Is it Safe to have a Second Breast Reduction?

I had a breast reduction at 18, I weigh 115, 5'6 and my breasts went from a double/triple D to a C after the surgery. However about 4 years later, they are an uncomfortable double D again. The surgery also left one almost a cup size larger then the other. I also used to have scoliosis and had an operation to reverse it at 14 so posture is a life long health concern for me. I want to have a 2nd breast reduction but would my insurance (medicaid) pay for it again? Also would I be a good candidate?

Doctor Answers (8)

Repeat Breast Reduction?

+1

Thank you for the question.

It is not unusual for patients to request further breast reduction after having had the 1st breast reduction at a young age.

One of the concerns  when repeating breast reduction surgery is related to blood flow to the remaining breast tissue;  is important to perform the operation in such a fashion that the blood flow to the nipple/areola/breast tissue is not compromised.   The  part of the tissue that is left in place  after breast reduction surgery is called the “pedicle"; this segment of tissue is responsible for delivering the blood supply to the nipple/areola/ breast tissue. If the pedicle (that was used during the previous breast reduction procedure)  is cut  then the blood flow to tissues may be compromised leading to serious competitions such as tissue necrosis etc.

It will be helpful for you to find the previous surgeon's  operative report  prior to the redo surgery,  if you are working with a different surgeon.

I hope this helps.


San Diego Plastic Surgeon
5.0 out of 5 stars 715 reviews

Second breast reduction

+1

On rare occasion, I have had to repeat a second breast reduction in similar circumstances (multiple years after the initial reduction).

Once key concern is the neurovascular supply to the nipple. This can be compromised in a secondary procedure and lead to loss, partial or complete, of the nipple and areola. It is in your best interest to provide your current surgeon with copies of your initial operative report to minimize this risk.

One possibility is the use of liposuction if your nipples are satsifactorily located on your breast mound. This may be an option you should consider.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 44 reviews

I would think that you certainly are a good candidate for further breast reduction procedure

+1

I would think that you certainly are a good candidate for further breast reduction procedure, particularly to try and improve the different sizes between your breasts and decrease them both evenly.

It's often impossible to get the breasts exactly the same particularly if you do have a scoliosis but certainly it would be possible to have attempt to make them more even.

Adrian Richards, MD
London Plastic Surgeon
4.5 out of 5 stars 17 reviews

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A Second Breast Reduction Surgery (Secondary Reduction Mammoplasty)

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While repeat breast reduction surgery is not common, it is sometimes be necessary. It is more likely for a woman having had breast reduction surgery at a young age. A young woman tends to want to preserve more fullness, may not be completely developed and has a longer life expectancy during which the breast may further enlarge.

The safest way to have a second breast reduction is to see your original surgeon. They have the best chance of knowing where the preserved blood supply is located, and will be less likely to injure it. If they are not available, the original operative report can help. It should have the technique used, but will not have all the details available to your original surgeon. Even in the best plastic surgeons hands, there is a higher risk of complications with a second breast reduction. Risks include the loss of breast volume and nipple loss, due to insufficient blood supply after surgery.

Insurance coverage is best determined with your insurance plan. If you contact them directly, you will have a better chance of getting coverage. Be certain to ask if they have guidelines for covering breast reduction. Some plans have specific symptoms that must be present, specific non-surgical treats that should be tried first, and even specific amounts of weight that need to be removed to qualify.

Joseph Mele, MD
Walnut Creek Plastic Surgeon
5.0 out of 5 stars 6 reviews

Medicaid and breast reduction

+1

The best way to figure out if medicaid will cover your breast reduction is by calling them to find out their requirements.

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

Second Breast Reduction

+1

Both of the previous posters are correct. A second reduction is a very difficult operation because the blood supply to the flaps and nipple/areolar are in question. A very wide pedicle is needed. Plus the uneven size adds to the degree of difficulty. As for medicaid covering the operation, my guess is NO but you can investigate it. Best of luck from MIAMI Dr. Darryl J. Blinski, 305 598 0091

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 62 reviews

Second Breast Reduction Difficult, But Not Impossible

+1

It is often difficult to have a second breast reduction.  The reason is that there can be alot of scar tissue in place and  the blood supply to the nipple/areola may be unknown.  In these situations, it is critical to have the old operative report or go back to the original surgeon.  The operative report can tell your surgeon where the blood supply was based the first time so he/she can plan appropriately.  Whether yur insurance covers it again is another matter, and you will not know untilyou try to pre-certify it.  I hope this helps.

Christopher V. Pelletiere, MD
Barrington Plastic Surgeon
4.5 out of 5 stars 21 reviews

Breast reduction the second time

+1

Breast reduction the second time is safe, although the risk of nipple sensory loss is greater, and there may be an increased risk of nipple loss due to poor circulation to the tissue. Still with care the risk is managable and you may be a candidate for further reduction. There may be a university program in your area able to help you.

Best of luck,

peterejohnsonmd

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 28 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.