Breast Reduction Surgery

Undergoing breast reduction surgery will help to alleviate physical pain caused by large, heavy breasts. The procedure involves removing and reshaping the skin and tissue below the nipple and moving the nipple and areola higher on the breast. Plastic surgeons find that breast reduction patients are some of the most satisfied in plastic surgery.

The Breast Reduction Surgery Procedure

Breast reduction surgery generally takes a few hours, although the length of the surgery will vary depending on the patient’s case and whether the breast reduction is combined with another procedure, such as a breast lift. More information about what to expect during the surgery is provided below.

Anesthesia

Before breast reduction surgery, your surgeon will place you under general anesthesia, which will allow you to sleep through the entire procedure. Although breast reduction surgery can be performed on an outpatient basis, some patients may opt to stay overnight.

Incisions

In a standard breast reduction, the surgeon begins the procedure by making an incision around the areola, vertically down to the crease of the breast, and horizontally along the crease in an anchor shape. This traditional breast reduction surgery technique is often known as the anchor method.

A newer procedure, called vertical incision breast reduction surgery, is less invasive, causes fewer scars, and holds up better over time; however, many doctors don’t offer this incision technique yet. If you are interested in this procedure, be sure to choose a breast reduction surgeon with the experience and abilities to perform the technique. Also known as the LeJour Technique, after the plastic surgeon who developed the procedure, the vertical incision technique involves making a “lollipop incision” around the areola and vertically down the breast. This type of incision does not leave a scar along the breast crease, which is one of the most difficult to heal.

A third type of procedure, known as “scarless” breast reduction surgery, involves using liposuction to remove breast tissue through tiny incisions. Though this technique doesn’t completely eliminate scarring, the resulting scars are only three millimeters wide and are discreetly located in the crease of the breast or in the armpit.

Reducing the Breast

When using the standard anchor technique, the surgeon will remove skin, fat, and tissue from the lower breast area to reduce the mass of the breast. The nipple and areola will be moved to a higher location on the breast, but not removed from the breast mound itself. Though many patients maintain sensation in their nipples following breast reduction surgery, loss of feeling does remain one of the most common breast reduction risks. With extremely large breasts, it may be necessary to entirely detach the nipple and areola from the breast, and graft it to the upper half of the breast. In this situation, you will lose all feeling in the nipple area. After the nipple is moved to its new position, the skin above the nipple is brought down and around the swell of the breast, and then stitched back to close the original incision.

In a vertical incision breast reduction, your doctor will make a “lollipop incision” around the areola and down the breast. After removing breast tissue and skin, the doctor will then stitch up the incision by pleating the excess skin over itself on the breast. The nipple can still be moved up in a method similar to that of the standard procedure, but not more than a few millimeters. This incision technique is generally a good idea for women with moderately large breasts, but may not produce the best results for patients with extremely large bust lines.

The “scarless” breast reduction technique removes fat through liposuction, and should be considered for patients with a large proportion of fat in their breasts compared to glandular tissue. This technique results in fewer scars, less trauma to breast tissue, and a reduced chance of possible breast reduction complications. Liposuction only removes fat tissue, not connective tissue, and is generally not considered an option for thinner women with large breasts. It is also not recommended for women with pendulous, or very large, dense breasts. Depending on your breast size and shape, and the surgical incision your doctor chooses, your surgery should yield positive breast reduction results.

Drains and Bandages

At the time of your breast reduction surgery, your surgeon may place drains in your breasts in order to prevent a build-up of fluid in the breast area and to promote faster healing. Fluid that collects at the end of the drains will need to be emptied about once a day. Your surgeon will give you specific instructions regarding your drains. If the drain fills immediately after it is emptied or you need to empty it more than three times per day, please contact your doctor.

After breast reduction surgery, your doctor will wrap your chest area in sterile dressings. The dressings will need to be changed one to two days after surgery and will eventually be replaced by a surgical bra, which will need to be worn for several weeks during your breast reduction recovery. You will be required to wear the surgical bra at all times, except when bathing.

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