Some women develop breasts at puberty which are out of proportion to their bodies; other women find that with the weight gain associated with pregnancy, their breasts do not decrease in size after childbirth and nursing. For many of these women, large pendulous breasts cause medical problems, including upper back, neck, and shoulder pain, shortness of breath, rashes beneath the breasts, and headaches. In addition, some women find it impossible to exercise because of the size and weight of their breasts. For these women a breast reduction operation, called a reduction mammaplasty, can provide relief of these symptoms.
What all breast reduction operations have in common is that breast tissue is removed, and the nipples are moved to a higher position on the chest wall. The site that surgeons choose for the nipples is opposite the fold beneath the breast, which is called the inframammary fold. Plastic surgeons choose that site because when the breasts developed at puberty, this was the site of the nipples In these operations, a smaller and more naturally appearing breast is created.
The best candidate for a breast reduction is a healthy woman who has symptoms related to her large breasts, and whose breasts are out of proportion to her body. A breast reduction operation is performed to alleviate her symptoms rather than for cosmetic improvement of the breasts.
Breast reduction operations are not simple operations, but take several hours, and are carried out in the hospital either as an outpatient or with an overnight hospital stay, or at Columbia Plastic Surgery as an outpatient.
Scarring on the breasts following a breast reduction can be significant. There is a scar around the flat part of the nipple, called the areola, another scar from the areola to the fold beneath the breast, and usually a scar of variable length in the fold. These scars will fade with time, but will always be present after this operation.
As with any surgical procedure, there are risks associated with breast reduction. There is no guarantee that a woman will have sensation in her breasts, but most retain some sensation. Also, there is no guarantee that she will be able to nurse following this operation, but many women can. A complication which was fairly common years ago, but now rarely happens, is loss of blood supply to a nipple, with nipple loss. If this were to happen, there are a number of operations to reconstruct a normal appearing nipple. Most women can return to work 7 to 10 days after this operation; many can resume an exercise program several weeks after surgery.
Plastic surgeons consider breast reduction to be a reconstructive, rather than a cosmetic surgical procedure, since the goals of breast reduction are to alleviate symptoms, and to return the breasts to a normal size and appearance. However, it has become more difficult to get health insurance carriers to pay for this surgery in North and South Carolina, and for this reason, Columbia Plastic Surgery will obtain a predetermination that the health insurance carrier will pay for the operation before doing the surgery. In the event that the carrier denies coverage for the procedure, the surgery could still be carried out a Columbia Plastic Surgery, but the patient would be responsible for costs.
Dr. Newkirk has carried out hundreds of breast reductions during the last 20 years, and finds it one of the most gratifying operations that he does. In 2013 the American Society of Plastic Surgeons reported that almost 125,000 breast reductions were carried out.