Breasts that are too large or heavy are often a source of more than just cosmetic unhappiness. The excessive size and weight may interfere with exercise and other activities, cause chronic neck and upper back pain, impair posture, or create indentations in the shoulders from the strap of the bra. Breast reduction surgery removes excess glandular and fat tissue while tightening the skin and raising the position of the nipple and areola. The result is a more proportionate, perkier shape that improves the way clothing fits and helps to alleviate these symptoms.
Given the endless variety of breast shapes and sizes, there is no single breast reduction method that suits everyone. Rather, the surgery needs to be tailored to fit the individual. All methods (with the rarely-indicated exception of liposuction) produce a scar of some sort. At minimum, the scar is a circle at the edge of the newly positioned areola, but more commonly also extends down from the areola to the bottom of the breast, and often along the crease beneath the breast. The scar is strategically hidden and fades nicely in almost everyone, but it is important to understand that it is always visible to some degree.
Few patients realize this, but the scar on the outside is actually not as important as the method used beneath the skin to re-size and reshape the breast. To produce a beautiful and perky shape with a long-lasting result, it is important to remove the excess breast weight from unwanted areas (typically the bottom and outer portion of the breast) while preserving the ‘good’ volume at the upper and central breast. (Surprisingly, the standard breast reduction method practiced for decades in the U.S. does just the opposite.)
The procedure is performed as an outpatient, though one can stay overnight if desired. Recovery is usually straightforward. A narcotic may be needed for 1-2 days to manage discomfort. Drains, if used, are removed on day two. A gentle support bra is worn for a few weeks. Aerobic exercise and lifting are gradually resumed after 2-3 weeks. Most swelling gradually resolves over the first few weeks, but additional settling occurs over several months. The scar itself fades in 6-12 months.
Surgical risk is kept to a minimum with careful technique and attention to detail. Still, risks include changes in nipple sensation or viability, poor healing of the skin, breast asymmetry and others that are reviewed in detail during consultation. In most women seeking breast reduction, the benefits of restoring proportion and alleviating symptoms associated with overly large breasts far outweigh the risks, making the procedure immensely satisfying.