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What Is a Breast Reduction?

Breast reduction (also called reduction mammoplasty or reduction mammaplasty) is the plastic surgery procedure which reduces the size of overly large breasts to a more desirable smaller size. It involves the strategic removal of excess skin and breast tissue, resizing and repositioning of the nipple-areolar complexes (if needed), and lifting and reshaping of the breast tissue for a perkier, rejuvenated appearance.

When performed skillfully and safely by an experienced board-certified plastic surgeon, breast reduction surgery is a very effective and successful procedure. Many of our happiest patients are those who have undergone breast reduction. In his more than thirty years of medical practice in the Scottsdale and the Phoenix metropolitan area, Dr. Steven H. Turkeltaub has not encountered an individual who expressed regret for her decision to have the procedure performed. In fact, many of his 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.

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

Breast Reduction Gallery

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 and embarrassment. 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 several 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 and embarrassment
  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
  10. Difficulty in finding attractive, quality clothing that fits

Does Breast Reduction Surgery Also Provide a Breast Lift?

An ancillary benefit of breast reduction surgery is that excess skin is removed and the breasts are contoured and raised to a more ideal position, thus simultaneously providing a breast lift. An instance where this would not be the case is if the breast reduction was exclusively performed via liposuction—a technique that is very rarely indicated due to its ability to solely remove fat and not glandular tissue or skin.

Is a Breast Reduction Covered By Insurance?

Insurance companies do provide coverage for breast reduction surgery though it is an exclusion in some policies. To determine whether you are eligible for coverage, you will need to carefully review your specific 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 the removal of at least a specified 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 defined symptoms that can include neck, shoulder and back pain; skin rashes; 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 medical specialists other than your plastic surgeon—this can include 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.

How Is the Breast Reduction Procedure Performed?

Breast reduction surgery 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 usually 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 complexes as well as the possibility of being able to breastfeed 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 anatomically correct locations as skin grafts. This approach, known as the free nipple graft technique, does have significant advantages in several situations. Some of the indications for its usage include breasts that are extremely large and/or elongated, women who are 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 breastfeed, depigmentation of the areola and lack of any nipple projection.

The incision most commonly used for breast reduction surgery is 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, appropriate postoperative wound management and given enough time to mature, these scars have an excellent 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 in order to obtain a more comprehensive and cost-effective improvement.

What Can I Expect During Breast Reduction Recovery?

A contoured form fitting dressing designed for comfort, support and protection is placed following surgery and remains in place for around two to three days at which time 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.

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

Most women who have undergone the procedure describe the initial discomfort as being relatively mild in degree. This often can be effectively managed with pain medicine. In fact, the majority of Dr. Turkeltaub’s 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.

Will I Have Obvious Breast Reduction Scars?

The most common technique for performing breast reduction surgery involves an incision that extends from around the outer perimeter of the areola, then vertically down to the bottom of the breast and then horizontally along the inframammary crease—forming an inverted “T” or anchor shape. The final visibility of this scar will be greatly affected by one’s genetic makeup and natural healing response. More controllable elements that can also influence the ultimate appearance of breast reduction scarring include the plastic surgeon’s incision closure method, how closely postoperative instructions are followed and which scar care products or treatments are used.

In Dr. Turkeltaub’s experience, virtually all patients are very pleased with the physical and emotional impact of their breast reduction results and are quite satisfied with the resulting scarring. Additionally, most women find that any visible scarring can be concealed by the majority of blouses, bras and bikini tops they wish to wear.

How Much Does Breast Reduction Cost?

The cost of breast reduction in the Phoenix area as listed on the RealSelf.com website ranges from $600–$15,000 and averages about $8,375.* The reason for such a broad price range is due to multiple components that impact the total expense of treatment. Some of the most notable elements that can affect what a patient pays for breast reduction include:

  • The amount of tissue needed to be removed as well as the degree of reshaping and lifting needed
  • Whether or not other procedures will be performed in the same surgical setting such as a tummy tuck as part of a Mommy Makeover
  • The plastic surgeon’s credentials, skill and experience
  • Fees for the anesthesiologist and operating venue
  • Medications that might be required before or after surgery
  • Any necessary lab work or pathology charges
  • The geographic location of the practice
  • How much—if any—of treatment is covered by insurance

If you are considering having a breast reduction, Dr. Turkeltaub would be happy to meet with you for a consultation. After assessing your unique needs, he can formulate a personalized surgical approach and provide you with an itemized breakdown of all costs associated with your treatment plan.

A member of our team can also help you determine if your insurance plan will cover any portion of your procedure and/or introduce you to a variety of plastic surgery financing options if desired.

*This price range and average cost were taken from RealSelf—an online aesthetic care forum that gathers data based on reviews submitted by patients. It does not indicate the exact cost of breast reduction surgery at Dr. Turkeltaub’s practice. To obtain a personalized price quote, please contact us today to schedule a private consultation.

Can I Still Breastfeed After Breast Reduction?

Assuming you are able to breastfeed prior to breast reduction surgery, there is a good possibility you will be able to do so after surgery though this would depend on a multitude of factors. With the free nipple graft technique where the nipple-areolar complex is totally removed as part of the procedure and then repositioned prior to completion of the operation, the ability to breastfeed is negated.

If you are planning to have kids in the future and wish to breastfeed, Dr. Turkeltaub recommends making this clear when you meet for your consultation. Since the risk of losing the ability to breastfeed does exist (as it does with most surgical breast procedures), disclosing this information from the start can result in improved treatment planning and a clearer idea of the appropriate timing for breast reduction surgery.

What Are Potential Breast Reduction Complications?

When surgery is performed by a board-certified plastic surgeon who is extensively trained, skilled and experienced in breast reduction, you are more likely to obtain far better results and with a much lower risk of complications (which are generally low). As with any surgical procedure, however, there can be complications and untoward outcomes so it is important to fully understand all aspects of a breast reduction prior to treatment.

Some potential risks and complications associated with breast reduction include:

  • Breast contour asymmetries and/or irregularities including of the nipple-areola complexes
  • Nipple and/or breast sensation changes
  • Thick and/or wide scars
  • Loss of breastfeeding ability
  • Adverse reactions to anesthesia
  • Infection
  • Seroma – a buildup of fluid deep to the skin
  • Hematoma – a buildup of blood deep to the skin
  • Necrosis of breast skin, breast tissue and of the nipple-areolar complexes

Influencing these risks are a person’s general health, nutrition, habits and compliance in their care. For example, those who smoke (including marijuana), are markedly overweight, diabetic, have autoimmune diseases, or are in a suboptimal nutritional state such as due to certain dietary restrictions, have increased risks for postoperative problems.

With that being said, it bears repeating that the possibility of encountering complications and poor results is significantly reduced when breast reduction is performed by a highly trained, skilled and experienced board-certified plastic surgeon.

Additional Breast Reduction FAQs

My breasts are very large and cause neck, back and shoulder pain. Will a breast reduction take care of this?
By markedly decreasing the breast size and weight and repositioning the remaining tissue, a breast reduction can be very effective in successfully addressing these symptoms. In fact, most women experience a marked decrease or even a complete disappearance of their symptoms after this surgery.
How old do you have to be to get a breast reduction?
When determining candidacy for breast reduction, age is not as important as whether or not the breasts are fully (or almost fully) developed. In fact, breast reduction is not uncommonly performed on patients who are in their teens, assuming they have permission from a parent or guardian if they are under 18.

Generally speaking, though, breasts that are still growing should not be operated on because they might continue to grow after the procedure, potentially reaching a size and volume that requires a second breast reduction. As a result, Dr. Turkeltaub often advises postponing surgery until the breasts are fully matured.

Is breast reduction painful?
Most women find the postoperative discomfort to be fairly mild in nature. Even with their initial postoperative dressing on, many will comment on the immediate improvement of their symptoms.
How can I reduce swelling after breast reduction?
It is important to understand that some degree of swelling may persist for as long as six months to a year following breast reduction. However, more notable swelling that might be present initially after breast reduction can often be reduced by:

  • Keeping the upper body slightly elevated when sitting and/or lying down—including while sleeping
  • Wearing a snug but not tight, well-fitting bra
  • Avoiding the lifting of heavy objects as well as any strenuous actions or activities for between four and eight weeks after surgery
  • Avoiding firm pressure on your breasts including sleeping on your chest for at least eight weeks after surgery

While these general tips are beneficial for most patients, the best advice for reducing breast reduction swelling will ultimately be to strictly follow the personalized recommendations provided by Dr. Turkeltaub.

When and how should I shower after breast reduction?
You will not be able to take a relatively “normal” shower until your surgical dressing is removed which is usually at two to three days. During that time, you can get in a shower but only to wash the lower part of your body because your dressing must be kept dry. Once this dressing is removed and you are placed in a sports bra, you can get most everything wet except the tapes covering the incisions on your breasts. Dr. Turkeltaub and his staff can provide you with more specifics and instructions regarding this.
When can I wear a bra after breast reduction?
Once your surgical dressing is removed, usually at two to three days after surgery, you will be placed in a sports-type bra that is to be worn around the clock (except when showering) for approximately two to three weeks. After this time, you can either continue wearing this type of bra as you may desire or wear another type that is relatively supportive and comfortable but it does not need to be kept on at night.

Dr. Turkeltaub recommends wearing supportive bras as often as possible to help maintain the shape of the breasts and protect against the persistent pull of gravity over time.

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

Breast Reduction Patient Testimonials*

*Individual Results May Vary

Testimonials

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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