Breast Reduction

You might consider a breast reduction if your breasts are too heavy for your frame or if you have symptoms related to your large breast size, like back pain, neck pain, shoulder pain, or grooves in your shoulders from your bra straps digging in.

After you arrive at our office, you’ll first meet with one of Dr. Kavali’s Physician Assistants. They will begin the consultation process by reviewing your medical history, establishing your goals for the surgery, and by taking relevant photographs for your medical record.

Dr. Kavali will complete the consultation process by meeting with you to personally hear about your goals for surgery. She will ask about your desired breast size and shape and anything else related to the appearance of your breasts that you feel is important. This conversation will help Dr. Kavali understand your expectations and determine whether they can realistically be met.

Dr. Kavali will examine your breasts. She will be looking at the size and shape of your breasts, the quality of your skin, and the location of your nipples and areolas (the pigmented skin surrounding the nipples).

The consultation time is meant to be comfortable and educational. We want you to feel completely informed, so you can make your own personal best decision. There are some questions that commonly arise during the consultation process, so we’ve included them here.

A breast reduction can be performed at any age, but Dr. Kavali usually recommends waiting until breast development has stopped. Pregnancy and breast-feeding may have significant and unpredictable effects on the size and shape of your breasts.

Nevertheless, many women decide to undergo breast reduction surgery before having children and feel that they can address any subsequent changes later. Since the nipples are left intact, breast reduction surgery usually will not affect your ability to breast-feed; however, this can never be guaranteed and you should discuss this with Dr. Kavali.

You should tell Dr. Kavali if you plan to lose a significant amount of weight, particularly if you have noticed that your breasts sag or become smaller with weight loss.

Breast reduction surgery may be covered by your insurance policy if you meet the criteria for coverage in your specific plan.  Many factors determine your eligibility for coverage, including the specific terms of your insurance policy. A letter of predetermination will be required by your insurance company prior to surgery. Dr. Kavali or a staff member in her office will discuss these matters with you.

Dr. Kavali makes every attempt to minimize scarring on the breasts. For many women having breast reductions, Dr. Kavali uses the SPAIR short scar technique. This technique uses only a “lollipop” scar around the areola and down the center of the breast and eliminates the traditional long scar beneath the breast.

For the very largest breast reductions, Dr. Kavali will use the more traditional anchor-type scar, which leaves a scar around the areola, down the center of the breast, and under the breast.

After Dr. Kavali has removed excess breast skin, the nipple and areola are shifted to a higher position. The areola, which in a sagging breast may have been stretched, can be made smaller. Skin that was formerly located above the areola is brought down and together beneath it to reshape and tighten the breast.

Fortunately, significant complications from breast reductions are infrequent. Every year, many thousands of women undergo successful breast reduction surgery, have no major problems and are happy with their results. Anyone considering surgery, however, should be aware of both the benefits and risks.

The subject of risks and potential complications of surgery is best discussed on a personal basis between you and Dr. Kavali.

Some of the potential complications that may be discussed with you include bleeding, infection and reactions to anesthesia. Following a breast reduction, sometimes the breasts may not be perfectly symmetrical or the nipple height may vary slightly. Minor adjustments often can be made at a later time. Permanent loss of sensation in the nipples or areas of breast skin may occur rarely. Revision surgery may sometimes be helpful in certain instances where incisions may have healed poorly.

Dr. Kavali’s goal is to make your surgical experience as easy and comfortable for you as possible.

Depending on your age, or if you have a history of breast cancer in your family, Dr. Kavali may recommend a baseline mammogram before surgery and another mammographic examination some months after surgery. This will help to detect any future changes in your breast tissue. Following a breast reduction, you will still be able to perform breast self-exams, which you should do monthly. Breast reduction surgery will not increase your risk of developing breast cancer.

If you are a smoker, you will be asked to stop smoking at least 3 weeks prior to your surgery. Smoking, and a history of smoking, causes significant and specific wound healing problems and can lead to poor scarring.

Breast reduction surgery is usually performed on an outpatient basis. If this is the case, be sure to arrange for someone to drive you home after surgery and to stay with you at least the first night.

The evening of your surgery, it is important that you get out of bed for short periods of time. After breast reduction surgery, it is often possible to return to work within a week or so, depending on your job. In many instances, you can resume most of your normal activities, including some form of mild exercise, after several weeks. You may continue to experience some mild, periodic discomfort during this time, but such feelings are normal.  Severe pain should be reported to Dr. Kavali.

Your sutures will be beneath the skin and will dissolve. Occasionally, a few dissolving sutures will be used on the outside of the skin as well.

You may notice that you feel less sensation in the nipple and areola areas. This is usually temporary. It may, however, take weeks, months or even more than a year before sensation returns to normal. Your breasts may also require some time to assume a more natural shape. Incisions will initially be red or pink in color. They should fade and soften over time (up to 18 months after surgery).

Breast reduction surgery will make your breasts firmer and more uplifted. You may experience relief from any back pain, neck pain, and shoulder pain that was caused by the weight of your breasts.  The position of your areolas and nipples will be improved, and the size of your areolas will be generally smaller than before the surgery.

The incisions from your breast lift surgery will heal and fade over time. It is important to realize, however, that the incision lines will be permanently visible. In some instances, they will eventually be only faint lines. Some women may have incision lines that are more noticeable. Fortunately, the incisions for your breast lift are in locations easily concealed by clothing, even low-cut necklines.

Unless you gain or lose a significant amount of weight or become pregnant, your new breast shape should remain fairly constant. However, gravity and the effects of aging will eventually alter the size and shape of virtually every woman’s breasts. If you again become dissatisfied with the appearance of your breasts, you may choose to undergo a second breast lift procedure to restore their more youthful contour and appearance.

Please remember that the relationship with Dr. Kavali does not end when you leave the operating room. If you have questions or concerns during your recovery, or need additional information at a later time, she would love to hear from you.