What Is Breast Reduction Surgery and Are You a Candidate?

Breast reduction, or reduction mammoplasty (sometimes spelled mammaplasty), is the surgery to reduce the size of the breasts to improve the life of the patient.

Macromastia is defined as the state of having disproportionate, heavy breasts on an otherwise average-sized patient. When one has very large breasts, it is difficult to exercise, play sports, swim, fit into clothing, or even function on a daily basis without pain. Macromastia can have a negative impact on a woman's quality of life; breast reduction can correct it and enhance her life.

Women with large breasts often seek breast reduction surgery due to related back, neck or other health problems. In fact, the American Society of Plastic Surgeons (ASPS) classifies breast reduction surgery as a reconstructive, rather than cosmetic, procedure because it is done to correct a physical or medical problem rather than strictly to improve appearance.

Indications For Breast Reduction

Breast reduction surgery may be an option for you if you have backaches, neckaches or stasis ulcers (skin irritation or death of skin tissue due to pressure), if you have difficulty breathing, notice grooves in your shoulders from your bra straps, have numbness of any portion of the breasts and upper chest from the excessive weight, are displeased aesthetically, or dislike the general size of your breasts for any reason.

Many patients who seek breast reduction are either postpartum, overweight, have a predisposition for large, disproportionate breasts, or had a sensitivity to estrogen during development or pregnancy. Big breasts often run in the family, inherited from our mother and grandmothers.

Breast reduction surgery is safer than it once was, but please remember it is major surgery. Sometimes a short hospital stay is recommended for moderate to severe cases.

Are You a Candidate for Breast Reduction?

First and foremost, you must be in good health, with no active diseases or pre-existing medical conditions, and you must have realistic expectations of the outcome of your surgery. You must be able to discuss what you want with your plastic surgeon so that you both can reach an understanding of what can realistically be achieved. Your skin must have good elasticity so that it can bounce back to its former tightness postsurgery. You must also be mentally and emotionally stable to undergo the procedure. Cosmetic surgery is not like getting a cavity filled. This is an operation that requires patience and stability to deal with the healing period.

Contraindications For Breast Reduction

Not everyone is a good candidate for breast surgery. You may fall into that category if you have a history of irregular mammograms, undiagnosed lumps or other types of masses, severe obesity, diabetes, wound healing disorders, if you are breastfeeding (or have recently ceased), if you smoke, have clotting disorders or a family history of them, heart or circulatory disorders or if you have unrealistic expectations.

A full examination by a qualified plastic surgeon can help you determine if breast reduction surgery is an option for you. Surgery is exhaustive both mentally and physically, so you must prepare yourself beforehand for a proper recovery.

What Is Removed During Breast Reduction Surgery?

The breasts are made up of fat and glandular tissue. When a patient is thin or of average weight but has large, pendulous breasts, the culprit is usually redundant glandular tissue. When a patient has a higher percentage of body fat, the breasts are usually heavy from fat. What is removed depends entirely upon the make up of each individual woman's breasts and her desired end size. Obviously if the patient has low percentage of body fat but still desires breast reduction, the removal consists mostly of glandular tissue and skin if the correction is great or if a lift is needed. If the patient has a higher body fat percentage, a significant amount of fat can be removed without touching the glandular tissue, unless there is redundant breast tissue present. Skin will also be removed, giving a lifting effect.

So, remember, the key properties removed from the breast are glandular tissue, fat and redundant skin.

Breast Reduction Surgery: Special Cases and Rare Occurrences

Other indications for reduction mammoplasty may include instances of gigantomastia. Gigantomastia can occur during puberty or pregnancy. With pregnancy-related cases, the incidence of occurrence is usually one in 100,000 women.

Gigantomastia may involve both breasts (bilateral), or it can occur in only one (unilateral), resulting in significant asymmetry. In the average woman, breast weight is usually approximately 200 grams. In patients with gigantomastia, the breasts may weigh in anywhere between 4 and 7 kg (kilograms) grams or more (total). That is equivalent to 8 to 15 pounds.

Rashes, ulcerations, infections and other skin anomalies are common under and around the breasts of gigantomastia patients. In more advanced cases, incidents of necrosis, and hemorrhaging are possible.

The cause of gigantomastia is currently unknown; however, it is hypothesized that estrogen may be a significant factor in triggering the disorder. Secondary complications arise from the enlargement of the breasts and must be treated as well. If the cause of the problem — the enlarged breast or breasts — is not taken care of, the secondary complications will more than likely continue to occur.

Patients with gigantomastia have significantly improved their lives and health after reduction mammoplasty.

Breast Reduction and Health Insurance

Another plus for breast reduction patients is that most health insurance companies will cover all or some of the costs of surgery for those suffering from either macromastia or gigantomastia. That's because breast reduction surgery is a reconstructive procedure when it is performed to relieve medical symptoms. However, the insurer may base its criteria on the amount of tissue that is removed, and precertification is required for reimbursement or coverage. It is important to carefully review your policy to determine coverage prior to surgery.

Common Reasons For Wanting Breast Reduction Surgery

The number one reason for breast reduction is, of course, to make them smaller. General discomfort, backaches, bra strap grooves and other liabilities drive many women to seek relief. They cruise the Internet looking for before-and-after photos, and checking out message boards and chat rooms to share information and experiences. The search is all about seeking out those who have "been there, done that" and are willing to help others through the same experience.

Some women have an overabundance of significant breast tissue, decide that enough is enough and go for it! Some have lost considerable weight but still have large, pendulous breasts, while others simply want to be able to wear more stylish clothes or be able to sleep on their stomachs for a change. Some patients have extreme asymmetry, some have congenital deformities, and some just need a lift.

The point of this section isn't to establish any one specific reason to have breast tissue removed, with the exception of one rule: If you decide to have breast reduction, please make sure you are doing it for yourself. Other than that, it can be for any personal reason you wish it to be. Breast reduction is a personal decision and the personal factors driving it are your own. The important point is to be sure you're not doing it for your spouse or boy friend or significant other — it must be for you. There are inherent risks and possible complications, and there may be considerable scarring. Realize that, take care in choosing a qualified surgeon and read up on the subject as much as possible so that you are making an informed decision.

We share that one goal — to improve the quality of our lives by altering our breasts surgically — and that is what this website is for: to inform and bring together like-minded patients.