Breast reduction surgery is a popular procedure for women who are experiencing physical discomfort or dissatisfaction with their appearance due to large breasts. According to the American Society for Aesthetic Plastic Surgery, almost 140,000 women underwent reduction mammoplasty in the United States in 2010. Still, there’s a lot the average person doesn’t know about this operation. Here are some common breast reduction myths disproved.

Breast Reduction Myth: Breast Reduction Surgery Is the Same as a Breast Lift

This isn’t exactly a myth – more of a difference of opinion among plastic surgeons. Some surgeons always do a lift as part of a reduction. On the other hand, a breast reduction surgery done with liposuction alone does not provide any lifting and may actually make breasts droop more. A reduction with a typical lollipop or keyhole incision does provide some amount of firming for the breasts since it makes the skin tighter around the underlying tissue. In addition, the nipples are repositioned so that they are higher on the breast mound. More substantial lifting may require sutures that are placed deep in the tissue to support the breast in a more youthful looking position. It’s very common for patients to have both a mastopexy (breast lift) and a reduction mammoplasty at the same time since both are done using the same incisions. Your surgeon will be able to advise you on whether a reduction will provide the amount of tightening/repositioning you want or if you need a lift as well.

Breast Reduction Myth: I Can Choose To Have My Breasts Reduced to a C Cup

Many women think of a C cup as being the “ideal” breast size – not too big or too small. However, it’s actually very difficult to predict the cup size you’ll end up with after a breast reduction. After all, if you’ve been bra shopping, you know that what one lingerie manufacturer calls a C cup might be a B or a D in another brand or style. You should have a good idea of what the new size and shape of your breasts will be from a visual standpoint based on computer imaging or before and after photos of similar patients. The most important thing is whether your breasts look well-proportioned compared to the rest of your body. Don’t get hung up on a cup size – just focus on finding bras and clothes that fit and flatter your new figure.

Breast Reduction Myth: Insurance Will Always Pay for a Breast Reduction

While this is a plastic surgery that is often considered medically necessary, it isn’t always covered by insurance. That’s why it is very important to make sure your surgery is approved in advance by your insurance company. Some reasons your insurance provider may deny part or all of a claim include:

  • The surgeon, hospital, or anesthesiologist is not “in-network” for your plan
  • The specific technique used for the reduction is not a covered procedure
  • Your reduction is not considered extensive enough to be medically necessary

You need to establish that your surgery is being done for health reasons and not for cosmetic reasons. Getting a referral to see a plastic surgeon from your primary care physician is typically the first step. Your physician should document the health problems you are having (such as back pain) that will provide evidence that your surgery is necessary. Get pre-approval from your insurance company in writing if possible stating the circumstances under which they will pay for your surgery. Make sure your surgeon understands these terms and conditions.

Breast Reduction Myth: If I Just Lose Enough Weight, I Won’t Need a Breast Reduction

Breasts are made up of two types of tissue – fat and glandular tissue. Some women tend to put on fatty tissue in their breasts when they gain weight. They may lose some breast volume with weight loss. However, women who have large enough breasts to require reduction usually have a lot of glandular tissue as well. Glandular tissue develops in response to hormones (this aspect of breast growth is often genetic and runs in families). Glandular tissue does not go away no matter how much weight you lose. It also can’t be effectively removed with liposuction. If you know from past experience that your breasts tend to get smaller when you weigh less, your plastic surgeon may recommend that you achieve and maintain a lower body weight prior to surgery. This reduces the amount of fatty tissue that must be removed during the operation. Being at a healthy weight will make you a better candidate for the procedure anyway. However, if your breasts are large enough that they are causing back pain and other problems, it is unlikely that weight loss alone will be sufficient to provide relief.

Breast Reduction Myth: Breast Feeding Is Impossible After Breast Reduction Surgery

In most cases of modern breast reduction, the nipple is left attached to the underlying tissue during the surgery. This is called the inferior pedicle technique. The nipple is only completely removed and re-attached in very rare cases. Usually, it can be repositioned higher without being cut off from its blood supply and the milk ducts. Some patients have difficulty breastfeeding after this surgery either because of compromised milk supply, nerve damage to the areola and nipple or other issues. The use of galactagogues (herbs that increase milk supply), breast feeding assistance devices, or bottle feeding with expressed milk may be workable solutions in these cases. It is not possible to guarantee that you will be able to breastfeed successfully after reduction mammoplasty. However, a plastic surgeon who understands how the milk production and delivery system works may give you better odds of maintaining your breastfeeding ability