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Breast reduction is performed most frequently to lessen the weight of very large breasts. Common complaints are neck, upper back and shoulder pain. The forward weight of heavy pendulous breasts changes the center of gravity and results in poor posture. Another frequent problem is chafing and rashes occuring in the folds under the breasts, especially in the hot summer months. Less frequently breast reduction is performed for cosmetic reasons or to obtain better symmetry after breast reconstruction.

Whatever the reason for performing the reduction, the goal is to lift the breasts, to reposition the nippples higher, and to decrease the volume and weight of the breasts. There are numerous surgical methods described for reduction of the breasts. The procedure will be chosen by your surgeon to achieve the best shape with the longest lasting results depending on your shape, size, goals, and skin elasticity. The method which has the best chance of obtaining these results with the least scarring should be used. Other goals are to preserve as much breast function as possible with as little internal scarring and disruption of breast architecture as possible. This will ensure the best chances for minimizing loss of nipple sensation and preservation of ability to breastfeed (approximately 50% of women can successfully breasfeed after reduction).

Reduction is performed under general anesthesia and can be performed as an in or outpatient. Recovery is about three weeks, although it may be more like six weeks until resumption of strenuous activity. Scarring varies and depends on shape considerations and the amount of reduction, but is most often around the areola (the darker skin surrounding the nipple), as well as, to varying degrees, under the areola in the lower portion of the breast and in the folds under the breast. Scars fade over time, about a year, but never disappear. The removed breast tissue is always biopsied and if unsuspected disease is found further surgery may be necessary.

As much symmetry as possible is created, however perfect symmetery can never be achieved. Occasionally a second more minor surgery may be needed months or years later for reshaping, symmetry, removing firm areas of deeper scar tissue, or scar revision. Other procedures which are often performed at the initial or subsequent surgery are liposuction and abdominoplasty (tummy tuck).

Because breast reduction is most commonly done to treat symptoms of pain and skin integrity problems, amongst other difficulties, insurance coverage may be available. Reduction is commonly performed and serious problems are rare, but there are risks which include but are not limited to infection, bleeding problems, loss of skin or nipple and areola, permanent change in sensation, and unsightly scars. As a rule breast reduction patients have excellent relief of symptoms and are very happy with their results.