Breast Reduction Information

Women with large, heavy, pendulous breasts often complain of associated neck and back pain, postural changes, grooves in the shoulders from the bra straps and frequent rashes beneath the breasts. In addition, very large breasts can make a woman feel “out of proportion” and can make clothing more difficult to properly fit. The breasts may interfere with normal activities such as exercise.

Breast reduction surgery from Dr. Jay S. Orringer reduces the size and the weight of the breasts and attempts to improve breast shape by elevating the nipple position and reducing redundant skin and underlying tissue of the breasts. While an incision is made around the nipple, it is not “removed” but rather left attached to the underlying breast and re-positioned to a higher location. The reduction in breast weight previously supported by the upper and lower back, neck and shoulders frequently improves symptoms and allows resumption of normal activities with greater comfort.

Breast reduction is usually performed in women in whom breast development is complete. Ideally, it is done following completion of breast-feeding and child-bearing. However, symptoms and psychosocial issues may not allow for delay until that time.

The Consultation
The Surgery
The Recovery
What are some of the particular concerns regarding breast reduction?
Making the Decision

Breast Reduction: The Consultation

Beverly Hills plastic surgeon, Dr. Orringer, will typically spend at least an hour discussing your medical history and goals. Examination will evaluate current breast size, shape, skin tone and degree of ptosis (droop). Scars, sensation and breast-feeding issues, as appropriate, will be discussed. Issues of proportion and appropriate degree of reduction will be discussed. Every individual has specific goals and unique anatomical considerations. The detailed consultation will address these important issues.

Health insurance may cover a portion of your surgery, depending upon your specific plan, height, weight and amount of tissue removed. Insurance carriers require a letter from Dr. Orringer and photos. The approval process can take several weeks to months.

Breast Reduction: The Surgery

The surgery is performed at the state-of-the art Surgery Center of Santa Monica or hospital setting, depending upon the extent of tissue removal, your overall health and insurance plan, if relevant. Anesthesia is administered by physician anesthesiologists. Prior to surgery, Dr. Orringer will plan with you the new nipple position, skin and underlying tissue removal. While an incision is made around the nipple, it is not “removed” but rather left attached to the underlying breast and re-positioned to a higher location. Incisions and resulting scars will vary according to the degree of breast “droop” and the amount of skin and tissue to be removed. The simplest incision involves a “lollipop” like scar, while more extensive reductions involve an “anchor” type scar which adds a scar in the fold to the “lollipop.” At the completion of the surgery, light tapes are placed over the incisions and a support bra is applied. The patient usually goes home, stays overnight at the hospital or goes to Serenity should she choose. Serenity is a warm, comfortable facility geared for the post-operative care of the plastic surgery patient. A customized booklet which discusses further the procedure, risks, and pre- and post-operative instructions will be provided for you at your pre-operative visit.

Breast Reduction: The Recovery

At surgery, Dr. Orringer will do nerve blocks to help control early discomfort. Patients usually can shower in 2 days. Arm use and motion is not restricted although lifting associated with straining is not advised for at least 2 weeks. The post-operative pain is usually the most severe during the first three days. It is usually well controlled with oral pain medications. By the end of the first week, much of the pain has subsided and many normal activities resumed. Driving should not be done until oral narcotics are no longer required for pain control. Generally, full exercise activity is not recommended for about 3-4 weeks post-operative. It is recommended that a support bra be worn, at all times, except when showering for the first post-operative month.

What are some of the Particular Concerns regarding Breast Reduction surgery?

Breast reduction patients tend to be very happy patients. However, there are some very important considerations that must be taken into account prior to proceeding. Breast reduction surgery results in permanent visible scars. While they fade over the first 1-2 years following surgery, they never disappear. In addition, there is a risk of loss of sensation to the nipple and to other areas of breast skin. Because this cannot be predicted, if this is an unacceptable risk, the surgery should not be done. In this procedure, while the nipple position is elevated and the amount of excess skin hanging below the breast fold reduced, there is not typically a long term increase in upper breast volume, as is desired by many patients. Although the breasts are smaller, recurrent ptosis (drooping) of the breasts will occur due to stretching of the skin and the effects of gravity. The degree of breast reduction should take into account the contour of the abdomen. While some patients wish to be “as small as they can be,” reduction to that degree tends to make a protruding abdomen look still larger. So, body proportions must be taken into account.

Breast Reduction: Making the Decision

Breast reduction, like every surgical procedure, has specific benefits and risks. Dr. Orringer wants you to feel comfortable asking any questions you may have during your initial consultation or at any other time while you are considering whether breast reduction is the right option for you. He understands that taking an adequate amount of time to discuss, plan, customize and perform your procedure is necessary and important for the best possible outcome.

Please contact Dr. Orringer for more information, or to schedule a breast reduction consultation.

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