Breast reduction is a surgical procedure that removes skin, fat, and tissues from the breasts in order to reduce their size, reshape, and lift them. Breast reduction is becoming increasingly popular as women with large breasts realize they don’t have to “just live with it” anymore. Excessively large breasts can damage self-esteem, reduce quality of life, and even cause physical problems like chronic back and neck pain. Individuals considering breast reduction may wonder if the procedure is permanent, if it interferes with breastfeeding, and if there is an optimal age at which to consider it.
Is Breast Reduction Permanent?
The skin, fat, and tissues removed during a breast reduction procedure are permanently removed and cannot grow back, so yes, breast reduction is permanent. However, gaining weight can cause new fat to be deposited in the breasts and may make them increase significantly in size. In addition, pregnancy and breast feeding can also cause the breasts to increase significantly in size and the aging process is well known to cause breast size and shape changes. If necessary, a second surgical procedure can be performed to reduce the breast size again or to lift aging sagging breasts into a more perky, youthful position.
Does It Interfere with Breastfeeding?
A breast reduction surgery may impair or even prohibit the ability to breast-feed because glandular tissue and milk ducts may need to be removed or are damaged during the surgery. However, some breast reduction surgical procedures have been developed to specifically try to preserve the ability to breastfeed, so if you think you may want to do so in the future, it is important to discuss this possibility with our surgeon before the procedure. Breast reductions performed without any effort to preserve breast feeding ability have been reported to result in only 4% of women being able to breastfeed versus 75% to 100% being able to breastfeed after a gland-preserving breast reduction. Unfortunately, the only way to determine if breast feeding is possible after a breast reduction is to try it and see if it works. If it doesn’t, don’t despair; human milk banks are available and although it is well-known human milk is the optimal method of feeding a baby, large numbers of infants thrive on formula.
Does It Interfere with Breast Cancer Screening?
Breast reduction surgery will not interfere with mammograms, ultrasound, MRI, or physical examinations routinely performed to screen for breast cancer. Some doctors may suggest getting a “baseline” mammogram about six months after breast reduction in order to have a record of what the scar tissue looks like in the post-surgical breast tissues that can be compared to any future mammograms in order to identify changes in the breast tissue that may be suggestive of developing breast cancer.
Is There an Optimal Age to Undergo Breast Reduction?
From the surgeon’s perspective, the “optimal” age to perform a breast reduction is after the woman has completed her family. Namely, she has no plans to become pregnant or breast feed in the future. However, from the woman’s perspective, the “optimal” time is usually as soon as possible, in the late teens to early 20s. Procedures performed on younger teenagers before their breasts have fully developed may require a second procedure later in life to maintain the desired results, but many teenagers and their parents feel the many benefits of early breast reduction are definitely worth it.
Problems with Large Breasts
While the media may glamorize large breasts, large breasts can actually cause many problems. It can be very difficult to find comfortable, well-fitting bras that provide sufficient support; some women even develop deep grooves in their shoulders from the weight of their breasts pulling their bra straps into their flesh. Dresses and blouses that fit are also extremely difficult to find, and many women with large breasts end up having to wear clothing that is several sizes too large in order to accommodate their breasts, a look that tends to be neither flattering nor professional. Women with large breasts may also appear to be overweight even when they aren’t.
In addition to the cosmetic issues, large breasts can cause health issues. Many women with large breasts find it difficult to engage in any kind of exercise; even when wearing heavy-duty sports bras, their breasts tend to bounce, which can be uncomfortable and even acutely painful. In addition, large breasts can actually physically get in the way of performing some types of exercise. Thus, women with large breasts tend to avoid exercising, which is unhealthy and increases their risk of developing conditions like cardiovascular disease and osteoporosis.
Women with large breasts also often develop chronic neck, back, and shoulder pain from assuming unnatural postures in an effort to counterbalance the weight of their breasts. Chronic rashes and infections commonly develop in the skin underneath the breasts. Due to the many physical problems associated with large breasts and their significant impact on quality of life and self-esteem, most insurance companies do not consider breast reduction surgery to be “cosmetic” and will cover the procedure.
What Is the Procedure Like?
It is important to have a frank and open discussion with our surgeon before the procedure where you share your goals and desired breast size. Most surgeons these days have software that can display images of the patient with different sizes of breasts to assist in decision making. You may be asked to undergo laboratory testing of your blood to ensure you are healthy enough to go through a major surgical procedure, and it is important to stop taking medications like aspirin or ibuprofen that can delay blood clotting for several days before the procedure.
The procedure itself is performed under general anesthesia and takes a few hours; often the patient can return home the same day instead of staying overnight. The exact surgical approach depends on the size of the breasts and the desired final size. The surgeon will place the incisions in locations where they are not visible, such as around the areola, in the crease under the breasts, and sometimes even in the armpits; usually however an incision also needs to be made from the areola straight down to the crease under the breasts. Liposuction may be applied to remove fatty tissues; tissue and skin will be trimmed away and the areola will usually be shifted upwards as the breasts are reduced in size. If the breasts are extremely large, sometimes the areola and nipple need to be completely removed and then re-attached in a new position. The breasts will be smaller, perkier, and lifted after the procedure.
What What Is the Recovery Like?
Full recovery takes about four weeks, but most women can return to work and their regular activities within a few days. The breasts will be sore, bruised, and swollen, and may need to be supported in a compression bra during healing. Physical activity, especially heavy lifting and anything that causes significant breast movement, should be limited during this time period. As the swelling goes down, the new size and shape of the breasts will become apparent. Many women report losing sensation in the nipples after the surgery, but the sensation usually fully returns within a few months.
Prior to the surgery, many women worry about the scarring. It is true there will be scars that form along the surgical incision lines. However, modern techniques place the incisions in locations where the scars will never be visible while clothed, even if wearing a very low-cut blouse or a minimalistic bikini. The scars will gradually fade over time into very thin pale lines that are barely noticeable. After surgery, very few women express any concerns at all about the scars.
Is There a Non-Surgical Way to Reduce Breast Size?
Unfortunately, there is no non-surgical way to reduce breast size. Creams, pills, and herbal supplements sold for this purpose simply do not work. Some women experience a reduction in breast size if they lose a significant amount of weight, but other women do not experience any changes in their breast size in response to losing weight. The breasts are a complex tissue composed of glands and fat, and while some women have a lot of fat in their breasts, others barely have any. The effect of weight loss on the fat in the breasts is also quite unpredictable; some women’s bodies strongly resist removal of the fat from the breasts even if the woman has an unhealthily low body fat percentage. A major downside of trying to reduce breast size by losing weight is the skin around the breast doesn’t shrink even if the breast does, resulting in sagging flaps of skin around the breast that may need to be surgically removed.
Breast reduction surgery has one of the highest patient satisfaction ratings of any “cosmetic” procedure. Patients usually report they are pleasantly surprised at how easy and quick the recovery is, and even more important, most report their unpleasant symptoms related to their large breasts are completely resolved after the surgery. The neck and back pain go away, the chronic skin infections/rashes go away, and the bra strap grooves rapidly heal. Many patients have to buy a whole new wardrobe, but they are usually quite happy about this-finally being able to wear comfortable bras and flattering clothing that fits. Women who have never been able to engage in anything more athletic than walking find themselves taking up soccer or striving to run marathons.
If you are troubled by excessively large breasts, don’t wait, Steven Block, M.D. at Body by Bloch in Highland Park and Glenview would be more than happy to answer your questions. Contact us today to schedule your consultation!