Breast Reduction
Reduction Mammoplasty
If a woman’s breasts are so large that they begin to cause chronic back, neck, and shoulder pain, a breast reduction may become medically necessary (and also be covered by Insurance). This procedure is designed not only to reduce the weight of the breasts, but also to re-position that weight higher up on the chest wall to achieve better balance and reduce tension on the back muscles.
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The same incisions used for Mastopexy procedures are also used for Breast Reduction procedures. An “anchor” shaped Inferior Pedicle Reduction is used by many surgeons in this country because of its simplicity and its reliability. It is a very formulaic procedure that produces a circular scar around the nipple/areolar complex, a midline vertical scar, and a long horizontal scar underneath the base of the breast (that oftentimes can extend almost all the way to the back). This style of reduction produces a nicely shaped breast at the time of surgery. Unfortunately, it can be more prone to “bottoming out” over the years, producing a flattened upper pole of the breast and a sagging lower pole. Dr. Lober still uses this procedure on select patients (who have a very short nipple to inframammary fold distance).
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More commonly, however, he prefers to utilize the less formulaic and more sculptural Vertical Breast Reduction for a number of different reasons. First, the scars are limited to the periareolar and vertical scars only, reducing total scar length by almost one half. Second, closure of the vertical pillars pulls the lateral breast tissue inward, helping to avoid “dog ear” folds of tissue underneath the arms (which the older procedure actually can accentuate). Third, he believes that the improved shape of the breast is better maintained long-term by the Vertical Reduction, with less “bottoming-out”. Finally, the Vertical Reduction intrinsically produces a higher inferior inframammary fold, while the older Inferior Pedicle Reduction intrinsically produces a lower inframammary fold.
Types of Breast Reduction
Surgery & Recovery
All Breast Reduction Surgeries are performed on an outpatient basis, either in our own Surgery Center, or in a local Hospital Outpatient Facility. The surgery itself is generally two hours long. No drains are used, and sutures are all absorbable. Patients can expect to return to light activity within several days, including driving. Those with “desk” jobs can return to work within 5 to 7 days. Those with physically demanding jobs (manufacturing, retail, nursing, etc.) should be able to return to work within 10 to 14 days.
With either style of procedure, Breast Reduction patients are in general a very happy patient group. They run the spectrum of very young patients who are having difficulty controlling their body weights or engaging in athletic activities to older, more mature patients who are tired of wearing tight bras and dealing with chronic back pain for years on end. For older patients, the decision to undergo a Breast Reduction is often an easy one. For younger patients, who may be very much concerned with any scars on their breasts, the decision to proceed with surgery must be very carefully considered. (In these patients, Liposuction of the breasts alone may be a good ‘bridge’ procedure to reduce the breasts enough to limit discomfort and physical restrictions).