19 year old 5'2 female with two children. Breasts sag and cause back pain, areola points down. What are my options? (photos)

Thank you for your question and for sharing your photographs. Large breasts can cause neck and shoulder pain, bra-strap grooving on the shoulders, rashes under the breasts, and can also make it hard to find clothing that fits. Breast reduction surgery is one of the most satisfying procedures I perform, as women often feel relief from their back and neck pain soon after surgery. Insurance will often cover breast reduction surgery if you meet and document certain criteria, such as pain that is not relieved with other non-surgical options (like physical therapy or medication) or rashes that require treatment. From what you are describing, it sounds like insurance may cover breast reduction surgery. A fully-trained plastic surgeon can speak with you about your options and help determine if insurance will cover your procedure. A breast reduction can be performed as an outpatient surgery and I perform breast reduction surgery under IV sedation in our fully-accredited operating room with board-certified anesthesiologists. There are many techniques used to perform a breast reduction, including the Wise/anchor pattern and short scar techniques. I use different techniques depending on the individual patient.

Hi, it is best to ask yourself what your cosmetic goals are first. Do you want significantly smaller breasts, lifted breasts, improved shape, and/or improved symmetry? Insurance plans will vary on their requirements for coverage in terms of breast reduction surgery and may require significant amounts of tissue removed to achieve those requirements. This sometimes is technically not possible if insufficient tissue is present (you must maintain certain amounts to preserve blood supply to the skin and nipple) or it may result in poor cosmetic results. I can't provide an accurate recommendation without seeing you in person to perform a physical exam and get a complete medical and surgical history. However, based on your images your best option may be a bilateral breast lift with a small Right side breast reduction for improved symmetry. This procedure will maintain a breast size proportional to your body, round out and lift your breasts, reduce areolar size, and improve symmetry.

Thanks for your question. From your pictures, you seem to be a good candidate for a breast lift with implants. I recommend you schedule a consult for a proper evaluation. Make sure your surgeon you choose has extensive experience with breast enhancement and clean credentials. Always consult with a board certified plastic surgeon. Take care, Moises Salama MD, Board Certified Plastic Surgeon