When it comes to the topic of breast augmentation, the first thing that comes to mind for many people is usually breast implant surgery or other cosmetic procedures to increase breast size. There is another common, but less popular, type of breast surgery, called the mammoplasty reduction, which is chosen by many women each year to reduce the size of their breasts and change their appearance. There were only 40,000 aesthetic breast reduction surgeries performed in the United States in 2015, according to the American Society of Plastic Surgeons’ 2015 Report, Plastic Surgery Statistics. This is compared to over 279,000 breast implant or other aesthetic augmentation surgeries that same year.
Mammaplasty reduction, also known simply as breast reduction, is a procedure that reduces that size of the breasts by removing excess tissue, fat and skin in order to give the patient a more proportioned look that is balanced with their frame. Patients with very large breasts and seek out the reduction procedure may do so because they feel self-conscious or are embarrassed about their appearance. They may also shy away from participating in some activities or avoid relationships because of their feelings about their breast size.
Aside from aesthetics, many patients seek out breast reduction surgery to relieve pain or discomfort caused by large or pendulous breasts. Large breasts can cause pain in the neck, shoulders or back. Breasts that are too large are often very heavy and can pull the body forward. This causes the shoulders to slump and gives the patient posture problems. Some patients also report contracting hard to treat rashes, as well as bacterial and yeast infections underneath their breasts.
Patients with very large breasts can even have difficulty sleeping, according to Dr. Mona Alquali, M.D., FACOG, of Clinton, Iowa. "Breasts that are too large can make everything uncomfortable – from buying clothes to exercising and even finding a position that is comfortable for sleep," she says. "Most patients have dealt with the pain and being uncomfortable for a long time. As a result, many women end up frustrated and seek out reductions to feel better – both physically and mentally."
Alquali frequently consults and counsels patients seeking breast reductions to answer questions about the procedure, and ensure interested patients are good candidates for surgery. "Breast reduction is a major surgery," says Alquali. "It is important to provide the patient as much information as possible about the procedure, and discuss their expectations for after surgery."
The process involves putting the patient under general anesthesia. After the patient is sedated, an incision is made around the areola. Most reduction procedures leave the nipple connected as a flap, but in some patients with extremely large or pendulous breasts, the nipple and areola are removed during the procedure.
After the incision is made, the excessive glandular tissue is excised along with unwanted fat. The remaining breast tissue is then reshaped and lifted, and the patient is sutured closed. If the areola and nipple were removed as part of the procedure, they will be replaced in a higher position that is more natural for the new breast. Some patients may experience a period of numbness in the areola and nipple after the procedure.
Because the mammoplasty reduction procedure is a major surgery, patients should be realistic about the postoperative downtime. "Most patients can expect two to three weeks off work and only light activities," she says. After surgery, patients should wear a surgical bra to support the reconstructed breasts. Patients should sleep on their backs to avoid putting pressure on the breasts. "Avoid aerobic exercise, like running or Crossfit, and do not lift weights until cleared to avoid straining or stress on the healing chest area."
Ideal breast reduction candidates are in good health, have a healthy weight, are nonsmokers, and do not have underlying medical conditions, like blood clots. Patients seeking breast reduction should find a professional who is licensed to perform the procedure and make an appointment to discuss their options. Alquali advises patients who are seeking breast reduction to wait until breast development has ended, and they are through with child birthing and breastfeeding. "Breasts often change during and after pregnancy, so it is best to wait to have the reduction procedure after having children," she says.