Breast Reduction

Breast reduction surgery is performed for symptomatic individuals with large, heavy breasts. Large breasts are responsible for a number of chronic health issues. As a result, breast reduction surgery may be covered by insurance- coverage varies by plan and policy. Breast reduction surgery is one of the most common plastic surgical procedures. Dr. Feiner’s breast reduction patients are some of his happiest. Symptoms often improve immediately following surgery and many wish they had done surgery sooner.

Symptoms of Macromastia (Large Breasts):
Back and neck pain refractory to conservative medical treatment and/or physical therapy or chiropractic treatment
Shoulder and back muscle spasms/tightness
Deep shoulder grooves from bra straps
Need for specialty bras, custom bras or widened straps
Interference with exercise and activities
Issues related to moisture under the breasts- rashes, infections, chafing
Nipple sensation changes, nipple numbness
Issues with breast imaging
Difficulty fitting into clothing
Psychological distress, depression
Breast reduction surgery combines removal of excess skin and breast tissue with a lift. Certain criteria must be met for insurance to approve the surgery. These criteria are defined by the symptoms above and the amount of breast tissue to be removed from each breast. The goal is to create smaller, symmetric breasts that are proportionate to a patient’s body. The incisions used are the same incisions utilized during a breast lift (mastopexy). Liposuction may be used to improve the results.

The breast tissue removed during a breast reduction is routinely sent for pathologic evaluation. A pathologist will assess for any abnormalities.

Typical Recovery:
Surgery is done on an outpatient basis- an overnight stay is not required. Pain and discomfort are minimal. Medication is administered during the surgery to facilitate recovery and minimize discomfort. Patients are given a prescription for oral pain medication, which is typically used during the first few days following surgery. A bra is typically placed immediately after surgery to provide support and to help with swelling. Activity is restricted during the first week to allow the incision time to heal. Exercise and heavy lifting may be limited for several weeks. Drains may be used depending on the extent of the lift.

Risks of Breast Reduction Surgery:
The risk of pain, bleeding, infection, and reactions to anesthesia may occur. There are risks specific to breast reduction that include the risk of changes in nipple sensation(numbness), interference with breast feeding, and asymmetry. Breast reduction carries a higher risk of wound healing complications than other breast surgeries due to the weight of the breast and the skin, which has often been thinned out and stretched.

All lifts carry a risk of injury to the nipple. This risk is increased in those who have previously had a lift or in situations where the circulation to the skin is impaired, such as in patients who use nicotine or have other medical conditions.

Nipple sensation may be lost in rare instances. Occasionally, patients with exceptionally large breasts will develop hypersensitive nipples following breast reduction. This occurs when the strain on overly stretched nerves is relieved by the reduction- the nipples can become overly sensitive. This improves with time, but it can take several weeks.

Patients with extremely large breasts and nipples that are very low may need to have the nipple removed and reattached as a graft to accomplish a reduction. This is an uncommon occurrence and Dr. Feiner will be able to assess this risk during your consultation.