How Does the Breast Reduction Surgery Differ for Low Density Vs. High Density Breasts?

I am 45yo with sagging, 40E breasts which cause neck pain, shoulder pain, and headaches. My mammogram tech always tells me I have the best breasts for mammos cause they are very low density. I have lost weight recently, but my breast seemed to have grown! I am still ~30lbs overweight at 5'8", and my PS believes reduction will help me be more active. Is the surgery "easier" depending on density? Is it quicker? I was told expect 4hrs, which is kind of scaring me, anesthesia-wise. Thank you

Doctor Answers 5

Breast Reduction and Breast Density

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Breast density relates to the amount of parenchyma (breast tissue) versus fat.  Breasst with higher fat components are easier to operate "through" allowing for faster surgical times.  I believe that longevity, projection and general shape are more affected by the technique chosen than anything else, including breast density.  In general vertical mammaplasty techniques provide these advantages over standard Wise Pattern (anchor) procedures. It is not the scar however, but where the breast tissue is resected.  Techniques leaving tissue in the lower portion of the breast have an increased tendency to "bottom out".  Choosing these techniques is patient and surgeon dependent. Talk to your surgeon about what your options are.  Related to weight loss, I often "split the difference" and would recommend losing 15 pounds prior to surgery, then post op exercise will be even easier!   

Philadelphia Plastic Surgeon
4.7 out of 5 stars 21 reviews

Density of the breast

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thanks for the post. this has to do with the amount of breast gland vs fatty tissue. It does not affect the outcome. Generally, fatty or low density breasts recover well and generally bleed less than dense white glandular breasts. A typical breast reduction takes me about 2 and 1/2 hours. 4 hours is a little on the longer side, but is still considered perfectly safe from an anesthesia perspective. 

I tell my patients to avoid aspirin / motrin due to bleeding. I also recommend a daily multivitamin and a sensible healthy diet high in fiber. The pain medication tends to cause constipation. 

Best wishes.

Bennett Yang, MD
Rockville Plastic Surgeon
4.8 out of 5 stars 21 reviews

Breast Reduction and Low/High Density Breasts?

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Thank you for the question.  Based on your description of breast size and symptoms associated with the large/low breasts, you may be an excellent candidate for breast reduction surgery. I do not think that you need to be concerned about the “low versus high” density breast tissue issue,  when it comes to the breast reduction surgery.

 You may be best served achieving a long-term stable weight  (if possible) prior to undergoing breast reduction surgery. Doing so will  help decrease risks associated with the surgery and hopefully prevent the need for additional surgery ( that occasionally becomes necessary when patients lose  significant weight after body contouring procedures).

 Best wishes;  hopefully you will be very pleased with the outcome of the breast reduction procedure. This procedure tends to be one of the most patient pleasing operations we perform.

Breast density and breast reduction

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Breast reduction surgery is performed the same way no matter what the density of the breasts may be.  Younger women tend to have thicker breast tissue.  As women age, the breast tissue tends to get displaced by fat.  If you are overweight, the loss of weight may be seen in the breasts.  Some women can gain/lose a few pounds and all of it is seen in the breasts and some women can gain/lose twenty or thirty pounds and none of it is seen in the breasts.  You know how your breasts change with weight gain/loss better than anyone.  As for the surgery time, four hours is about right for a breast reduction.  If you are in the hands of a capable plastic surgeon and in an accredited facility then you should be fine with that.

Edwin C. Pound, III, MD
Atlanta Plastic Surgeon
4.6 out of 5 stars 26 reviews

Breast reduction relieves musculokeletal symptoms best

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Thanks for the question.  Based on the symptoms reported and your current bra size, BR would definitely alleviate the neck and shoulder pain.  Headaches may not completely resolve, unless there is a component of muscle tension.  The terminology of "high" vs "low" density refers to the percentage of "glandular or fibrous" tissue vs fat, (i.e. high density is predominantly glandular).  The mammographic appearance of fat is more uniformly dark.  While radiographic imaging may be easier with low density or more fatty breasts, breast reduction shaping and longevity of the lift is more sustained with denser breasts. The recent "growth" of your breasts, despite weight loss is undoubtedly related to hormonal fluctuations, which typically "fluff out" around perimenopause.  Try to loose some of your 30lb surplus; fat loss in the breast will result in loss of volume.  If necessary, follow a medically supervised diet, so that the weight loss is gradual and sustained.  The composition of breast tissue doesn't influence the ease of the procedure, although fatty breasts can occasionally develop post-op "lumps" known as fat necrosis, which eventually dissolve.  The operating time of 4 hours is quite standard and should be well tolerated.  Try to speak with other patients who have had the same technique with your PS.  Good luck :)

Lavinia K. Chong, MD
Orange County Plastic Surgeon
4.8 out of 5 stars 58 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.