Large breasts can cause problems in many aspects of a woman’s life. When they are larger than the usual standards of attractiveness in our society, the breasts are considered aesthetically displeasing. There can be a feeling of uncomfortable fullness, neck or back pain, and shoulder grooving. These symptoms may contribute to limited performance in certain occupations and in sports. Finally, large breasts can also be difficult to assess for lumps or masses, thus making cancer detection much more difficult for the patient or for her physician. Because of these medical problems, in many cases, medical insurance may cover some of the cost of breast reduction.

The goal of reduction mammoplasty is to reduce, recontour and reshape the breasts. The breasts are made smaller. The nipple areola complex is repositioned upward, and if indicated, reduced in size. Excess skin and breast tissue is removed from the lower and outer portions of the breast.

A preoperative plan is made which allows both the surgeon and the patient to share in the decision as to the proposed size of the breast after surgery. The surgeon will attempt to make the breasts as identical as possible, but some asymmetry may remain. Further more, it is not possible to predict exactly how larger the breast will finally be after surgery. Healing results in some progressive change in breast size, since some swelling may be present for several months following surgery.

Incisions are made in the lower breast resulting in three scars: one around the nipple, which usually heals very nicely; a vertical incision from the nipple to beneath the breast, which remains visible; and finally, an incision in the fold beneath the breast. Breast tissue is sculpted using a combination of sharp dissection and occasional liposuction. The nipple remains attached to the deeper breast tissue. Care is taken to close these incisions as carefully as possible. Nevertheless, patients must realize that resultant scarring is as much a factor of tissue response as it is surgical skill, and occasionally wide scars can form despite a nice overall breast shape. Most often, with time, these scars do tend to blend into the normal skin, becoming less noticeable.