Is it Safe to have a Second Breast Reduction?

Question

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?

Tom J. Pousti, MD · Answer

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 &ldquo;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.

Otto Joseph Placik, MD · Answer

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.

Joseph Mele, MD · Answer

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.

Christopher V. Pelletiere, MD · Answer

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.

Adrian Richards, MBBS, MSc · Answer

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.

Is it Safe to have a Second Breast Reduction?

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Answer: Second Breast Reduction Difficult, But Not Impossible

Answer: Second Breast Reduction Difficult, But Not Impossible

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

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

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Is it Safe to have a Second Breast Reduction?

Answers (8)

Answer: Second Breast Reduction Difficult, But Not Impossible

Answer: Second Breast Reduction Difficult, But Not Impossible

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

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

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Everything you need to know about Breast Reduction

Our mission is to create a world where every investment in modern beauty is Worth It.