Breast Reduction: Why Do the Before-and-afters Appear Saggy and "Floppy"?

Question

I am fit but my chest is rather large. Despite the strengthening excercises I do my back still hurts. My insurace is willing to cover it -- all my doctors agree that a reduction will alleviate the pain. My issue is this: despite having a large chest, my breasts may be heavy, but they are not "saggy" and have quite a bit of volume. I've noticed in after shots of BR women tend to have deflated, oddly shaped breasts. Is there a way to avoid this? I'm still young and I don't want ugly breasts. :/

Gary M. Horndeski, MD · Answer

The reason breast reduction photographs appear so floppy and saggy is because they use a technique that was developed in 1956 called the Wise pattern.  This technique does not transfer the weight of the breast to the underlying muscle and consequently the breast re-stretches over time.  The Wise pattern also results in nipple numbness, the inability to breast feed and ugly vertical scars.  It is for these reasons that a new technique has been developed called The Ultimate Breast Reduction.  This technique uses circumareola and inframammary incisions that are hidden around the areola and in the shadow of the breast.  Your breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage.  Breast pain is eliminated by transferring the weight of the breast to the underlying muscle, nipple sensation and the ability to breast feed is maintained.  

	 

	Best Wishes,

	 

	Gary Horndeski, M.D.

Steven Wallach, MD · Answer

All i can say is it depends where you start from. You can look at my website and see some young women. It all depends. Good luck.

Lewis Ladocsi, MD, FACS · Answer

Hi Katedi. You should not have saggy or ugly breasts after a breast reduction. If you have good skin tone, firm breast tissue, and heal well, you should have a satisfactory appearance after a breast reduction. That being said, remember that if your insurance company is paying for the operation, your surgeon may need to remove a specified amount of breast tissue. If cosmetics is your main priority, not pain relief or adjustment of your body proportion, you may want to consider bypassing your insurance company and asking your plastic surgeon to perform the operation like any other cosmetic surgical procedure. This may give you more control of the final result.

Anureet K. Bajaj, MD, FACS · Answer

Following any plastic surgical procedure, your "after" results will depend to a varying degree on where you started from. In other words, every patient will have different degrees of skin elasticity, medical history, and genetics which will affect the ultimate outcome. Typically, after breast reduction surgery, the breasts will be swollen; as the swelling subsides and they "settle", they will assume their natural shape. It is impossible to guide you with regards to realistic aesthetic expectations without a consultation. I would recommend that you consult with a board certified plastic surgeon and discuss your aesthetic concerns with him or her. Hopefully, he or she will be able to lesson your concerns and assuage your fears. Good luck!

Breast Reduction: Why Do the Before-and-afters Appear Saggy and "Floppy"?

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