Q&A Topic: Breast Reduction Surgery
Michael H. Rosenberg, MD, FACS
Q. What motivates women to want breast reduction surgery?
A. The reasons are physical, emotional, and cosmetic. Let’s look first at the physical. Because breast tissue isn’t held back by muscle or bone, its weight sits on the upper back, neck, and shoulders. That’s why “many patients come to me with chronic neck/shoulder/back pain. Very heavy-breasted women can have pain or grooves where the bra strap cuts into the skin. There’s often pain or grooves where the bra strap cuts into the skin. Large breasts often droop, causing breast tissue to sit on the upper chest skin, creating a moist, covered area prone to fungal and bacterial infection, and undesirable skin changes. In addition, running a mile or swimming with very large breasts is painful and difficult. Decreased activity can lead to weight problems. As to emotional problems, young women with large breasts often feel they don’t fit in, that they’re different. From a cosmetic perspective, large, heavy breasts that droop can make it impossible to wear the clothing a woman wants to wear.
Q. Who is a good candidate for breast reduction surgery?
A. A woman who’s in general good health with realistic expectations. It’s very important to be a non-smoker, because smoking constricts the blood vessels, which can cause poor healing and bad scarring. The patient should have goals that are compatible with what we can achieve. She should be true to herself; the decision should not be driven by a partner, friends, or family.
Q. What does the surgery consist of?
A. Its three basic components are: lifting of the nipple/areolar complex; removal of breast tissue to reduce size; and tightening of the skin envelope. At Northern Westchester Hospital’s Center for Plastic Surgery, breast reduction surgery is a two-and-a-half to three-hour outpatient procedure. You go home the same day or the next morning.
Q. How should I choose a surgeon?
A. Look for a board-certified plastic surgeon who is highly experienced in this particular surgery. At NWH, we take careful measurements, drawing out a plan before we start surgery because dimensions change when a woman is lying down. Your ability to communicate with your surgeon affects your future satisfaction. This isn’t like removing a gallbladder stone—there’s variability here. If a surgeon can’t hear you, you’ll end up fitting into your surgeon’s view of what you should look like.
Q. What should I expect right after surgery – and long-term?
A. At NWH, we do something special: Just before completing the procedure, we inject a long-acting local anesthetic into the area to get good pain control for the first one to two days. Scars are well-hidden and fade with time. Three to four percent of women initially experience some loss of sensitivity in the breast and/or nipple. Sensitivity often comes back, though some women have a degree of permanent loss. About 80 percent of women who have breast reduction surgery can successfully breastfeed.
Learn More about Dr. Rosenberg
Medical Director of the Institute of Aesthetic Surgery & Medicine,
Center for Plastic Surgery;
Associate Medical Director
Northern Westchester Hospital
Northern Westchester Hospital is a proud member of Northwell Health (formerly North Shore-LIJ Health System).