Breast Reduction before I'm done having kids or should I wait?

Question

I am 25 years old and a size 38HH. I have 1 child and want more kids. I wasn't able to breastfeed the best since they were too large and have back pain and rashes under them, so considering surgery and insurance covers it. My only thought is that the breasts will grow back and having the reduction surgery will be pointless and have to do again.

James N. Romanelli, MD, FACS · Answer

It is very unusual for breasts to “grow back” after a breast reduction.  And it sounds like you are really struggling with your breast size. Breast reduction can interfere with the ability to breastfeed, so don’t count on breastfeeding if you proceed. You're correct that a future pregnancy may compromise the results of a breast reduction procedure, and so you may need revision surgery. On the other hand, if your back pain is severe and causing other physical issues, it may be wise to go ahead with the procedure. I would schedule a consultation with a board-certified plastic surgeon who can examine you in person and help you consider these pros and cons. Best of luck.

Paul Vitenas, Jr., MD · Answer

Thank you very much for your question. There is no reason why you cannot have a breast reduction now, even if you are considering having more children in the future. While there is a chance that pregnancy and breast feeding will have an effect on your breast tissue, the immediate improvements may be worth the risk. I recommend that you schedule a consultation with a board certified plastic surgeon. At this time, he/she can perform an in-person examination and discuss your breast reduction options.

William T. Stoeckel, MD · Answer

I think that your decision will all depend upon the symptoms that you are having. If you are having difficulty with back pain and skin rashes, having the reduction sooner than later will improve your overall quality of life. There is a chance that having more children afterward could affect your results. But there is a better chance that it will not have a dramatic effect. I would say that if you have plans to have another child in the next year, it makes sense to wait. If you just have plans to have more children some time in the unknown future, I would proceed with your surgical plans.

Adam Tattelbaum, MD · Answer

It makes a lot of sense to wait until you are done having kids is you can stand it. Breasts change dramatically with each pregnancy, sometimes getting larger, but sometimes getting smaller as well. If you are miserable you could do it sooner, but then may want a repeat or adjustment in the future.The right answer really depends on you and your goals.Best wishes.

Timothy Fee, MD · Answer

This would depend upon your comfort level. I recommend caring for yourself before considering hypotheticals. If you want more children, I would discuss this with your surgeon to see if they are comfortable or recommend surgery now or later.

Steven Wallach, MD · Answer

It is up to you to decide when to have the breast reduction. If you are in the midst having more children, then you may want to wait.

Sharline Z. Aboutanos, MD · Answer

Thank you for your question. Timing of breast reduction surgery depends on your ultimate goal. Oftentimes, patients ask about breast reduction before completing their family planning. Breast reduction surgery can be performed before you finish having children; this will alleviate your back, neck and shoulder pain. It will also help with rashes under your breasts. However, as with every pregnancy, you may gain weight and the results may not be as lasting as you would like them to be. You may require an additional surgery or a revision.

If you do decide to have a breast reduction before having more children, I would encourage you to talk to your board-certified plastic surgeon about the possibilities of breast feeding if that is something important to you. This may depend on the technique your surgeon uses.

If you do decide to have a breast reduction before having more children, I would encourage you to talk to your board-certified plastic surgeon about the possibilities of breast feeding if that is something important to you. This may depend on the technique your surgeon uses.

Tom J. Pousti, MD · Answer

Thank you for the question.

Breast reduction surgery is one of the most patient pleasing operations we perform. By removing “excess” breast tissue, adipose tissue, and breast skin this operation reduces and lifts the breasts to a higher position on the chest wall. By doing so, patients often find improvement in neck, back, and shoulder discomfort and find it easier to form their activities of daily living and exercise.There is no "right answer" when it comes to timing of breast reduction surgery in relation to pregnancies.

Timing of the operation will depend on the patient's life circumstances. In general, it is best to do this procedure ( like all other elective body contouring the stages, when patients have reached their long-term stable weights. In doing so, improve the safety of the procedure and minimizes the need for further surgery ( in the event of weight gain/loss after the breast reduction procedure). Again, there are no "absolute rules"; in my opinion, it is best to individualize every patient's care.

For example, there are patients who present with “juvenile” breast hypertrophy will benefit from breast reduction surgery ( for both physical and psychosocial reasons) at an early age ( even as teenagers). Patients should consider carefully the pros and cons of the procedure as well as the potential need for further surgery if the breasts “regrow” in size.

Having said the above, if at all possible, it is best to wait until after completing pregnancies before undergoing breast reduction surgery. Again, doing so will minimize the chances that patients will require further surgery after pregnancy related breast changes.

On the other hand, it can be argued that, patients with breast hypertrophy benefit from breast reduction surgery prior to pregnancy ( to prevent the symptoms that may occur as the breasts grow even larger during and after pregnancy/breast-feeding). However, in the interests of avoiding additional surgery, I feel that it is in most patients best interest, to wait until pregnancies have been completed and a long-term stable weight has been reestablished.

I hope this, and the attached link, helps.

Daniel Greenwald, MD (in memoriam) · Answer

If you have breasts that are so large that they are impacting your daily life then you should immediately proceed with breast reduction.  If you are going to have more children in the next year or so then wait until after this since pregnancy can affect breast size and shape.  Surgery now will provide significant relief from discomfort and will also improved your shape and proportionality, but if you then go on to have another pregnancy you may need additional surgery later.

Breast Reduction before I'm done having kids or should I wait?

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