Breast Reduction

Breast Reduction Newport Beach

“They always say time changes things, but you actually have to change them yourself.”-Andy Warhol, The Philosophy of Andy Warhol

Breasts are composed of a skin envelope, nipple-areolar complex and variable amounts of fat, fibrous and glandular tissue. Under times of hormonal fluctuation (puberty, pregnancy & lactation, menopause), breasts enlarge, change composition and sag. Apart from unsatisfactory appearance, breast reduction (mammoplasty) patients may have active functional complaints:

  • Musculoskeletal strain, affecting shoulders, neck, upper spine;
  • Dermatological symptoms, such as intertrigo or frequent heat rashes;
  • Interference with activities of daily living, exercise, etc.;
  • Persistence of breast weight and volume, independent of weight loss

Size does matter both to a potential breast reduction candidate, as well as their insurance company. Insurance pre-authorization is difficult as criteria are increasingly more stringent:

  • Height/Weight (BMI= Body Mass Index) must be in non-obese range;
  • Must document failure of conservative measures, such as treatment by chiropractor, massage therapists, wearing of supportive garments, failure of reversal of symptoms with weight loss;
  • Attachment of letters documenting severity of symptoms and recommending reduction mammoplasty from other medical specialists (Dermatology, Orthopedic Spine, etc.);
  • The weight (gm)/breast is specified by the insurance company; as a consequence, patient’s aesthetic goals may not be respected.

The Method:

Breast reduction principles mirror mastopexy, with the exception that the weight of breast tissue excised is sufficient to alleviate functional symptoms. Analogous to any elective breast surgery, lactation should be complete to reduce the possibility of complications. The goals, pre-op work up, type of anesthesia, operative time and recovery are identical to mastopexy. Breast tissue resected is submitted for Pathology exam. Accessory breast tissue often extends around the rib cage and into the armpits; both areas can be reduced with concurrent liposuction.

Breast reduction can have many variations, depending on the patient’s objectives:

  • For mothers who decide to “opt out” of breast implants, breast reduction may be combined with explantation and removal of internal scar capsule;
  • Volume reduction, in the context of a “tight” skin envelope, may be accomplished by simple implant exchange;
  • Elective breast reduction is primarily a cosmetic procedure with secondary reconstructive features, (i.e. offloading of chest, shoulders, arms & back).

Post Operative Considerations:

Relief of musculoskeletal symptoms is immediately appreciated. Post-op recovery, final shape development and scar maturation is comparable to mastopexy. Rarely, subcutaneous “knots” (fat necrosis) occur but can be differentiated from tumors by Ultrasound; eventually, they dissolve during healing. Recurrent droopiness or regrowth occurs with time and weight gain.