Incision Pattern

Vertical – This breast reduction creates a “lollipop” incision, one that runs circumferentially around the nipple, with an extension to the chest wall along the bottom of the breast.  This reduction works best for patients with good skin quality, a small amount of skin excess, and a need for a moderate breast lift.  This approach also allows for an areolar reduction, if needed.

Wise-Pattern – The most common breast reduction, this creates an “anchor,” or “inverted-T,” shape incision, that runs circumferentially around the nipple, with an extension to the chest wall along the bottom of the breast, and horizontally along the breast crease.  Though a longer scar, a Wise-pattern is the more powerful breast reduction, allowing the greatest amount of breast lift, and removal of excess skin.  This approach also allows for an areolar reduction, if needed.

Incisions are created using the selected breast reduction technique, producing skin flaps to expose and isolate the underlying breast tissue.  The patient’s nipple and areola are protected on a segment of healthy breast tissue, and the excess tissue removed.   Once the desired breast size has been obtained, the nipple and remaining breast tissue are lifted and shaped into an improved, youthful contour.  The skin flaps are redraped, and any skin excess is removed.  Drains are placed to prevent the accumulation of fluid within the breasts, as they heal.  The skin incisions are then closed in multiple layers, sterile gauze applied, and a chest wrap placed for comfort.

Patients typically go home the day of surgery, and will need a few days, to a week, off from work to allow for a comfortable healing period.  Most women will require prescription pain medication for the first few days after surgery, before being able to transition to over-the-counter medications.  On the follow-up appointment, the surgical dressing is removed, and patients are placed in a sports bra or other non-underwire bra until the incisions are completely healed.

Final surgical results will take several weeks to months, as swelling resolves, incisions fade, and the breasts settle.

We believe in being preemptive to avoid common risks associated with surgery, but occasionally the following may occur:

Bleeding/Hematoma – A small amount of bleeding is common after surgery, but if severe enough, another operation may be required to stop it.  Bleeding can also form a collection, termed a hematoma, which presents as a swollen, painful, and enlarged breast.  These require drainage to prevent secondary problems.

Seroma – A fluid collection may form within the breast, and may require drainage.

Infection – A breast reduction carries a small risk of infection, but if one occurs, it may require oral, or intravenous, antibiotics.

Poor Cosmesis: This may include poor wound healing, with a widened scar, irregularity of the scar contour, or partial wound separation.  There may also be asymmetry in nipple positions, breast sizes, shape, or contour, between the two breasts.

Fat Necrosis:  When operating on the breast, there is the possibility that a part of the tissue loses its blood supply.  This can lead to a localized area of hardness within the breast

Nipple Sensation: A change in nipple sensation, either increased or decrease sensitivity, is not uncommon following surgery.  Usually temporary, sensation typically returns to normal within a few weeks.  In rare instances, this altered sensation may be permanent.

Nipple Loss:  As both breast reduction techniques involve circumferential incisions around the areola, and removal of tissue that supply the nipple with needed blood and nutrients, there is a chance that the nipple and areola lose their blood supply and die.  This risk increases as the size of the breast reduction increases.

Blood Clots:  Breast reduction can result in the development of blood clots in the legs.  These clots can travel to the lungs where they can be fatal.  Precautions before, and after, surgery are taken to avoid blood clots from forming.

Bra Size – Bra and cup sizes are useful for initial discussions on the desired size of the breast reduction, but because of the variety of bra manufacturers, each of which use their own sizing, there is no guarantee on a particular bra, or cup, size after surgery.

Long Term Changes: Time, pregnancy, weight loss, gravity, and menopause will continue to affect the appearance of your breasts.  These changes may require surgery to restore a more youthful contour.

Will my breast reduction be covered by insurance?

The short answer is, it depends.  Insurance companies will require 3-6 months worth of documentation from your primary care provider of breast-related symptoms (rashes, neck/back pain, and shoulder grooving), and treatment failures (weight loss, physical therapy), that have led you to pursue surgery.  Once approved, the insurance companies will determine either a fixed amount of breast tissue, or an amount proportional to a patient’s height, that needs to be removed in order to have the operation covered by insurance.

Are my breast reduction results permanent?

Though a breast reduction dramatically improves the shape and contour of a woman’s breast, time, gravity, and weight fluctuations will cause sagging of the tissues. Future revisions may be needed to maintain a desired breast shape and position.