should gently wash your incision sites and breasts. When drying off after a shower, you will need to pat your incisions dry, rather than rubbing, to avoid irritation. Avoid baths and pools for at least 2 weeks to prevent bacteria from infecting your incisions.

What Should I Wear After Breast Reduction?

Before your surgery, you will be recommended a compression garment or surgical bra to wear for about 6 weeks after your procedure. This can be removed when you shower, but you will need to wear the garment the rest of each day and night. After this initial period, you will need to wear regular bras that don’t contain an underwire, as this can irritate your incision lines. You should be able to return to wearing underwire bras after 3 months.

How Can I Reduce Swelling After Breast Reduction?

You will experience the majority of your swelling for the first few weeks after your reduction surgery. This is normal and simply your body’s response to your surgery. If your swelling becomes severe, however, this may indicate you have an infection and should contact your surgeon as soon as possible to be evaluated. Subsequent swelling can persist for 3 or 4 months. To help control the amount of swelling you have, you should wear the recommended compression garments during your recovery. Slowly returning to light physical activity, staying hydrated, and keeping the area elevated can also help.

Will I Be Able to Breastfeed After Breast Reduction?

If you were able to breastfeed prior to breast reduction surgery, you should still be able to after your procedure. Dr. Zemmel and Dr. Reddy take every precaution to minimize the risk of complications during and after surgery. Patients with significant breast tissue being removed, however, may require the nipple to be completely removed during their breast reduction, which is then repositioned to a higher location. These individuals have a higher risk of not being able to breastfeed after surgery. If you are considering a breast reduction and hope to breastfeed in the future, please tell your surgeon during your consultation. This may affect the surgical plan tailored by your surgeon, as they may prefer a technique that minimizes contact with the nerves and milk ducts.

Contact Richmond Aesthetic Surgery

For more information, visit our website dedicated to breast reduction. If you would like to schedule an in-person consultation, please contact Richmond Aesthetic Surgery today.