Breast reduction surgery is probably my single favorite surgery to perform at my Scottsdale plastic surgery practice! The reason for this is that a breast reduction can be an excellent way to improve both a patient’s aesthetics as well as their physical well-being, and it is generally a very dramatic surgery that results in extremely happy patients!
How Do You Perform Breast Reduction Surgery?
Breast reduction surgery is a variation of breast lift surgery, as almost every patient that wants a reduction has some degree of ptosis (drooping) that needs to be corrected. There are multiple ways to perform a breast reduction, but over the last two decades of performing over a thousand of these surgeries, I have found that the best way to perform this procedure in my opinion is with a superomedial pedicle technique.
What does this mean? The pedicle is the tissue that is left intact with the nipple / areola connected to it so it continues to get blood supply. This is the tissue that provides volume and roundness to the breast. Superomedial means upper-middle, so with this technique, the upper-middle breast tissue with the nipple connected is maintained, and the heavier outer and lower tissue is removed. This allows the breast to keep excellent fullness in the cleavage and upper breast while removing the heavy, mobile tissue at the bottom, which results in a round, perky and youthful breast.
What Kind of Scars Can I Expect from a Breast Reduction?
The skin resection pattern is independent of the pedicle, but anyone having a standard breast reduction will either have a vertical (lollipop scar) or an inverted-T (anchor scar) pattern. In other words, there will be a circle scar around the areola, a line down the breast, and sometimes a scar under the breast (in the case of an anchor scar pattern). These skin resection patterns basically create a bra pattern out of the breast skin and allow for a full three-dimensional reshaping of the breast. I used the lollipop pattern more during my early practice but have transitioned more to the anchor over time as the breast crease scar usually heals very well and lower breast skin removal can add another significant degree of tightness and reshaping to the breast.
How Much Tissue Is Removed During a Breast Reduction?
Breast reductions can be large or small depending on the patient’s wishes. Some degree of tissue removal is needed to help create a perkier shape, and the more the weight of the breast is reduced, the more back, neck and shoulder pain relief the patient will experience. A careful discussion with each patient with review of breast reduction before and after photos is helpful to understand what each patient’s final goal size is. I am also always careful to explain what range of sizes will work for each patient realistically.
Can a Breast Reduction be Combined with Other Procedures?
In addition to a breast reduction, sometimes additional procedures can be helpful in order to achieve the best result. One common option is bra fat liposuction. For patients that have some extra fullness where the breast meets the armpit (which often pokes out of sports bras), a small amount of lipocontouring can help create a nicer curve to the outer breast. This involves a tiny armpit incision and adds minimal risk or recovery.
Another nice option for certain patients is upper pole fat grafting to the breasts. This is where I take fat with liposuction from areas of the body where it is unwanted and reinject it into the upper breast to create more fullness without the sense of heaviness that lower breast fullness causes. This technique is called addition-subtraction because problematic volume is subtracted from the lower breast and beneficial volume is added to the upper breast. This technique can be helpful for patients seeking a more “augmented” appearance.
Will I Need Implants If I have Breast Reduction Surgery?
Patients often ask if breast implants are needed with breast reduction surgery. In my opinion, implants are really not needed for reduction as there is already too much natural tissue, so it does not make sense to then add more volume with a foreign body (breast implant) that requires maintenance over time. For patients that want a fuller, rounder look, I simply leave in more of the natural tissue and sometimes add upper pole fat grafting as I discussed above.
What Is Recovery from Breast Reduction Surgery Like?
Recovery from breast reduction is usually straightforward as no muscle work is done, so the pain level is usually quite manageable. Patients are fine to return to desk work within a week or so and can start to ramp up exercise after a month. No drains are needed with this surgery so postoperative management is quite simple.
Who Is a Good Candidate for Breast Reduction Surgery?
If you are a patient suffering from back, neck or shoulder pain due to large, heavy breasts, this is an excellent surgery. It also helps with proportion, it can relieve rashes and moisture under the breasts due to skin overhang, and it can make buying clothes that fit easier and can make exercise more comfortable. Lifting the breasts also creates a longer torso by revealing more of the abdomen, which makes patients look longer and leaner. All of these benefits can be life changing, and this is why breast reduction surgery is known for creating some of the happiest patients!
Request a Consultation
If you are interested in learning more about breast reduction surgery, request a consultation with one of our board-certified plastic surgeons or call our Scottsdale, AZ, office today at (480) 423-1973 to schedule your appointment.