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Breast reduction surgery (also called reduction mammoplasty or reduction mammaplasty) is a very effective and successful procedure for women who have disproportionately large breasts and want them to be smaller in size. Many of our happiest patients are those who have undergone breast reduction. In thirty years of medical practice in Scottsdale and the Phoenix metropolitan area, board-certified plastic surgeon Dr. Steven H. Turkeltaub has never encountered an individual who expressed regret for her decision to have the procedure performed. In fact, many of our patients have commented that if they had known years ago what they know now, that is, the dramatic change and improvement in the quality of their lives that breast reduction surgery could provide, they would have sought treatment long ago in order to have avoided the physical and mental issues that they had suffered from because of their enlarged breasts.

Could You Benefit from Breast Reduction Surgery?

At many levels, overly large breasts (macromastia) can be both physically and psychologically debilitating. They are frequently associated with pain and/or discomfort in the neck, shoulders and back, skin rashes and irritation, infections and tender, undesirable grooving in the shoulders caused by pressure from bra straps. Women often face real difficulties and limitations in the type and extent of physical activities that they can engage in as a result of the associated discomfort. Trying to obtain bras that not only fit properly and comfortably but also provide the right amount of support and alleviation of discomfort can be a challenging task. Being able to find attractive, complementary and well fitting clothes because of one’s disproportions is another real problematic area.

There are many reasons why a woman would want to seek a breast reduction. Listed below are situations that may make one a candidate for the procedure:

  1. Disproportionately large breasts for one’s body
  2. Massive, pendulous breasts that hang down and over the abdomen
  3. Pain in the back, neck and shoulders caused by the weight of the breasts
  4. Chronic irritation and shoulder indentations created by bra strap pressure
  5. Infections and skin irritations beneath the breasts
  6. Substantial breast size differential with one noticeably bigger than the other
  7. Limitations in engaging in certain sports and other physical activities due to associated breast pain
  8. Low confidence and self-esteem due to the enlarged breasts being a focal point
  9. Trouble finding properly fitting and supportive bras that are not also causing persistent pain

Insurance Coverage or Private Pay?

Insurance companies will offer coverage for breast reduction surgery though it is a frequent exclusion in many policies. In order to determine if you are eligible for coverage, you need to closely check your particular insurance policy. In the event that your plan does offer benefits, several criteria must be met in order to be approved for surgery with insurance coverage. These requirements will vary significantly among insurance providers and their particular policies. A few of these issues include:

  1. requiring at least a specific minimum weight of breast tissue to be removed per breast, the exact amount of which is directly related to one’s weight and height
  2. the presence of certain symptoms including pain in the neck, shoulders and back; rashes on the skin; shoulder grooving; skin infections; headaches
  3. the duration of time that the symptoms have been present
  4. failure to respond to various therapeutic modalities including pain relievers and nerve blocks
  5. persistence of symptoms despite undergoing a course of physical therapy which, in some cases, needs to be a minimum of six months
  6. documentation of symptoms by a primary care physician
  7. written recommendations from other medical specialists including orthopedic surgeons, chiropractors, neurologists and neurosurgeons
  8. not exceeding a specific body-mass index (BMI) – a measurement based on one’s weight in relation to their height – in addition to meeting many of the above criteria

If you have insurance coverage and specific benefits for breast reduction surgery, Dr. Turkeltaub’s staff will try to obtain pre-authorization for coverage of the surgery. However, if you are denied coverage for any reason, we do offer significantly discounted package pricing that may allow you to pursue your dreams of having breast reduction surgery.

Breast Reduction Procedure

Breast reduction entails decreasing the size of the breasts by removing skin and breast tissue and reshaping and lifting what is left in order to create smaller, firmer and more youthful appearing breasts. The nipple-areola complexes are reduced in size and lifted to a more ideal position while still remaining attached to the underlying breast tissue.

This technique provides the opportunity to maintain at least some feeling and sensuality of the nipple-areola complex as well as the possibility of being able to breast feed in the future (for those in whom this is a consideration).

In some higher risk breast reductions, the nipple-areola complexes are physically detached from the breasts and then placed in the anatomically correct locations essentially as skin grafts. This approach, known as the free nipple graft technique, does have significant advantages in certain situations.

Some of the indications for its employment include for breasts that are extremely large and/or elongated, in heavy smokers, patients who have high medical risks, individuals who are at risk for impaired blood flow within the breasts and patients who desire very small breasts. Disadvantages of this technique include loss of nipple sensation and sensuality, inability to breast feed, depigmentation of the areola and lack of any nipple projection.

The incisions most commonly used for breast reduction surgery are in the shape of an inverted “T” or anchor. This involves one around the nipple-areolar complex, extending down to the inframammary fold at the bottom of the breast and then along the fold. When performed with the utmost precision and given enough time to mature, these scars have a good chance of becoming relatively inconspicuous.

There are other less commonly used incision configurations that are intended to minimize the overall length of the scar. Unfortunately, these techniques often result in a less than ideal breast shape, irregular or uneven nipple positioning, or scars extending below the inframammary crease that may be visible when wearing many types of clothing.

Liposuction breast reduction is a rarely indicated procedure that employs liposuction to reduce the size of the breasts. Since glandular breast tissue cannot be removed with liposuction, only excess fat in the breasts can be removed with this technique, therefore limiting its applicability. Furthermore, because there is no skin excision with this approach, reshaping and lifting of the breasts is severely limited except related to the fat removal and less gravitational effects due to lighter mass. Therefore, droopy and/or sagging breasts will remain that way.

The touted advantage of this approach is the minimal incisions (1/4 to 3/8 inch) that are employed to insert the cannulas for suctioning.

Breast reduction surgery is generally performed under general anesthesia as an outpatient procedure. It can be done in combination with many other aesthetic procedures such as an abdominoplasty, liposuction and facial plastic surgery for a more comprehensive and cost-effective improvement.

Breast Reduction Recovery

A snug fitting dressing designed for comfort, support and protection is placed following surgery and remains on for around two to three days at which point you are placed in a sports-type bra. This should be worn day and night for around two weeks after which it is recommended that you wear a supportive bra regularly in order to help maintain your new breast shape longer.

When your incisions are well healed and non-tender, you may be able to wear an underwire bra if you so desire. For more on this, read the blog: Wearing an Underwire Bra After a Breast Reduction.

I rarely use drains in breast reduction surgery. However, when they are employed, they will typically be in place for around one week.

Postoperative discomfort is generally described as being mild in degree by most women and can be effectively managed with pain medicine. In fact, the majority of my patients take little or no pain medication.

Initially, you will notice some moderate swelling and firmness of your breasts, causing them to appear larger than they will be long term. It may take six months to a year for this swelling to completely dissipate.

You can resume aerobic activities or sports at approximately three to four weeks though there are limitations of some activities for up to eight weeks. Most women can return to school or work within four to seven days.

Please read our reduction FAQs (frequently asked questions) section to learn more about reduction mammoplasty.

Breast Reduction Before-and-After Pictures*

There is an extremely high satisfaction rate in women who have had a breast reduction. These patients find that this procedure resolves virtually all of their symptoms. In fact, women who have undergone breast reduction surgery are the happiest, most satisfied and most appreciative of our patients.

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*Individual Results May Vary

“Your surgical expertise is Genius! The warmth and professionalism that you give is the ultimate comfort. Thank you for all that you are doing. May you continue to bless and help all those who are fortunate to be in your care!”

B.L. Breast Reconstruction Patient, Glendale AZ

*Individual Results May Vary

*Individual Results May Vary

For additional helpful information on a variety of issues related to breast reduction, you can visit Dr. Turkeltaub’s Blog.

Dr. Turkeltaub also offers a variety of other breast surgery procedures, such as breast augmentation, breast lift, and breast reconstruction.

Find Out How a Breast Reduction Can Benefit You

If you are troubled by excessively large breasts, there are numerous reasons to consider breast reduction surgery. Contact the Arizona Center for Aesthetic Plastic Surgery to discover how you can benefit from a breast reduction.

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