Excessively large breasts are referred to as macromastia. Macromastia is often described as disproportionately heavy breasts on an otherwise average size patient. Women generally seek consultation for breast reduction surgery (reduction mammoplasty) because of psychological reasons, physical reasons, or both. Large breasts can cause multiple physical problems including but not limited to pain in the neck, shoulders, and upper back, shoulder grooving from bra straps, skin rash or even skin breakdown in the breast folds, limitation in physical activities, and poor posture. Studies have shown that women living with physical pain due to large, heavy breasts compared their symptoms to people living with chronic medical conditions such as arthritis in the knee, low back pain, and chest pain from heart disease.
At the time of breast reduction consultation, your surgeon will discuss with you the indications for breast reduction as well as review realistic expectations. When being covered by a patient’s health insurance because of some of the symptoms mentioned above, the insurance company usually requires a certain amount of tissue be removed per breast for it to be deemed “medically necessary”. The amount of tissue that is required to be removed depends on the specific insurance company, but the minimum amount is usually 500 grams (1.1 pounds) per breast.
There are several different techniques that can be used to reduce the size of the breast, and each of these techniques also achieve some degree of a breast lift.
The technique performed is determined by the patient’s preoperative breast size, droopiness of the breasts (ptosis), her desire for a certain size postoperatively, as well as history of smoking among other factors. Some surgeons are quite comfortable with one particular method of breast reduction and simply apply that method in every case whereas other surgeons attempt to apply different techniques on a case by case basis.
The most common techniques of reduction mammoplasty result in a final scar around the areola and down to the base of the breast (lollipop scar, vertical reduction) or around the areola and down to the base of the breast and out to each side (anchor or inverted-T scar, Wise pattern reduction).
(This patient underwent Wise pattern reduction with final scars in an inverted-T)
Your surgeon will discuss with you the pros and cons of each technique, his/her preference, and explain what he/she recommends in your individual case. Lastly, patients who undergo breast reduction mammoplasty have a high level of satisfaction with improvement in symptoms and body image.