Breast reduction surgery can dramatically improve how patients feel physically and emotionally. It’s an extremely gratifying procedure that a lot of my patients feel has a positive benefit.

Breast reductions are very effective at alleviating chronic pain, poor posture, nerve compression, bra strap grooves, and skin irritation. By repositioning the breasts into a higher, more natural position and reducing overall breast mass, we off-load excess strain on the neck, shoulders, and back muscles.

If you’re considering a breast reduction, here are some of the main questions that my patients want to know about the procedure, insurance coverage, and aftercare.

During breast reduction surgery, also called reduction mammaplasty, we remove glandular tissue, fat, and excess skin. After breast reduction surgery, patients can expect to have smaller, more proportional breasts. Patients with disproportionately large breasts are usually diagnosed with macromastia, and their breast reduction surgery may be covered by insurance.

We also perform breast reductions on patients who don’t have macromastia. These patients are usually uncomfortable with their breast size and want to achieve less volume in the chest.

Before Breast Reduction Surgery

We will discuss your overall health, medical history, and desired surgical outcomes. We typically perform these procedures on patients who are non-smokers, at a healthy weight, and in generally good health.

Breast reductions can be done on young adults, but some providers may advise women who plan on having children to wait until after pregnancy and breastfeeding to undergo a breast reduction. This is a conversation to have with your surgeon and will depend on your needs and goals. It is possible for women to breastfeed after breast reduction surgery and you should talk with your doctor about your personal plans.

During your breast reduction consultation, we’ll measure your breasts, talk about the procedure, and discuss what you want your breasts to look like. We’ll also talk about anesthesia, surgical risks and benefits, medications, and recovery instructions.

After Breast Reduction Surgery

Breast reduction surgery often helps many patients feel more comfortable and confident. Here are just a few of the benefits that our patients report after undergoing breast reduction surgery:

• Reduced chronic back, shoulder, or neck pain.
• Decreased pressure from bra straps digging into the shoulders.
• Less or fully eliminated nerve pain, rashes, or skin irritation.
• Improved self-image and confidence.
• Increased comfort during high-impact activities, such as running.
• Able to fit into certain clothing or bras for personal style.
• Lighter, lifted, and sometimes more youthful breasts without excess sagging tissue.

Breast reduction patients can expect to see results immediately. As the area recovers, the swelling with go down and incision scars hidden by natural breast contours will naturally fade over time.

Here’s one of our breast reduction patients before and after the procedure. As you can see her breasts retained the desired volume, we resolved asymmetry, and the breasts are lifted to a more natural, youthful position. The nipples and areolas are now also positioned more centrally. Her incisions were still healing when we took the second photo and the scars continued to fade over time.

In this patient, we reduced breast volume and mass, restored a natural breast position by lifting the tissue, repositioned the nipple and areola, and decreased areolar circumference.

At Plastic Surgeons of Northern Arizona, we perform breast reduction surgery in our outpatient surgical center. Breast reduction patients can go home the same day after surgery, but somebody will need to drive them due to the effects of anesthesia.

During the procedure, we make incisions around the areola, and vertically from the areola to the breast crease. Depending on the individual patient, we may also make an incision hidden underneath the natural contour of the breast crease.

Next, we’ll remove excess fat, tissue, and skin using liposuction or excision. During this time we can reposition and reduce the size of the areola if necessary and will lift and shape the breasts into a natural position. In rare cases, we need to transplant the nipple and areola to achieve an ideal nipple position.

Finally, we’ll close the incisions and support the breast tissue with sutures layered under the skin. To read more about common breast reduction incision patterns and how we minimize the appearance of scars, read my follow-up article, “How to Minimize Breast Reduction Scars.”

Many patients with macromastia who meet certain eligibility criteria are able to receive breast reductions covered by their insurance. In these cases, we’ll often submit pre-authorization documentation to your insurance provider in advance. Patients usually need to provide the following documentation to insurers:

• Records showing that they experience chronic health problems due to having disproportionately large breasts. These symptoms may include chronic pain, nerve compression, bra strap grooves, spine alignment and posture problems, rashes, skin irritation, and/or difficulty performing certain physical activities.
• Other treatments have not relieved the symptoms.
• A letter from their physician and/or plastic surgeon explaining symptoms, previous treatments, and how long the symptoms have persisted.
• Their height, weight, and photographs of the breasts.

Patients who aren’t eligible for insurance coverage may choose to pay out-of-pocket. Nationwide, the average cost of breast reduction surgical fees is around $6,000, according to the American Society of Plastic Surgeons. Keep in mind, this doesn’t include fees associated with anesthesia, surgical facility fees, recovery garments, and prescriptions. Make sure you ask your plastic surgeon for a final quote that includes ancillary fees – especially if you’re paying out-of-pocket.

Most of our breast reduction patients return to work after two weeks and are fully recovered without any activity restrictions by 4-6 weeks. If their job is particularly strenuous, then they may need to prolong their recovery period. I tell my patients to take it easy for at least the first four weeks and avoid high-impact exercise or activities to help ensure a healthy recovery period.

Here are some other important aftercare instructions I explain to patients:

• Incision Aftercare: We’ll apply a surgical dressing to protect incision areas directly after surgery and advise patients to be gentle with this area.
• Bathing: We don’t want patients showering within the first 48 hours after surgery. Baths, hot tubs, pools, lakes, and oceans are off-limits for four weeks to reduce the risk of infection.
• Post-operative Garment: We provide breast reduction patients with a post-surgical bra to wear for six weeks. This garment provides slight compression, helping to cut swelling and improve wound healing. This may be substituted for a sports bra or soft bra – no garments with underwires for 8 weeks postoperatively.
• Medications: Pain medications are usually prescribed to help patients feel more comfortable as they recover from surgery.
• Return-to-Work: Most patients return to work two weeks after their breast reduction.
• Driving: Someone else will need to drive the patient home, as they’ll be unable to operate a vehicle for two days due to the effects of anesthesia and to keep from affecting the results of the surgery.

If you’d like to learn more about breast reductions, we’d love to bring you in for a consultation. Our team of board-certified plastic surgeons and experienced providers at Plastic Surgeons of Northern Arizona can answer your questions and discuss your goals.