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Breast reduction surgery: Decrease breast size, ease discomfort

Breast reduction surgery may be the solution to the discomfort caused by excessively large breasts. Find out what the procedure involves and what you can expect from the surgery.

By Mayo Clinic staff

Constant back and neck pain, gouges in your shoulders from bra straps, deteriorating posture and an inability to participate in certain activities rank among the common complaints of women with large breasts. Breast reduction surgery (reduction mammaplasty) may help relieve these symptoms. As technology advances and surgical techniques improve, more women are seeking consultations from plastic surgeons to discuss options for adjusting their breast sizes to a healthier and more comfortable level. According to the American Society of Plastic Surgeons, more than 104,000 breast reduction surgeries were performed in 2006.

If you're considering breast reduction surgery, find out more about who the surgery can benefit and what you can expect from the procedure.

What are the indications for breast reduction surgery?

Breast reduction surgery is for women who have large breasts and want to resolve one or more of the following associated problems:

  • Chronic back, neck and shoulder pain
  • Poor posture
  • Skin rash under the breasts
  • Deep grooves in the shoulders from bra strap pressure
  • Restricted levels of activity
  • Low self-esteem
  • Difficulty wearing or fitting into certain bras and clothing

You can have breast reduction surgery at any age, but it's generally advisable to wait until you're at least age 20, by which time your breasts are likely to be fully developed. However, sometimes surgery is performed in teens who suffer significant emotional and psychological effects of having too-large breasts.

If you want children, consider postponing breast reduction surgery until you've had them. Changes to breast tissue during pregnancy could alter your surgical results. Also, after the surgery, breast-feeding may be difficult.

What can you expect during the initial consultation with your plastic surgeon?

During your first visit, your plastic surgeon should:

  • Provide a detailed description of the procedure and its results, including likely scarring
  • Discuss your expectations for breast size and appearance after the surgery
  • Examine and measure your breasts
  • Take photographs of your breasts for insurance preapproval and for reference during and after the surgery
  • Discuss factors that may affect the surgery, such as your age, the size and shape of your breasts, and your skin condition
  • Discuss the positioning of the nipple and areola — the circular, pigmented area around your nipple
  • Explain the type of anesthesia used
  • Determine where the surgery will be performed — in a hospital or outpatient surgery center
  • Discuss costs and insurance considerations

The extent of surgery — specifically, how much breast tissue will be removed — depends on many factors, including the breast size you hope to achieve and the guidelines followed by your insurance provider.

Is breast reduction surgery covered by insurance?

It might be. Insurance providers stipulate that the procedure be medically necessary, not cosmetic. To meet the standard of medical necessity, you might be required to have your breasts reduced to a predetermined size shown to provide significant symptom relief. To be sure you're covered, check with your insurance company beforehand.

The cost of breast reduction surgery varies, depending on what your procedure involves and where you have it done, and it can range from $5,000 to $10,000. If your insurance company won't cover these costs, be prepared to pay all expenses out-of-pocket.

How do you prepare for breast reduction surgery?

Your first consultation with a plastic surgeon is a good time to ask questions and find out exactly what breast reduction surgery entails. Make sure you fully understand what you're about to go through, and review the possible complications.

If you've never had a mammogram, you may be required to get one before surgery, depending on your age and family history of breast cancer. If you smoke or use other nicotine products, you'll be asked to stop for a period of time before and after the surgery. Nicotine use impairs blood flow to the tiny vessels that supply the nipple area.

Follow your surgeon's directions in preparing for surgery. This might include restrictions on eating, drinking or taking medications.

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Oct. 9, 2007

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