According to the American Society of Plastic Surgeons (ASPS), 70,463 breast reduction procedures were conducted (for both women and men) in the United States in 2019. Some of the most common reasons patients are presenting for mammaplasty include head, neck, and/or back pain; shoulder grooving; mammary intertrigo; coracoid syndrome; or simply the desire to acquire a better breast shape.
Types of Breast Reduction Procedures
Your plastic surgeon can use one of several different techniques when performing breast reduction surgery. The technique used for any given patient is determined by existing anatomy, the amount of breast tissue being removed, and the desired outcome.
Some of the most common techniques include:
Liposuction for Breast Reduction
In some cases, a breast reduction procedure can be performed using only liposuction.
Liposuction for breast reduction is typically a much shorter procedure, is minimally-invasive, leaves virtually imperceptible scarring on the breasts, and offers lasting results. However, not all patients achieve optimal results with only liposuction.
Ideal patients for liposuction breast reduction include those who need or desire very little augmentation and have good skin elasticity and little to no sagging to correct. In most cases, liposuction is the best option for women whose excess breast size is due to excess fatty tissue.
For women with sagging, asymmetrical breasts or patients with stretched skin requiring the removal of a significant amount of tissue, the following techniques may benefit the most.
Vertical or “Lollipop” Method
A vertical breast reduction surgery follows the basic principles of plastic surgery – with a complete dermoglandular pedicle and no skin undermining. Both vertical and inverted-T both refer to skin resection patterns used for the procedure.
The vertical reduction method is best for women who require a more moderate breast resizing and have more noticeable sagging. This technique requires two incision sites: one around the nipple and areola and a second incision that runs vertically from the bottom of the areola to underneath the breast. This allows a plastic surgeon to remove excess breast tissue, skin, and fat, reshape the breast internally, and lift the breast into a more youthful position.
Although a vertical reduction lift can leave some scarring, it is limited to the area below the nipple. They are typically easily hidden beneath a bra or bikini top.
Inverted-T or “Anchor” Method
The inverted-T technique is one of the best options for women with moderate to severe breast ptosis (sagging). This method uses three separate incisions: periareolar, vertical, and horizontal incisions. Meaning, one incision will be placed around the edge of the areola, one vertically from the areola to the inframammary fold, and an additional incision along the inframammary fold.
This procedure removes excess breast tissue and allows for an increased ability for a plastic surgeon to reshape and reconstruct the breast if a patient desires a more significant breast size reduction or has considerable ptosis or asymmetry to correct.
Scarring from an inverted-T procedure may be more significant and noticeable compared to a vertical reduction. Unfortunately, the edge of the horizontal incision may extend medially to the sternum and laterally beyond the limits of a modern brassiere. However, with proper care, your scarring can fade significantly within the first year and can be easily concealed with clothing and, at times, a bikini top.
What to Expect After Breast Reduction Surgery
Breast reduction surgery is an outpatient procedure. It does not require general anesthesia and is typically performed under IV sedation and a local anesthetic. Once the procedure is complete, you may spend some time in supervised recovery until your anesthetic wears off, but you will usually be able to go home that same day. When you are sent home, you will likely have your chest bandaged and may be given a surgical bra to give you some support.
During the first few days post-operation, you can expect to feel considerable soreness and may experience loss of sensation near the surgical site for the first few weeks. Your surgeon will most likely prescribe pain medications to help keep you comfortable during your initial recovery period. Gently placing ice packs on top of the bandages may be recommended to help alleviate discomfort and any pain or swelling, but make sure you first check with your surgeon.
Recovery time after a breast reduction surgery varies from patient to patient. Your natural healing rate and the extent of the surgery performed are the two main factors for recovery time. Most people will be able to get up and walk around within a few short hours after the procedure – although it may be best to have a trusted adult to be with you for the first 24 hours. Showering or bathing will be permitted after the first few days post-op, but you may need assistance getting dressed and performing certain tasks as it may take time for you to recover full range of motion in your chest and shoulders.
Most patients report feeling comfortable returning to a desk job within the first week, typically once they are no longer taking prescription pain medication. Your cosmetic surgeon may request you wait between 3 to 4 weeks before returning to any extensive physical activities aside from walking. It is necessary for your health and wellness that you follow your cosmetic surgeon’s instructions regarding activity post breast reduction surgery.
Is a Breast Reduction Permanent?
A breast reduction is designed to be permanent, so it is important to weigh all options before you have the procedure. However, breast volume can and does change during pregnancy, childbirth, and breastfeeding. Most likely your breast size will temporarily increase and then drop back to the size after your reduction.