Reduction mammaplasty is a surgical procedure designed to reduce overly large breasts to a more comfortable size and contour. Typically, the desired result is smaller, better-shaped breasts that are proportioned with the rest of your body.

Various surgical techniques are possible. When determining which technique to employ, Dr. Bonness will consider the patient's individual condition and the desired outcome for the size and shape of her breasts. Each technique involves the removal of excessive breast tissue, recontouring of the breast, and upward repositioning of the nipple or lifting of the breast.

Who can benefit from breast reduction surgery?

Women with disproportionately large and heavy breasts (a condition called hypertrophy) are candidates for breast reduction surgery. Breast reduction is a wonderful operation that has benefited many women. (If you ask any plastic surgeon who his or her happiest patients are, it is most often the breast reduction group.) We frequently hear from our patients, “Why did I wait so long?” or “I should have done this years ago.”

Large-breasted women often have a variety of symptoms, including:

· Pain in the neck and upper back,

· Deep shoulder grooving from the bra strap,

· Skin rashes beneath the breasts,

· Occasional numbness and tingling in the arms and hands,

· Tension headaches, and

· Poor posture.

In addition, these women frequently report feelings of extreme self-consciousness and constrained lifestyle choices, such as the inability to exercise freely due to their breast size. Moreover, excessive breast tissue can interfere with efforts to detect breast cancer.

While there is no specific size that warrants breast reduction surgery, most women who undergo this procedure have a D cup size or larger.

How is the surgery performed?

Breast reduction surgery is performed on an outpatient basis in the hospital operating room under general anesthesia. It takes between two to three hours.

Incisions are made around the areola and a keyhole shaped portion of skin, fat, and breast tissue is removed. The remaining breast tissue with the attached nipple is then shaped into the new breast. The majority of time spent in the operating room is during the placement of the stitches. Three layers of absorbable sutures are placed deep under the skin; sutures on the outside of the skin are avoided to minimize the appearance of the scars. Scars will be visible around the areola, vertically down the center bottom of the breast, and under the breast in the crease.  This is often referred to as an anchor pattern. 

Dr. Bonness no longer uses drainage tubes for breast reduction surgery. Instead, she carefully places dressings and the patient is fitted for a special bra.

What can I expect after the operation?

While breast reduction is a significant operation, the recovery is typically quite simple. There will be some discomfort that is primarily limited to underneath and on the sides of the breasts. There will also be moderate bruising, swelling, firmness and drainage. Typically these occur for only the first three days, and most patients are no longer taking prescription pain medications by the third day, taking Tylenol after that. Showering is permissible after day two.

What are the risks?

Breast reduction surgery is very safe. Although complications can occur after any surgery, they are rare and can be minimized by recognizing patients that are at higher risk. Some risks include bleeding, infection, poor healing, poor contour, breast symmetry, loss of nipple sensation, thick scars and inability or difficulty breastfeeding. One group of patients that are at higher risk for healing problems is smokers. Smokers are at a higher risk for healing problems and tobacco is known to signifantly increase the likelihood of poor results after breast reduction surgery. Dr. Bonness will discuss with you the importance of stopping any tobacco use before your operation. 

What are the goals of breast reduction surgery?

The goals of breast reduction surgery are:

• To reduce the size and weight of the breasts,
• To relieve back, neck, and shoulder pain, and
• To correct sagging, which will help eliminate rashes that occur under the breast.

Unfortunately, breasts cannot be reduced without some scarring. Scars will be visible around the nipple and underneath the breast, and they usually heal very well.

Unwanted Male Breast Enlargement

Gynecomastia is the medical term for over-developed male breasts. This condition is much more common than most people realize; it affects an estimated forty to sixty percent of men, especially those over age fifty. There are many causes for male breast enlargement, including heavy exercise, a family predisposition, or even steroid use. In addition, some men who lose a large amount of weight can develop gynocomastia if the breast glands retain a certain amount of fat. Other medical conditions and certain drugs can also cause men to have enlarged breasts.

New techniques have been developed that can correct gynocomastia in order to alleviate the embarrassment and potential for ridicule that sufferers might experience. Specialized liposuction instruments can be used through very tiny puncture sites for removal of the unwanted tissue. This is a relatively quick same-day procedure, and patients return to normal activities with little downtime. There will be no visible scar left as an unpleasant reminder.

Men who are interested in removing excess breast tissue should schedule an extended consultation with a plastic surgeon to review their specific needs and goals.