Breast Reduction Surgery
Traditional Breast Reduction

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good candidates
initial consultation
satisfaction rates

Good Candidates

Good candidates for breast reduction surgery:
  • Women that have pendulous breasts (often signifies more glandular tissue than fat)
  • Women who are thin (thin women tend to have more glandular tissue than fat)
  • Women that have excessively large breasts (liposuction normally only provides a 30-50% reduction in size)
  • Women that have excessively dense breast tissue (often signifies more glandular tissue than fat)
  • Women before menopause (during menopause fat replaces glandular tissue)

Initial Consultation

At the initial visit, your doctor will likely ask you to describe in detail what you would like improved. Be specific about what you would like done. If your surgeon fully understands your expectations, she'll be able to determine whether your goals are realistic. Your surgeon will examine your breasts. She talk to you about the what size you want your breasts to be and will show you where she intends to position the nipple and areola.

You are at increased risk for complications if you have diabetes, poor circulation, heart, lung or liver disease, smoke, have a family history of blood clots, take certain medications, etc. You'll want to discuss your medical history thoroughly with your physician before you choose to undergo surgery.

Because the size, shape, and amount of tissue in the breast will change after reduction, most women are advised to have a preoperative mammogram and a postoperative mammogram six months to a year after surgery for comparison.


Anesthesia: General
Location: Hospital
Surgery time:3-4 hours

A mammoplasty is a surgical procedure that reduces, lifts and reshapes the breasts. It can also reduce the size of the areola (the dark skin surrounding the nipple). Many women seek breast reduction to alleviate painful discomfort and other conditions (back pain, shoulder pressure, rashes, skin tags, etc.) as well as to improve the appearance of their breasts.

The procedure is usually performed under general anesthesia. The operation takes about 3-4 hours, and you may require an overnight stay or be allowed to go home the day of surgery.

During mammoplasty, the surgeon makes an incision which is normally in a keyhole pattern: a circle around the aerola and two incisions down the breast which will be closed to form one line. Fat and extra tissue are removed. The surgeon then repositions the nipple and areola to a higher position and removes excess skin from beneath the breast.

In Figure 1 the outlined areas show where skin, breast tissue, and fat are typically removed and how the areola and nipple are repositioned. The arrows show how skin formerly above the nipple is brought down and sutured together to reshape the breast. After surgery, scars will appear around the areola and in the crease under the breast.

Figure 1

In some cases, the nipple and areola are transferred as a skin graft to their new position. This is only done when absolutely necessary, since nipple sensation is almost completely lost. Drains are then placed on the sides of the breasts to drain blood and excess fluid. The drains are not removed for 1-2 days. The incisions are then sutured closed and taped.


The scars extend around the nipple, vertically down from the nipple and under the breast. The scars fade in time but tend to be wide scars and are still visible.

Satisfaction Rates

Patient satisfaction rates range from 80% to 95%, and symptom relief is reported from 70% to 100%.


For Immediate Release
May 1, 2002

ARLINGTON HEIGHTS, Ill. - Women who suffer from painful physical symptoms of overly large breasts show greater improvement with breast reduction surgery over conservative treatments such as special bras, weight loss, physical therapy, or medication reports the April issue of Plastic and Reconstructive Surgery, the official medical journal of the American Society of Plastic Surgeons (ASPS). The study also confirms the benefits of breast reduction surgery are considerable and not dependent on body weight, bra cup size or amount of tissue removed.

"This study provides additional and even more convincing evidence that breast reduction effectively improves the overall health and wellness of large-breasted women with chronic pain related to their breast size," said E. Dale Collins, MD, a plastic surgeon at Dartmouth Hitchcock Medical Center in New Hampshire and first author of the study. "The findings also support the fact that more conservative methods of treatment -- often required by insurance companies -- have failed to deliver significant or lasting relief."

The study group included 363 women, 179 women with a median bra cup size of DD who underwent breast reduction surgery, and two sets of control groups that did not - 96 women with a bra cup size less than D and 88 women with a bra cup size of D or larger. Prior to surgery, 50 percent of the patients who had breast reduction surgery reported pain in the upper back, shoulders, neck, and lower back all or most of the time. While less than 10 percent experienced these conditions after surgery.

Prior to seeking surgical relief, the patients who had breast reduction surgery tried a number of conservative treatments including weight loss, supportive bras, medications and physical therapy. About 85 percent of these women previously tried weight loss to relieve their symptoms, but more than half found the effort completely ineffective and none of the women reported complete or permanent symptom relief. Additionally, 77 percent of them tried one or more medications to manage pain, including narcotic and non-narcotic analgesics, non-steroidal anti-inflammatory agents and muscle relaxants. After surgery, only 13 percent of these women required medication, just slightly more than the control group consisting of women with a bra cup size less than D (11 percent).

None of the conservative treatments provided full or permanent relief of symptoms. In contrast, both pain and overall health were markedly improved by breast reduction surgery, restoring patients to normal levels of function.

Plastic surgeons have long observed that reducing breast mass can effectively alleviate the symptoms associated with overly large breasts. However, insurance denials and policy exclusions for the procedure are becoming increasingly common. Insurers often request patients seeking surgery try conservative measures first. Additionally, some companies set arbitrary body weight restrictions. This study demonstrates that all women, regardless of weight, benefit from surgery and that conservative treatment weight loss was not effective in relieving related symptoms.

"I believe insurance companies drastically underestimate the severity of symptoms associated with having overly large breasts," said Dr. Collins. "Patients seeking surgery reported suffering from pain comparable to low back pain or arthritis. Breast reduction surgery is a safe and highly effective treatment option and should not be considered a last resort."

According to ASPS expanded statistics, 99,428 women had breast reduction surgery in 2001. Breast reduction surgery was the fifth most performed reconstructive plastic surgery procedure in 2001.

ASPS, founded in 1931, is the largest plastic surgery organization in the world and the foremost authority on cosmetic and reconstructive plastic surgery. ASPS represents physicians certified by The American Board of Plastic Surgery (ABPS) or the Royal College of Physicians and Surgeons of Canada.

Information provided is for general education about traditional breast reduction, male breast reduction, breast reduction by liposuction and other cosmetic plastic surgery procedures. This information is subject to change. Smart Breast does not guarantee that it is accurate or complete, and is not responsible for any actions resulting from the use of this information. General information provided in this fashion should not be construed as specific medical advice or recommendation, and is not a substitute for a consultation and physical examination by a physician. Only discussion of your individual needs with a qualified physician will determine the best method of treatment for you. All board certified plastic surgeons listed are board certified by the American Board of Plastic Surgery. Board certified plastic surgeons are verified by the American Board of Medical Specialties.

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