Breast Reduction Breast Reduction surgery is performed to help treat symptomatic breast hypertrophy (large breast size). It is also has cosmetic value in that the appearance of the breast is improved by lifting of the nipple areola, change in breast shape, and reduction in breast size. Symptoms due to heavy and sagging breasts include upper back pain, neck pain, bra strap grooving, and rashes in the breast folds. Breast Reduction surgery for symptomatic breast hypertrophy can be covered by some health insurance plans. A certain amount of breast tissue removed is required for most health plans to cover the costs of the surgery. Smaller reductions are usually not covered by health insurance plans. Dr. Slatton uses the Vertical Mammoplasty technique in a majority of breast reductions. This technique, which was pioneered by plastic surgeon Dr. Madeline LeJour, avoids the horizontal incisions, which comprise the "anchor" pattern of scarring with breast reduction surgery. Although the horizontal incisions may be required with the Vertical Mammoplasty technique, the scars are shorter and don’t run into the pre sternal skin or axilla. Vertical Mammoplasty breast reduction may be combined with liposuction of the axillary region and tail of the breast. Wrinkling of the breast skin in the lower half of the breast is present initially after Vertical Mammoplasty. However this usually smoothens after time as the breast tissue settles and the skin contracts. This process usually takes 3 to 6 months. Although the future shape of the breast is not immediately apparent after the Vertical Mammoplasty breast reduction technique is used, the long-term benefits are a better breast shape and prevention or significant reduction of the horizontal breast crease scar. Breast Reductions are performed as an outpatient procedure. A friend or family member must accompany you to and from the surgery center or hospital on the day of surgery. Some discomfort after surgery is inevitable, but this can be significantly reduced with prescription pain medication, which is taken at regular intervals for the first several days after surgery. Be prepared to take at least a few days off work after the surgery until you no longer require prescription pain medication during the daytime hours. Many patients can return to work within a week of the surgery. However, physical activity restrictions that apply for home and work will be necessary in the immediate postoperative period. Activities at home or work related which require lifting or carrying objects greater than five pounds, are prohibited for the first three weeks after surgery. Patients can begin limited exercise three weeks after breast reduction surgery and most people can return to full activity, with a few exceptions, 6 weeks after surgery. The final postoperative appearance of your breast shape may take 4 months or longer to occur. Taping and applying adhesive silicone gel strips to the incision scars helps improve the early postoperative and final scar appearance. Although many breast reduction scars have an acceptable and often excellent appearance in the first months following the procedure, it may take up to a year for the scars around the areola, and on the lower breast to reach their final appearance. It is important that you attend your post op visits to optimize your final result. David S. Slatton, MD