What Exactly is a Breast Reduction?

No two breasts are alike–even the ones side by side on the same chest. Some are big and some are small. Some stand at attention and some hang low. If you want to even yours out or make them both smaller, a breast reduction can get the job done.

And just as no two breast are alike, neither are any two breast reductions. A breast reduction, also called a reduction mammaplasty, can involve a number of different procedures, depending on the needs of each patient.

There are many reasons people have breast reductions, including physical symptoms like headaches and back pain and cosmetic issues like uneven breasts, enlarged areolas, or stretching from weight loss or breastfeeding.

The right procedures depend on the goals of the patient: how much of a change in size and shape is desired; whether they are looking for a more feminine or masculine result (Breast reductions are the fastest growing plastic surgery procedures among men in the US); or whether a woman wants to be able to breastfeed.

Depending on these goals and on the initial size, shape and position of the breasts, the surgical approaches will vary. 

Here are the surgical terms to know:

Reduction Mammaplasty
This is an umbrella term used to describe the surgical removal of breast tissue that can include excess fat, skin, and/or glandular tissue. This may be accomplished by surgical excision (cutting out) of breast tissue or with liposuction. mastopexy (breast lift) is a part of most breast reductions.

Mastopexy
This procedure is also called a breast lift, and it is usually a component of a breast reduction. The procedure can also be done on its own. The surgery entails removing excess skin around the nipple and lower aspect of the breast to decrease droopiness.

Liposuction
This is a minimally invasive procedure used to reduce the breast by removing fat. Liposuction alone does not lift the breast however. 

Some patients with smaller breasts may only need a little liposuction to reduce their breasts. Others will need more tissue removed and a lift (mastopexy).

Dr. Slack explains, “With any reduction technique, except liposuction-only, the breast is lifted, meaning the droopy lower pole of the breast is elevated so that the breast starts at the breast fold and moves up from there. The nipple/Areola complex is elevated along with the breast and is typically made smaller.

The extent of the breast lift and scar pattern varies depending on the location of the nipple, the elasticity of the skin, and the amount of tissue to be removed.

Here are the three general types of breast lifts used during a breast reduction:

Periareolar “doughnut” mastopexy
An incision is made around the areola and excess skin is removed. With this technique the areola is repositioned and reduced in size. 

Circumvertical “lollipop” or “keyhole” mastopexy
A keyhole incision is made around the areola and then vertically down to the crease of the breast. Excess skin, fat and glandular tissue are removed. The areola can be reduced in size as well.

Extended circumvertical  “wise-pattern” or “anchor” mastopexy
Using an inverted “T” incision pattern, this procedure does all of the above but skin is also removed horizontally leaving a scar along the breast fold. This allows for the removal of more skin, fat, and glandular tissue and relocation of the areola. The horizontal incision along the breast fold is extended out toward the armpit.

During a breast reduction, the nipple is usually left attached to the breast tissue below. With extremely low placed nipples or larger breasts, the nipple may need to be completely removed and replaced as a skin graft after the reduction is complete. This possibility should be discussed with your surgeon before hand, particularly if you are concerned about breast feeding. 

All breast reductions are performed under general anesthesia or conscious sedation. Because of this and the many choices that go into any breast reduction, it is important to choose a qualified plastic surgeon. Preferably one with special training in surgery of the breast, like Dr. Slack. Take a look at his breast reduction before and after photo gallery of patients seen in Collin County, Texas.

As with all plastic surgery, there will be some scarring, the extent of which depends on the procedure performed: there is little scarring with liposuction alone and more if extra tissue needs to be removed. In most cases, your surgeon will do his best to hide incisions within the areola and in the breast crease. Some scarring is likely to remain visible but will fade over time. Most patients report it is a worthwhile tradeoff for all the benefits of the breast reduction.

Recovery time after a breast reduction will also vary depending on the amount of tissue removed and the extent of the incisions. Your results will be apparent immediately after surgery. You will need to take it easy for at least a week and it is important to follow your doctors instructions. These instructions will help minimize scarring and lead to the best possible results. It may take a few months for all the swelling to subside and your final results to be fully realized.

If you are interested in a breast reduction, and you want to learn more about the options available to you, call Dr. Slack’s office and schedule your consultation today.