Breast reduction surgery is a procedure that removes skin, glandular tissue and fat to make the breast smaller, lighter and more attractively shaped. While this operation is often done by cosmetic surgeons, it is not necessarily considered a purely aesthetic procedure. A reduction mammoplasty is often medically necessary for the health of the patient.
Reasons Women Choose Breast Reduction Surgery
Patients who seek this surgery typically have one or more problems with their breasts that can be successfully addressed by reduction. These include physical symptoms caused by the excessive weight of the breasts such as:
• Poor posture leading to back, neck and shoulder pain
• Chafing or indentations where bra straps dig into the shoulders
• Recurring skin rashes under the breasts where the skin remains constantly moist
Emotional and cosmetic concerns can be secondary factors in the decision to have a breast reduction. For example, women may feel self-conscious about having large breasts or feel that their body draws unwanted attention. In some cases, one breast may be much larger than the other. This can make it especially difficult to find properly fitting clothing.
Who Can Benefit from Breast Reduction Surgery?
Women whose health and quality of life are negatively impacted because of excessive breast size benefit the most from breast reduction. It can also be helpful for women who are dissatisfied with the appearance of their very large breasts. There is no upper age limit on breast reduction surgery for patients who are in good health. This means that women who have suffered through decades of back pain from having large breasts may find relief from this surgery.
Many patients seeking reduction mammoplasty started experiencing problems with their breasts during puberty (the tendency to have overdeveloped breasts can run in families). Teens can be candidates for breast reduction surgery in extreme cases. They should be mature enough to understand the risks and responsible enough to follow post-operative instructions. Since breast development may continue well into early adulthood, the results of breast reduction for teens may be unpredictable. They may need additional surgery in the future to maintain their desired results.
Who is the Ideal Candidate for Breast Reduction Surgery?
This procedure tends to have the best outcome for women who:
- Are in overall good health with no medical conditions that would increase the risks of surgery
- Have fully developed breasts that are finished growing
- Are done having children. Reduction has the potential to interfere with breastfeeding.
- Are at or near their ideal body weight. Future weight gain may increase breast size.
- Don’t smoke (or are willing to stop smoking well in advance of surgery)
- Have realistic expectations for surgery; reduction doesn’t make breasts substantially firmer and it will leave visible scars.
Types of Breast Reduction Surgery
There are a number of options available for reduction mammoplasty. Here is an overview of the various surgeries based on the incision type. Breast size and other factors (such as whether another procedure is done at the same time) determine which one a specific patient is a good candidate for:
Circumareolar – The incision goes partially or fully around the areola. Fat and glandular tissue can be removed through this incision. Excess skin is removed around the incision (in a shape like a donut) and the edges are sutured together to create a smaller breast. This type of breast reduction is designed for women who do not need a lot of skin and underlying tissue removed.
Lollipop – The incision goes around the areola and down the underside of the breast to where it meets the ribcage. Fat and glandular tissue can be removed through this incision. Excess skin is removed in a keyhole shape. This approach allows for the breast size to be decreased by a fairly substantial amount.
Anchor – The incision goes around the areola, down the underside of the breast, and along the breast crease. Fat and glandular tissue can be removed through this incision. This approach allows skin to be removed both vertically and horizontally for maximum reduction. It is designed for women with extremely large breasts who need to have a lot of excess tissue removed.
Liposuction – Small incisions are made at several points on the breast to allow the insertion of a cannula (a metal tube) to remove fat. Unlike other breast reductions, a lipo-only mammoplasty is usually done for cosmetic reasons. It removes only a small amount of fatty tissue from the breast. Since it does not address excess glandular tissue or skin, it provides only minimal improvement.