What Is Breast Reduction (Reduction Mammoplasty)?
Whereas many women seek to enlarge their breasts for aesthetic reasons, the opposite can also hold true. There are women who feel that the size of 
their breasts are too large and not in keeping with the proportions of the rest of their bodies.
There are also those women who suffer from chronic neck and back pain as a result of large, sagging breasts and the cosmetic benefits of breast reduction are secondary to the health benefits.
Men can also seek breast reductions for the very same reasons. They wish to improve health and obtain cosmetic benefits than can directly relate to self esteem.
Long-Term Benefits of Breast Reduction
In addition to the immediate relief from physical discomfort, breast reduction surgery offers long-term benefits that enhance a patient’s overall well-being.
Women who undergo this procedure often experience improved posture, reduced neck and shoulder strain, and an increased ability to engage in physical activities such as running, yoga, and weight training.
Many women also report an improvement in their self-confidence and mental well-being, as they feel more comfortable in their bodies and find it easier to wear clothing that fits properly.
Who Is a Good Candidate for Breast Reduction Surgery?
The first question that you may ask yourself is “Am I a good candidate for breast reduction?” There are several factors to be looked at, when considering breast reduction surgery.
A good candidate for breast reduction surgery is someone experiencing physical discomfort or medical issues due to overly large breasts. These are women who understand that the purpose of a breast reduction is mainly health related.
Women who suffer from chronic neck, back, and shoulder pain, skin irritation under the breast fold, or posture problems caused by the weight of their breasts may benefit from the procedure. Additionally, individuals who find it difficult to engage in physical activities or exercise due to breast size may consider reduction surgery to improve mobility and overall quality of life.
Finding clothing that fits properly can be frustrating. Over-sized breasts can also chafe against the underlying skin, causing irritation, rashes, and infections. However, beyond the medical considerations, over-sized breasts can also be a source of self-conscious issues. Women who possess any of these characteristics or symptoms may be good candidates for breast reduction surgery.
Ideal candidates should be in good general health, non-smokers, and have realistic expectations about the outcome.
Initial Consultation
It’s extremely important to have a detailed consultation with a qualified cosmetic surgeon prior to making a decision regarding breast reduction surgery.
Medical concerns will be discussed as well as outcome expectations. Photos will also be taken in order to document the pre-existing condition and for comparison with post-surgical results.
A mammogram (breast X-Ray) may also be taken to check for abnormalities or cancer, prior to surgery. The costs of surgery and all miscellaneous charges should also be discussed as well as the specifics of the procedure, itself.
Procedure
Prior to surgery, your surgeon will give you a list of instructions on how to prepare for surgery. This will include guidelines on eating, drinking, smoking, and taking or avoiding certain medications/vitamins. Some surgeons will also suggest that their patients diet before the operation.
The breast reduction procedure involves the removal of selected breast tissue consisting of fat, glandular tissue and skin. The procedure is performed under general anesthesia, so the patient will be asleep during surgery. The procedure may be performed in the surgeons own surgical suite, an outpatient medical facility or a hospital.
Prior to surgery, markings will be made on the breasts in order to determine the position of the breasts while the patient is in a sitting position. This will assist the surgeon in making the correct incisions while the patient is lying down. This will also assist with the determination of the new position of the nipples and areolae.
Once the patient is under anesthesia, the incisions are made along the markings and flaps are created along the sides of both breasts. This allows breast tissue to be removed and nipples to be moved to a higher position on the breasts. Usually, the nipples will remain connected to the nerves and blood vessels.
However, in cases that involve very large breasts, it may be necessary to completely move and graft the nipples to a new location – which will result in a loss of sensation to the nipples. The flaps are then refolded and sutured into place, thus shaping the breast into its’ proper proportion.
Breast Reduction Recovery
After surgery, sutures will remain around the areolae, in a vertical line beneath the nipple and sometimes horizontally beneath the breast (depending on breast size prior to surgery). Swelling, tenderness and bruising will be experienced and pain management can be assisted by prescription medication from your doctor.
Bandages are usually worn for 2 days after surgery and stitches will be removed in about 2 weeks. Drains may also be put into place during surgery and these will be removed within one week.
There should be no heavy lifting or strenuous activity for 3-4 weeks and a soft surgical bra may be recommended by your doctor during the recovery period. It may take a few months before the breasts settle into their natural shape with up to a year before the final result is seen.
Risks and Complications
As with all surgeries, there are standard risks involved that can include issues such as infection or reactions to anesthesia. Antibiotics can be used to treat infection and will be prescribed by your doctor.
There are other side effects associated with breast reduction surgery such as the loss of nipple sensation and the inability to breast feed.
Additional effects include permanent scarring on the breasts and possible asymmetry (where the breasts are not the same shape and size). Improper positions of the areola and nipple can also occur.
A qualified cosmetic or plastic surgeon can answer your questions regarding possible side effects and these questions should be covered in your consultation.
Cost of Breast Reduction Surgery
There are three major costs when considering breast reduction surgery: the surgeon’s fee, anesthesia and the facility expenses.
The surgeon’s fee is dependent on qualifications as well as the extent of the procedure, itself. The average cost for the entire procedure can range from $8,000-$13,000. Factors influencing the overall cost include the complexity of the surgery, the type of facility where the procedure is performed, and other fees such as anesthesia and post-surgery garments.
It’s also important to check with your medical insurance company to determine if the costs are covered under your health care plan. If not, surgeons usually offer multiple financing options that can make the procedure more affordable.
Insurance Coverage for Breast Reduction
Unlike many elective cosmetic procedures, breast reduction surgery is often considered medically necessary, particularly if a patient suffers from chronic back pain, shoulder grooving from bra straps, or recurring skin rashes under the breasts.
Many health insurance providers may cover the cost of the procedure, but specific requirements must be met.
Patients should document any related health issues and obtain medical records and referrals from their primary care physicians or chiropractors.
Consulting with the insurance provider ahead of time can clarify whether breast reduction qualifies for coverage under their policy.
Choosing a Surgeon
When choosing a surgeon, it’s important to choose a board-certified plastic surgeon. The surgeon chosen should have extensive experience in all types of breast surgery. Please note that the type of certification is important.
There are more than 150 self-designated boards, but only a handful that are designated by the American Board of Medical Specialties (ABMS), such as the American Board of Plastic Surgery. You should also request to see a sizable number of before and after photos as well as obtaining patient references.
Gynecomastia
Gynecomastia is the enlargement of one or both male breasts and is experienced by roughly half of all men today. This condition can be caused by a number of factors to include steroids, blood-pressure medication, anti-depressants, an imbalance of sex hormones (estrogen and testosterone) or heredity conditions.
Surgery, liposuction or a combination of the two may be used to treat enlarged breasts. The reasons for surgery in men can be to reconstruct the contour of the chest for cosmetic reasons that may be related to self esteem.
Another reason may be to determine if a suspicious lesion in the chest is cancerous. Enlargement typically occurs on both sides of the chest. If it is one-sided, firm and hard, you should see a doctor immediately to rule out male breast cancer.
Other Procedures
Liposuction may sometimes be used as a breast reduction method for women in cases where a smaller amount of tissue (fat) removal is indicated. However, the skin must be extremely elastic in order to consider this procedural approach.