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Breast Reduction: Options

December 7th, 2011

Just as some women may experience a decrease in breast size over time, others will notice an increase in breast size.  When a woman is uncomfortable with having too much breast tissue, there are several options to correct this condition. A  dramatic  increase in size may result of an increase in overall weight gain or a pronounced sagging of the breast tissue.  Increase of breast size may result in physical discomfort, including  symptoms like neck pain, back pain, shoulder grooving and irritation beneath the breasts.  Patients routinely turn  to breast reduction surgery to reduce their symptoms, along with their breast size.

Reducing breast size can be done with direct surgical removal of breast tissue or with liposuction.   Liposuction does not adjust nipple position.   It is effective only when there are significant amounts of fat in the breasts.  Young women may not be candidates for this surgery because of the relatively low amount of breast fat.  Traditional breast reduction surgery reduces breast size through excision of breast tissue, while repositioning the  nipple and areola (pigmented skin around the nipple).  The size of the areola  can also be reduced.   Scars, which are similar to breast lift surgery, are placed around the nipple and beneath the breast as well.  Scars will be less noticeable as they continue to heal.

I recommend that any breast tissue removed be sent for examination by a pathologist.   This includes a   visualization under a microscope after tissue  staining to determine the presence of conditions or abnormalities which might increase chances of breast cancer.   On rare  occasions, breast cancer is diagnosed this way.

My patients choose of their final size, based on decisions made during our office consultation.  A range of implant “sizers” are helpful in this regard.
Time to schedule reduction surgery following pregnancy is determined by normal involution of breast tissue and the end to breast-feeding.   Generally this takes six months to a year after delivery or three months after breast-feeding.  Unfortunately, some women will not be able to breast feed again after breast reduction surgery.  Therefore, if breast-feeding  is an important consideration, I advise my patients to postpone breast reduction surgery until they are finished having children.

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