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Breast Reduction Details. What Do You Recommend?

I am definitely going to have a breast reduction, but am concerned about a couple of details.I am a 32FF, 5'4"120 lbs I would love to end up as a C cup but am concerned about the resulting oblong shape. Also, I do not want to have the nipples detatched as Iwant to breastfeed and haven't had children yet.Any advice on procedure methods orwhat kind of size I could expect would be greatly appreciated.One other comment- my ptosis is mildmy nipple sits higher than the crease and does not point down.

Doctor Answers (7)

Breast Reduction Details

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Details for Breast Reduction Surgery:


Candidates for Breast Reduction surgery are women who wish to have smaller breasts to achieve a more proportional appearance or to alleviate physical discomfort.  Breast reduction can correct symptoms from excessively large, heavy breasts that may cause the inability to do certain exercises, or create back, shoulder and neck pain, poor posture, bra-strap shoulder indentations and chafing or rashes under the breasts.  Women experiencing these discomforts may benefit from Breast Reduction, also called Reduction Mammoplasty.  Furthermore, large breasts may interfere with normal daily activities or exercise and will be more comfortable when reduced.  Women who feel that their excessive breast size decreases a sense of attractiveness and self confidence, or results in unwanted attention are also candidates.

Intended Result
Also known as reduction mammoplasty, Breast Reduction is an operation intended to reduce the size of a woman’s breasts and improve their shape and position. Frequently, the areola (dark skin around the nipple) is also made smaller.  Functional symptoms (medical problems) caused by excessive breast weight may be relieved or improved by this operation.  Mammoplasty patients will experience a more attractive contour and smaller breast size, freedom from health problems associated with excessively large breasts and improved self image. There is an extremely high rate of patient satisfaction from this surgery. They are some of the happiest group of patients we see at Pacific Center for Plastic Surgery.

Procedure Description
Breast Reduction is performed as an outpatient procedure and the vast majority of our patients tell us that there was far less discomfort in the early recovery period than was anticipated.I would  use a minimal incision surgery most likely for your case using a “vertical” or “lollipop” scar technique this method has been used in Brazil and France for many years but is performed by a minority of Plastic Surgeons in this country.  The benefits include: approximately fifty percent less scarring, a narrower breast, better forward projection and shape, longer lasting improvement, shorter surgery time and less complications. In general, we have stopped using the older traditional “anchor” or inverted “T” incisions as these provide inferior results.  The procedure is done under general anesthesia on an out-patient basis or in the hospital it there are additional medical conditions.

Liposuction may be used during the procedure to reduce the size of the breast in selected patients. Liposuction alone has the least number and size of scars but has the greatest limitations in shaping and reducing the breast. Liposuction may be combined with the vertical method to give an optimal shape to your breasts. Adjustments of the Nipple and/or Areola can also be done at the same time.

In rare circumstances for extraordinarily large or bulky breasts, gigantomastia, for technical reasons, we sometimes remove the nipples completely and reattach them as “free grafts”. The sensory nerves are all cut, and even though a certain amount of sensation returns after healing, it will never be normal and erotic sensation if present prior to surgery (many of these patients preoperatively do not have this due to stretch of their nerves)  is lost completely. The milk ducts are interrupted in this operation, so nursing would be impossible. You will be amply informed in advance if your breasts are in this category. This may be one of the exceptions where the inverted T or Anchor technique is utilized.

Post-Operative Healing
The incisions are covered with light dressings, and you will be place in a bra, which you should bring to the surgery center with you. The bra holds the breasts symmetrically during the initial healing. The initial discomfort subsides daily and can be controlled with oral medication.

Some discomfort, swelling and discoloration of the breasts are to be expected for several weeks. Usually, our patients return to almost normal activity within two weeks. The scars at the incision lines typically become reddish and few weeks after surgery are raised and firm.  After many months they become pale and soft.  After 8-12 months, the scars are relatively inconspicuous. The nipples and some areas of the skin may be numb or sensitive after surgery.  Sensation may return within a few weeks or months, but may be diminished or overly sensitive.

Breast reduction may prevent your ability to breast feed, however the newer short scar techniques that we use lessens that risk.

Gravity continues to have its effect, and there is a tendency for the skin of the breasts to stretch over a long period of time. This can be slowed by regular bra use when upright. Although, women very a great deal in this respect, in general, the smaller the breasts the less the tendency for sagging to recur.  If the breasts sag again, further excision of the skin on an outpatient basis can be used to correct the problem.  If we try to lift heavy breasts without making them smaller at the same time, sagging will return soon. One key to a satisfying result is realistic expectations.

Risks of Surgery
The specific risks and suitability of this procedure for a given individual can be determined only at the time of consultation. All surgical procedures have some degree of risk. Minor complications that do not affect the outcome occur occasionally. Major complications are rare.


Orange County Plastic Surgeon
5.0 out of 5 stars 45 reviews

It depends upon the length of the pedicle

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and the type of reduction.  I tend to do use a vertical mastopexy with a medial pedicle and can comfortablely reduce the breast between actual resection and liposuction to mold a new smaller and more aesthetic breast.  This leaves a 'lollipop' incision rather than the more traditional anchor incision.  I have not had to take off nipples with the lollipop incision, and very rarely with the weiss or 'anchor' incision.  Be aware however that depending upon your genetics, as well as weight changes and pregnancies, you may have to redo your breast reduction in 15 or 20 years.  Good luck and enjoy your new shape!

Eleanor J. Barone, MD
Tampa Plastic Surgeon
5.0 out of 5 stars 4 reviews

Breast Reduction Details?

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Based on your description of breast size and body type you may be an excellent candidate for breast reduction surgery; it is one of the most patient pleasing operations we perform. I think the best way to go about planning your procedure is to meet with a few well experienced board-certified plastic surgeons who can demonstrate significant experience achieving the types of results you are interested in. Once you have chosen a plastic surgeon the precise details of the planned operation will be reviewed.

Before undergoing the breast reduction procedure it will be very important to communicate your size goals with your surgeon.  In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or "C cup” etc means different things to different people and therefore prove unhelpful.
 Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.

For most patients, I recommend that they try to decrease the size of the breasts such that symptoms are relieved as much as possible;  yet the breast  size remains proportionate to the remainder of their torso.

The majority of patients who undergo breast reduction surgery are able to breast-feed.

Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 715 reviews

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Breast reduction for 32FF breast

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I assume from your question that you were told you needed a free nipple graft-is this true?  A free nipple graft is rarely needed.  If the nipple is very low and you need a lot of breast tissue removed to achieve your goal cup size, this is sometimes recommended.  This can only be determined by your plastic surgeon after he/she examines you.  Second, patients are usually advised that they most likely cannot breast feed after breast reduction, even if they do not have a free nipple graft; the amount of breast tissue removed usually prevents the production of adequate amounts of milk.  Hence, the amount of milk produced does not provide enough calories for the baby.  So, while you physically are able to breastfeed if the nipple is not removed, the baby requires more calories than the patient can produce and you supplement must with a bottle.  I am not sure about your question about oblong breasts.  After breast reduction surgery the breast should have a good shape.  Hope this helps.

Tracy M. Pfeifer, MD

Tracy Pfeifer, MD
Manhattan Plastic Surgeon
5.0 out of 5 stars 17 reviews

Breast reduction

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Breast do not have to look oblong after a breast reduction and many times patients can breast feed.  You should go for a consult with a board certified plastic surgeon.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

Breast reduction

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I don't think it is unreasonable to aim for a "C" cup because it sounds like you are young and may gain weight over time. The decision as to whether to perform free nipple grafting is based on the nipple to infra-mammary crease distance and nipple heights and risks re blood supply to the nipples. Just because your nipple is higher than the crease does not establish that the operation without nipple grafting is right for you. See a board certified plastic surgeon in consultation to explore your options.

Robert L. Kraft, MD
New York Plastic Surgeon
5.0 out of 5 stars 11 reviews

Reduction

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Having a breast reduction is a very important decision to make, make sure that you are well informed. You going from 32 FF to a C is a huge difference. Maybe you should think about a full C to a possible small D. You don't want it to be a dramatic change, in regard to the shape if you go to a qualified Plastic Surgeon you should be in great hands.

Stuart B. Kincaid, MD, FACS
San Diego Plastic Surgeon
4.5 out of 5 stars 7 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.