What is breast reduction?

Breast reduction, or reduction mammoplasty, is a safe and effective option for women with large, heavy breasts. Women with large breasts may not only be dissatisfied with their body image, but also experience physical pain and discomfort, including back or shoulder pain in addition to suffering from skin irritation, bra strap indentations, concerns with posture, and limitations with physical exercise.

Plastic surgeons from Cleveland Clinic Cosmetic & Plastic Surgery Center have perfected breast reduction techniques to effectively remove excess tissue and skin to achieve a breast size in proportion with your body and to alleviate the discomfort associated with overly large breasts.

Am I a candidate for breast reduction?

The best candidates for breast reduction surgery include:

• Women whose breasts are fully developed and breasts are enlarged (generally, a size D or larger)
• Healthy women who do not have a life-threatening illness or medical conditions that can impair healing
• Non-smokers (smoking may delay healing and increase the risk of complications).

A consultation with a cosmetic surgeon at a Cleveland Clinic Cosmetic & Plastic Surgery Center is the first step to learn if you are a candidate for the procedure. Our Plastic Surgeons can explain how a breast reduction can improve the appearance of your breasts and relieve pain, discomfort and any associated symptoms you may have resulting from large, pendulous breasts.

How do I prepare for breast reduction?

Preparation for your breast reduction surgery at Cleveland Clinic Cosmetic & Plastic Surgery Center includes:

• Evaluation of your general health and any pre-existing health conditions or risk factors
• Examination of your breasts, and possible detailed measurements of their size and shape, skin quality, placement of your nipples and areolas
• Taking photographs of your breasts for your medical record
• Discussing your options and recommending a course of treatment
• Discussing likely outcomes of your breast reduction procedure and any risks or potential complications
• Discussing the use of anesthesia during your procedure for breast reduction

The success and safety of your breast reduction procedure depends on you being completely open and honest during your consultation. Being able to discuss why you want the surgery, your expectations and desired outcomes, along with a thorough medical evaluation will help lead to the best end result.

• Before and Afters
• Specialists
• FAQs
• Consultation

Before

After

Woman in her early thirties interested in decreasing her breast size. Patient underwent breast reduction surgery, and is shown before surgery (left) and after surgery (right).

Woman in her early thirties interested in decreasing her breast size. Patient underwent breast reduction surgery, and is shown before surgery (left) and after surgery (right).

Woman in her early thirties interested in decreasing her breast size. Patient underwent breast reduction surgery, and is shown before surgery (left) and after surgery (right).

Woman in her early fifties interested in decreasing her breast size. Patient underwent breast reduction surgery, and is shown before surgery (left) and two months after surgery (right).

Woman in her early fifties interested in decreasing her breast size. Patient underwent breast reduction surgery, and is shown before surgery (left) and two months after surgery (right).

Woman in her early fifties interested in decreasing her breast size. Patient underwent breast reduction surgery, and is shown before surgery (left) and two months after surgery (right).

Woman in her early twenties interested in decreasing her breast size. Patient underwent breast reduction surgery, and is shown before surgery (left) and six months after surgery (right).

Woman in her early twenties interested in decreasing her breast size. Patient underwent breast reduction surgery, and is shown before surgery (left) and six months after surgery (right).

Woman in her early twenties interested in decreasing her breast size. Patient underwent breast reduction surgery, and is shown before surgery (left) and six months after surgery (right).

Male in his early fifties who had correction of his chest area. Male patient is shown before breast reduction surgery (left) and 11 months after breast reduction surgery (right).

Male in his early fifties who had correction of his chest area. Male patient is shown before breast reduction surgery (left) and 11 months after breast reduction surgery (right).

Male in his early fifties who had correction of his chest area. Male patient is shown before breast reduction surgery (left) and 11 months after breast reduction surgery (right).

Male in his early fifties who had correction of his chest area. Male patient is shown before breast reduction surgery (left) and 11 months after breast reduction surgery (right).

Male in his early fifties who had correction of his chest area. Male patient is shown before breast reduction surgery (left) and 11 months after breast reduction surgery (right).

Young adult female interested in reducing her breast size. Patient underwent breast reduction surgery, and is shown before surgery (left) and five months after surgery (right).

Young adult female interested in reducing her breast size. Patient underwent breast reduction surgery, and is shown before surgery (left) and five months after surgery (right).

Woman in her late forties interested in decreasing the size of her breasts. Patient underwent breast reduction surgery, and is shown before surgery (left) and fourteen months after surgery (right).

Woman in her late forties interested in decreasing the size of her breasts. Patient underwent breast reduction surgery, and is shown before surgery (left) and fourteen months after surgery (right).

• Edward A. Levy, MD
• Armand Lucas, MD
• Andrea Moreira, MD

• Francis Papay, MD
• J. Vicente Poblete, MD

• Randall Yetman, MD
• James Zins, MD

Is there much pain and/or bruising following breast reduction surgery?

Swelling from breast reduction surgery is normal and usually takes several weeks for most of the swelling to subside. Some patients are more prone to bruising than others. You should take your prescribed pain medication to alleviate any breast reduction pain or discomfort that you experience. If you feel that your pain is severe or if you begin to run a fever, call Cleveland Clinic Cosmetic & Plastic Surgery Center immediately.

At what age can a breast reduction procedure be performed?

The breast reduction procedure can be performed at any age, but is generally performed after 18 years of age.

Will I need more than one breast reduction surgery?

Although good results are expected from your breast reduction surgery, there is no guarantee. However, the need for revision surgery is infrequent.

Will my breasts be perfectly symmetrical after breast reduction surgery?

Though surgery can correct asymmetries of the breasts, it may be impossible to make your breasts and nipples perfectly balanced. Most women do not have symmetrical shoulders or chest wall structures. Additionally, related muscles, bones and joints are usually different on both sides of the body. As a result, even with the best surgical techniques, it is possible to notice differences in breast shape or size following surgery.

How will breast reduction surgery affect my mammograms and cancer screenings?

You should wait approximately one year following breast reduction surgery to get a mammogram since mammogram compression can be painful if performed before the breasts are completely healed. Changes resulting from breast reduction surgery are visible on a mammogram, including alterations in the internal breast structure and outside breast contour, scarring, asymmetrical densities and the appearance of calcium deposits. Most of these findings however are commonly radiographically visible from other pathologies such as malignancies (cancerous findings). Sometimes, other tests such as an ultrasound or MRI may be required. It is extremely important that you let your physician/radiologist know that you have had breast reduction surgery prior to getting a mammogram.

One of the best ways to decide if cosmetic surgery is right for you is by meeting with a cosmetic or plastic surgeon at the Cleveland Clinic Cosmetic & Plastic Surgery Center.

During this first consultation, you and your surgeon will discuss your goals and expectations. Your surgeon will also:

• Review your complete medical history (including past and current medications)
• Evaluate the part of your body that you want treated
• Give recommendations
• Answer any questions you have
• Learn more about a physician consultation

How is breast reduction performed?

Breast reduction surgery involves removal of excess skin, fat and glandular tissue through incisions on your breasts. Excess fat may also be removed through liposuction along with various excision techniques used by Cleveland Clinic cosmetic surgeons. If your breast size is due primarily to fatty tissue and excess skin is not an issue, liposuction alone may be used as the key technique for breast reduction.

Plastic Surgeons at Cleveland Clinic Cosmetic & Plastic Surgery Center will determine the best technique to reduce the size of your breasts based on your individual condition, breast composition, amount of reduction desired and your personal preferences.

Techniques for breast reduction include:

Vertical mammoplasty or “short scar” breast reduction.

The short scar procedure uses an incision that circles the nipple/areola area and extends down vertically below the breast. This approach avoids making a horizontal incision beneath the breast, reducing the total length of scarring by 50 percent, offering a superior cosmetic result, and a rounder, more natural outcome. The best candidates for the short scar procedure are women who have moderately large breasts. Women with massive breasts are better candidates for the traditional reduction procedure.

Traditional reduction procedures.

These procedures involve an inverted T or anchor-shaped incision that extends vertically down the middle of the breast and horizontally along the underside of the breast, or a keyhole or racquet-shaped pattern with an incision around the areola and vertically down to the breast crease. This type of breast reduction procedure elevates the nipple to a more normal location, reduces volume and improves contour while usually preserving breast sensation.

What results can I expect?

The results of your breast reduction surgery will be long-lasting. Your new breast size should help relieve pain and physical limitations you experienced prior to breast reduction surgery in addition to enhancing your self-image and confidence.

Breast reduction cannot, however, stop the natural effects over time that can cause your breasts to change due to aging, weight fluctuations, hormonal factors and gravity. Long-term follow-up with your plastic surgeon at Cleveland Clinic Cosmetic & Plastic Surgery Center is highly recommended to monitor these ongoing changes.

What is involved in recovery?

Breast reduction surgery is usually performed as an outpatient procedure at Cleveland Clinic Cosmetic & Plastic Surgery Center. If this is the case, be certain to plan for someone to drive you home after surgery and stay with you at least the first night following surgery.

When your breast reduction procedure is complete, dressings or bandages will be applied to the incisions. You may also wear a support bra at home to minimize swelling and support the breasts as they heal.

A small, thin tube may be temporarily placed under the skin to drain any excess blood or fluid that may collect at the incision sites.

Your Cleveland Clinic cosmetic surgeon will give you specific instructions for breast reduction recovery that may include:

• How to care for your breasts following breast reduction surgery,
• Medications to apply or take orally to aid healing and reduce the risk of infection
• Specific concerns to look for at the surgical site or in your general health, and when to schedule your follow up appointment at Cleveland Clinic Cosmetic & Plastic Surgery Center.

Is breast reduction safe?

All surgical procedures carry some risk. Although rare, possible risks associated with breast reduction include:

• Bleeding and infection
• Unevenly positioned nipples
• Partial or complete loss of sensation in the nipples
• Tissue or nipple loss
• Possible loss of the ability to breastfeed (due to the removal of milk ducts)

Women who smoke are at a higher risk for all complications. Poor healing and wider scars are also more common in smokers.

Breast reduction surgery does leave permanent scars that may be problematic, with “raised” or “hypertrophic scars” common. Yet, these are typically hidden by a bra or swimsuit.

Why Choose Us

If you’re considering breast reduction surgery, look for a board-certified plastic surgeon with specialized training and significant experience performing breast reduction procedures. Consider going to a cosmetic surgeon who is affiliated with a major medical center, such as Cleveland Clinic. Ask your cosmetic surgeon about their credentials, training and how many breast reduction procedures he or she has performed.

Is this procedure covered by health insurance?

Breast reduction is both a functional and appearance-related procedure and is covered by insurance if a significant reduction of breast tissue is performed (when generally greater than 400 grams of breast tissue is removed). Ask to talk with a financial representative from Cleveland Clinic Cosmetic & Plastic Surgery Center who can explain costs of the procedure and if insurance coverage is an option for you.

This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.