Reduction

Breast Reduction:

Also known as reduction mammoplasty, is a surgical procedure to reduce and reshape your breast contours, making them smaller and more proportionate to your anatomy. This achieve by removing excess fat, tissue and skin from the larger breast, followed by adjustments to the size and position of the areola and nipple in line with the reduced breast size.

Often, a breast lift is also combined with breast reduction in order to elevate sagging breasts, which is usually a common problem in women with large breasts.

I always tell my patients that the ultimate goal of any breast reduction surgery should be natural and proportionate body contours. Breast reduction is a procedure that needs to be artistically and meticulously balanced with your specific anatomy and desires.

Breast Reduction is usually done as an outpatient procedure, under twilight anesthesia, and the patient can go back home the same day.

A breast reduction surgery may be medically necessary to correct postural issues, or may done for aesthetic reasons to give you more self-confidence, and flexibility in your choice of attire.

Breast Reduction is a good option in the following cases:

• Disproportionately large breasts causing back, shoulder or neck pain
• Concerns about playing sports or being appropriately active due to large breast size
• Correction of natural breast asymmetries
• Correction of asymmetry following significant weight loss, pregnancy, or breast feeding
• Inability to wear desired attire due to oversized breasts
  

It is very essential for me that you are clear on why you are considering breast reduction. So, even before your initial consultation, you should reflect on some questions:

I will be asking you these questions in my initial consultation, and your answers will help me to assess whether you are a right candidate for this surgery.

If you are an adult woman, who has very large breasts which cause discomfort, is in generally good health, not currently pregnant or breast-feeding, ideally a non-smoker, have a positive attitude, and have realistic expectations from the surgery, you are potentially a good candidate for breast reduction.

I will be keenly assessing your suitability for breast reduction through your answers in our initial consultation, and will proceed only if satisfied that you are a good candidate.

Breast reduction can be done in various ways depending upon your specific circumstances – volume of reduction to  achieved, the existing shape and slope of your breasts, and the desired outcome.

The different types of breast reduction techniques have the incisions and scars in different places, but none of the scars would be visible with regular attire:

• Breast Reduction via Liposuction/ Periareolar Reduction Type
• Vertical or “Lollipop” Type Reduction, with Lejour Technique
• Inverted-T or Anchor Type Reduction

Breast Reduction via Liposuction:

Breast reduction can achieved via liposuction alone, in cases where only a moderate reduction in breast size  required, the candidate does not have drooping breasts, and has good breast skin elasticity. The incision in this case is just around the areola. The advantage of breast reduction through liposuction are: shorter procedure, less-invasive, minimal scarring, and long-lasting results.

Vertical or “Lollipop” Type Reduction

This breast reduction technique is used for moderate reduction in breast size and moderate sagging correction. The technique requires 2 incisions. The cut starts around the areola, goes straight down to the crease under the breast.

A variant of the vertical type reduction is the Lejour technique, which is best accomplished only by skilled breast surgeons. The incision starts around the areola, and goes down the breast, but not under it. This technique permits small, medium or large adjustments to breast size, and allows to maintain better shape and fullness, and helps counteract the effect of gravity.

Inverted-T or Anchor Type Reduction:

This method of breast reduction used when considerable breast size reduction or sagging correction is required, as it permits maximum flexibility in excess fat and tissue removal and reshaping. This technique requires 3 incisions. The first cut starts is around the areola, the second goes straight down to the breast crease, and the final one is under the breast. Visually, the cut looks like an inverted-T or the anchor of a ship, hence the name.

The technique I will use for you will be determined after a complete evaluation of your anatomy and based on your desired aesthetic goals. I specialize in the Laser technique of breast reduction, and that is usually my preferred choice for its flexibility and advantages.

It is quite possible that you will be unable to breastfeed after a breast reduction, so you should carefully consider that in your decision-making process. In some cases, women are able to breastfeed even after the surgery, but there is no guarantee.

I will discuss your maternity plans during our consultation and determine the right technique for you based on those discussions and other pertinent factors. If you have motherhood plans, I would suggest that you defer your surgery until after you have finished nursing your child.

A Breast reduction surgery has lasting results. If you do not gain weight, you will retain your reduced breast size. Pregnancy and breast-feeding could also impact the size of your breasts.

The surgery itself takes 2-3 hours, is usually an outpatient one, and you can go home the same day. Most women are able to resume work within 7-10 days, and might need just 1 week leave from work along with 2 weekends.

I will prescribe what exercises will need to done to aid recovery, medication, etc. Heavy exercises should only resumed after my consent.

Every surgery carries some risks, but at this stage of my experience and expertise, the risks that my patients have are minimal. Standard risks include:

• Anesthesia risks
• Bleeding
• Infections of any kind
• Scars (though these will fade over time)
• Reduction/ loss of sensation in nipple or breast
• Damage to milk glands, nerves, ducts – inability to breastfeed

Risks minimized in the hands of an expert surgeon, by doing the surgery in a good, licensed clinic or facility, following proper protocols; and by the patient carrying out all given instructions – both before and after surgery.

Breast reduction cost varies based on the following factors:

• Type of surgery and the extent of reduction needed
• Whether the procedure is doing under general or local anesthesia
• Whether it involves overnight stay
• Hospital/ Clinic used for the surgery
• Skill & expertise of the breast surgeon

When breast reduction is done as a cosmetic procedure, insurance does not cover the cost. If, however, it is done for medical reasons, all or part of the cost may covered by insurance. Please check with your insurance provider about your policy entitlement.

Another significant aspect to take into consideration, besides just the initial surgical costs, is your comfort factor with the breast surgeon, and your faith in the surgeon’s expertise. Pay a bit more – but be sure, and be comfortable with your surgeon.

The choice of your breast surgeon is a decision to made with due care. While cost is a relevant consideration, there are other more important factors that should determine your decision:

• Years of experience as a plastic surgeon, number of surgeries done
• Number of breast surgeries done
• Proof of work – before/ after images
• Patient testimonials
• Surgeon reputation
• Your comfort factor with the surgeon, his manners, his patience in answering your questions
• Surgeon’s philosophy regarding patient safety

You are planning a significant surgery, and one that requires very specialized training and even artistic flair, so it’s extremely important that you decide wisely. Pay more if needed, but choose a surgeon who has an extensive portfolio of successful breast surgeries. Make sure that you are fully comfortable with your surgeon.