Breast reduction + lift options? Back and rash problems

Question

I'm 39 years old, 38DDD+ with back and rash problems. I've had a few reduction + lift consults with one looking into insurance. Insurance would cover but requires min 575g of tissue on one side and 675g on other (to make them even), follows the schnur scale. This would be about 2/3rds of my chest. Seems like A LOT! With no insurance, the price is $13-16k in greater Boston. My husband says to go smaller since they will get larger as I age so just go thru insurance. I'd rather have flexibility...

Alan Gonzalez, MD, FACS · Answer

Hello @realselfuser40397 thank you for your question. When making the surgical plan all aspects are taken into account, including future aspects. Improving the volume will not only have good results with the weight load that the back assumes. Also through a proper surgical technique you can obtain an anatomical and aesthetic shape that allows you to have volume and aesthetic symmetry. For more information and recommendations it is best to consult with one or several board certified plastic surgeons. Best wishes! Alan Gonzalez MD, FACS.

Finny George, MD · Answer

Hi, thank you for sharing your question. Without photos it is hard to say what might benefit you, however, if you have these symptoms, your best approach is to remove the excess tissue based on your body surface area. Removing less will risk persistent pain.

Johanna D'Agostino, MD · Answer

Significant pain and rashes are usually indications for a breast reduction. If your symptoms are not tolerable, surgery could provide improvement or resolution of your symptoms and a better quality of life. Unfortunately, insurance and not your surgeon will determine the gram required for coverage. Based on the composition of your breast (fat vs glandular tissue) a reduction of 675gr may still leave enough breast tissue and achieve the desired cosmetic results. However, to properly determine this, a detailed physical exam performed by a board certified plastic surgeon is needed. Good luck!

Gary M. Horndeski, MD · Answer

The technique I recommend is The Bellesoma Method. This will reduce and reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. The weight of the breast is transferred to the underlying pectoralis major muscle resulting in pain relief without excessive reduction. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Daniel Barrett, MD · Answer

Dear realselfuser40397,
breast reduction is best suited for women who wish to decrease the size of their breasts. While there are different techniques used to perform this surgery, I prefer the vertical incision (lollipop pattern) breast reduction technique instead of the anchor scar pattern, which reduces more noticeable scarring than usual. I also use a SAFE liposuction technique to reduce additional fat around the stubborn axilla area and bra line. This way, my patients are achieving beautiful results with minimal incisions which reduces downtime and delivers an overall better breast shape long term.If you are considering breast reduction surgery, you should consult with a board certified plastic surgeon to discuss your options and make sure your surgeon understands your goals. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

James Knoetgen, III, MD · Answer

If you're experiencing back pain, rashes, or other discomfort due to large or sagging breasts, combining breast reduction with a breast lift may be an effective solution. Here's what you need to know about your options:1. Consultation: Schedule a consultation with a board-certified plastic surgeon who specializes in breast surgery. During this consultation, you can discuss your concerns, symptoms, and goals. Your plastic surgeon will evaluate your breast size, shape, and skin quality to determine the most appropriate surgical approach.2. Breast Reduction with Lift: Combining breast reduction with a breast lift allows for both the removal of excess breast tissue and skin and the reshaping of the breasts to achieve a more lifted and youthful appearance. This combination procedure can alleviate back pain, shoulder grooving from bra straps, and skin irritation/rashes under the breasts, while also improving breast shape and symmetry.3. Surgical Techniques: The specific surgical techniques used will depend on your unique anatomy and desired outcome. Common techniques for breast reduction with lift include:• Vertical or "lollipop" lift: This technique involves incisions around the areola and vertically down to the breast crease, allowing for reshaping and lifting of the breast tissue.• Anchor or "wise pattern" lift: This technique includes additional horizontal incisions along the breast crease, which may be necessary for more significant breast ptosis (sagging).4. Anesthesia and Recovery: Breast reduction with lift is typically performed under general anesthesia. Recovery time varies but generally involves some discomfort, swelling, and bruising for the first few weeks. Most patients can return to light activities within a week or two but should avoid strenuous activities and heavy lifting for several weeks.5. Risks and Complications: Like any surgical procedure, breast reduction with lift carries risks, including bleeding, infection, changes in nipple or breast sensation, scarring, asymmetry, and difficulties with breastfeeding. Your plastic surgeon will discuss these risks with you during the consultation.Combining breast reduction with a lift can provide both functional and aesthetic improvements, addressing your physical symptoms while also enhancing the appearance of your breasts. It's essential to choose a skilled and experienced plastic surgeon and to thoroughly discuss your goals and concerns during the consultation process.

Camille Cash, MD · Answer

From your description it sounds like you would benefit from a breast reduction procedure.  An examination is needed to determine if the removal amount required by insurance is realistic for you in order to have a good result.  I encourage you to visit with a few board certified plastic surgeons to hear opinions.

Cagil Meric Erenoglu, MD · Answer

Thank you for your question.
Do not have an operation that you will later feel sorry about just because of insurance topics. In breast reduction; both function (treatment of back pain and rashes) and aesthetic outcomes is important. So reducing too much will cause irreversible aesthetic outcomes that one may regret. 
If the breasts are over-reduced they will not grow back in time. New operations will be needed to increase to the desired shape and volume.

Scott C. Lindsay, DO · Answer

Thanks for your question! That choice is yours, of course. If you are comfortable with the insurance requirements, proceed that way. If you'd rather have control and flexibility, you should consider proceeding cosmetically. Good luck!!

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