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Frequent Asked Questions about Breast Reduction (Reduction Mammaplasty) - Sam Jejurikar, M.D.

Who is a candidate for breast reduction?

Women with large, disproportionate breasts with pain, discomfort or embarrassment due to their breast size may be good candidates for breast reduction  (reduction mammaplasty). Ideal candidates for a breast reduction are women who are not pregnant or breastfeeding, are done having children, and are at a stable weight. Although breast reduction is generally recommended for mature women with fully developed breasts, surgery may be performed on younger women if their breasts are causing serious pain and physical discomfort.

When can patients return to work and resume normal daily activities?

After breast reduction surgery, it is often possible to return to work within one to two weeks, depending on the patient’s job.  Many patients resume most of their normal activities, including some form of mild exercise, within a few weeks. You may continue to experience some mild, periodic discomfort during this time, but these feelings are normal.

Because sexual arousal could cause incisions to swell and create the possibility of delayed healing, sexual activity should be avoided for at least two weeks after breast reduction surgery.

When can patients shower after breast reduction surgery?

Patients are often concerned that limited mobility after surgery will prevent them from showering for several days.  Dr. Jejurikar recommends that patients shower as soon as their drains are removed after surgery, generally about 48-72 hours postoperatively, to help them feel refreshed and to keep their breast skin clean.

Will health insurance cover the breast reduction procedure?

Breast reductions may be covered by medical insurance if the purpose of the breast reduction surgery is to alleviate physical discomfort and pain caused by oversized breasts. Many factors determine your eligibility, including the specific terms of your insurance policy and the amount of breast tissue to be removed.

Insurance companies require specific documentation from plastic surgeons prior to approving reduction mammaplasty.  This usually includes photographs demonstrating large breasts and shoulder grooving from bra straps, as well as a letter describing patient’s symptoms, other treatment modalities attempted, and the estimated amount of tissue that will be removed.

Supporting documentation from other physicians and health care professionals can be very helpful in facilitating the approval process.  Letters from physical therapists and chiropractors documenting failed therapy for back pain and neck pain, as well as from primary care doctors demonstrating neck pain, shoulder pain and heat rashes despite appropriate use of a support bra, all help immensely.

How long will the results of breast reduction surgery last?

After breast reduction surgery, provided patients do not gain or lose a significant amount of weight or become pregnant, breast size should remain relatively constant in size. However, the effects of aging and gravity cause all tissues to sag over time; the breasts are no exception. If, after a period of years, the breasts become saggy or droopy, patients may choose to undergo a breast lift procedure to restore a more youthful contour.

Will there be scarring?

The various techniques for breast reductions require different incisions. Traditional breast reduction surgery uses anchor-like incisions that extend around the nipple, down the middle of the breast, and at the crease at the base of the breast. Vertical incision (lollipop) breast reduction surgery creates shorter scars that also circle the nipple and extend vertically down the breast, but avoid making an incision at the crease below the breast.   Dr. Jejurikar designs his incisions with the goal of minimizing scars while still creating an aesthetically pleasing breast. Scars from breast reductions tend to fade over time and can be hidden under bras, bathing suits, or a low cut top.

Can I breastfeed after a breast reduction?

There is a significant chance that breastfeeding is not be possible after breast reduction.   It is not possible to predict with certainty who will be able to breast feed after breast reduction surgery. Thus, if this is of paramount importance to a patient, she should delay surgery until a later time.

What are the risks and complications of breast reduction surgery?

Breast reduction surgery may have potential complications that are possible for all surgeries, including bleeding, infection, hematoma, adverse reactions to anesthesia, and poor scarring.  Potential risks that are specific to breast reduction surgery include asymmetrical breasts, altered or loss of nipple and areola sensitivity, and the inability to breastfeed.

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