Breast reduction is a procedure that has three goals. The first is removal of excess weight. The second is to remove excess skin. The third is to form the remaining tissue in an esthetically pleasing shape. Yes, every breast reduction should end with a breast lift.
The reasons patients seek breast reduction are many. Some experience pain in their backs, shoulders, neck, and sometimes even the breasts. Some patients have grooves from the persistent pulling of their bra straps on their shoulders. Some are so large that it’s difficult to keep the skin beneath the breasts clean. Some simply want to look better. Recognizing the varied reasons that patients have for seeking relief with breast reduction, it’s important to remember that all breast reductions are not the same.
Many studies have addressed the question of whether breast reduction is a good idea. Nearly all agree, that if a woman has symptoms consistent with excessively large breasts such as pain or physical limitations, then breast reduction will improve her life.
In today’s realities, the common question is whether insurance will cover the cost of breast reduction. The best answer is: it depends. Insurance policies act as contracts that specify what medical treatment is a covered benefit under what circumstances. Many do cover reductions; some do not. Of those policies that do, some require a period of conservative care prior to approving the operation. Most specify a weight of tissue removal to be considered medically necessary. It is extremely important for every patient to remember that if you have an esthetic goal, you must make it explicit. A covered benefit that results in an unhappy patient is not a good benefit. Sometimes a mastopexy (breast lift) with a small reduction, even with liposuction, will provide a superb result that meets your expectations much better than an overly reduced breast.
Breast reduction can be performed through a variety of techniques. A circum-areolar approach can be performed but is seldom applicable for any but the smallest reductions. The vertical reduction technique is applicable to many sized breasts and has the advantage of limited scarring. There are some shortcomings that limit its utility. The anchor technique is still the most common approach for breast reduction and has the advantage of good shape control though with the cost of added scars. On rare occasions, breast reduction can be performed with liposuction alone. In properly selected patients such as revision reduction patients where the prior notes are unavailable, or in very small reductions, it works quite well. In large reductions, it results in deflated breasts.
Breast tissue removal can be performed through a variety of different techniques. The question hinges on how the blood supply and nerve supply to the nipple and areola are maintained with the removal of breast tissue. These are technical questions that depend on the surgeon’s preferences and the patient anatomy. Sometimes, patients have specific goals in mind that may sway the surgeon to one approach or another. These include breast-feeding and sensation.
The American Society of Plastic Surgeons published data on how many breast reductions were performed in 2012. It showed that 68,400 patients underwent reconstructive breast reductions. But it also showed that 42,000 patients had the procedures for esthetic goals only.
All tissue removed (except liposuction) must be evaluated by a pathologist to rule out breast cancer. In many states, it’s statute, but it’s always good medicine.
No two patients are alike, so no two patients have exactly the same course of treatment. The techniques, plans, esthetic intent, and outcomes are highly individualized. With Dr. Geldner’s superior skill, 25 years of experience, and his experienced and compassionate staff, we exceed our patient’s expectations.
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“I had been talking about having breast reduction surgery for years (I used to be a 32DDD). I was looking for a plastic surgeon who cared about his patients more than his paycheck. I found everything that I was looking for in Dr. Geldner. My results are great, and I am so happy I went through the process and I chose him as my surgeon.”