A breast reduction surgery, also called reduction mammaplasty, reduces the breast size by removing excess fat, glandular tissues, and skin to achieve a breast size proportionate to the rest of the body and relieve discomfort caused by overly heavy breasts. Generally, patients undergo breast reduction surgery for medical concerns (macromastia — abnormal enlargement of breast tissues). However, patients who don't suffer from macromastia can also consider pursuing breast reduction for aesthetic reasons. Women who get a breast reduction for aesthetic concerns cite several reasons like social stigma, negative self-image, or difficulty fitting into clothes.
What is Breast Reduction?
Breast reduction, also called reduction mammaplasty, is a surgical procedure to remove excess fat, skin, or glandular tissues from excessively enlarged breasts to give them a firm, perky, and proportionate appearance.
Mostly, breast reduction surgery is a medical necessity. Disproportionately heavy breasts cause pain in the head, shoulders, and neck muscles due to the constant tugging of muscles. This pain makes carrying out physical activities very challenging for a few people and impairs their ability to lead an active life. Besides physical challenges posed by macromastia, many people suffer from emotional distress caused by their enlarged breasts. Also, women undergo breast reduction for cosmetic reasons. They choose breast reduction due to the social stigma associated with awkwardly heavy breasts, or it makes donning specific clothes difficult.
You may be a candidate for this electric surgical procedure if you are an assigned female at birth and suffer from macromastia or an assigned male at birth and suffer from gynecomastia (disproportionately enlarged breasts in men). A few other factors that govern your candidacy for breast reduction surgery are:
You are in good physical and mental health.
You are ready to bear scars.
You don't plan to have a baby.
You have a negative self-image.
You have chronic rashes and irritation under breast folds due to their size.
Your breast size impairs your physical activity.
Your bra straps make indentations in your shoulders due to the heaviness of your breasts.
Your heavy breasts cause shoulder, neck, or back pain or kyphosis (abnormal hunching of the spine) due to heavy breasts.
What to expect before the procedure?
Reduction mammaplasty needs a multi-step approach to achieve aesthetically pleasing results. The first step to preparing for breast reduction surgery is a pre-operative consultation. During the consultation, your surgeon will discuss the risks and benefits of the procedure. They will also ask if you have had any surgeries, mammograms, lumps removed, or any medical condition affecting the breasts. They will also ask you about your detailed medical history, any specific medications you are taking, your smoking record, any previous or anticipated pregnancies, and your family history of breast cancer. What matters the most in the pre-operative consultation is your honesty in telling the surgeon your details. The more you keep things transparent, the lesser the chances of post-operative complications. Any emotional distress you have dealt with due to volumized breasts is also documented.
After assessing your overall health, your surgeon may take photos of your breasts, discuss how much tissue should be removed to get the desired outcomes or perform a mammogram before starting the procedure. Pre-operative consultation gives you an insight into what happens during the surgery and how to prepare for recovery.
It's important to choose a well-balanced diet plan and quit the intake of tobacco products well before surgery to ensure proper healing.
What to expect during the procedure?
Generally, breast reduction surgery is performed in an outpatient unit and may take about three to five hours. In a breast reduction surgery, you will be given anesthesia. Your surgeon will make an incision on your breast. The type of incision depends on your individual condition, your desired outcomes, and how much glandular tissues need to be removed from the breast.
A breast reduction surgery follows the following steps:
The surgery starts with giving intravenous sedation or general anesthesia to comfort you during the surgery.
Your surgeon can make any of the three types of incisions depending on your specific needs:
A circular incision around the areola
A racquet-shaped incision around the areola running vertically down to the breast crease
An inverted T or anchor-shaped incision pattern
Once the incision is made, the nipple is repositioned while remaining tethered to its original blood and nerve supply. If necessary, areolar size is reduced by removing skin at the perimeter.
Underlying breast tissues are lifted, removed, and reshaped. Sometimes, if the breasts are excessively pendulous, nipples are removed and transplanted at an elevated position on the breast.
Closing the incisions
After removing the desired amount of breast tissues, incisions are closed with sutures, skin adhesives, and/or surgical glue or tape. The scars are permanent but fade away with time.
What to expect after the procedure?
The patient can be admitted to the hospital if the pain is not manageable. However, laboratory surgeries are usually not required after the surgery. The results of the breast reduction surgery are almost immediately visible. Dressings can be removed on the first day after the operation and replaced with a clean gauze and surgical bra. The swelling subsides within a few days. The patient is allowed to bathe on the first day if there are no drains. Otherwise should wait for them to be removed. If you strictly follow the post-procedural guidelines, your recovery will be smooth and free of complications. The scars are permanent and visible. However, they get whitish with time.
Types of Breast Reduction
Which Breast Reduction is Right for You?
Once the patient is declared suitable for breast reduction surgery, the surgeon will choose one of the several methods depending on your breast anatomy, desired outcomes, and extent of the enlargement. The chosen method must result in the lowest chance of serious complications such as wound dehiscence, overelevation of the nipple, flap necrosis, and ischemic loss of the nipple. Patients frequently inquire about how their surgery will be tailored to their needs. Let's start by explaining that:
In this type, breasts are reduced by liposuction alone. Liposuction works by suctioning the fats from the breasts through small incisions using negative pressure. Liposuction is a minimally invasive procedure. The duration of this procedure is short and involves smaller incisions. It is ideal for candidates who want a moderate reduction and have skin elastic enough to snap back to its original position after the surgery.
Patients with moderate enlargement are the ideal candidates for the Lollipop incision method. In this method, your surgeon removes excess tissues by making one incision around the circumference of your areola, and another incision running down from the areola to your inframammary fold. The surgeon removes the excess mass, reshapes the breast, and lifts it. Avoiding scars may not always be possible but they fade with time.
Inverted T (Anchor)
This type is breast reduction is best for patients with overly huge breasts as it involves a maximum degree of tissue removal and more incisions. The incision shape for this method looks like an anchor or an inverted T. In this type, your surgeon makes an incision around the areola. From the areola, the cut runs down to the inframammary fold and then along the fold.
Scars left are similar to the lollipop incision, with one additional scar along the breast crease. However, with proper care, they fade significantly over time.