Reduction mammoplasty is also known as breast reduction surgery. During the procedure, a surgeon removes fat, glandular tissue and skin to reduce the size of the breasts. It is most commonly performed on women, but men also can have the surgery.
The most common reason for having reduction mammoplasty is macromastia, or enlarged breasts. Women might have the procedure because of back pain or neck pain from breast weight, cystic breast infections, posture problems or grooves in the shoulders from bra-strap pressure. In some cases, skin can stretch under the weight of large breasts, which can cause scar-like lines. Some women also experience chronic skin rash under the breasts.
Reduction mammoplasty usually is performed with the woman under general anesthesia. There are several techniques that a surgeon might use. The most common is the inferior pedicle technique, in which the incision resembles the shape of an anchor or inverted letter T. With this technique, the incision is made around the areola, vertically down the breast under the areola and horizontally on the underside of the breast.
Often, the areola remains attached to its blood and nerve supply, but in some cases, it must be removed and later re-attached. The surgeon removes breast tissue and shapes the remaining tissue. At the end of the procedure, the surgeon brings together the incision points, removes excess skin and closes with sutures deep within the breast tissue.
After the surgery, the woman will have some pain and tenderness. The doctor might prescribe antibiotics as well as medication to manage pain and nausea. Breasts are often swollen and bruised during the recovery period.
As with any major surgery, there are considerable risks to reduction mammoplasty. A woman could experience excessive bleeding, infection or a reaction to medication. After reduction mammoplasty, a woman could lose sensation in her nipples and might experience difficulty breastfeeding. Scars from the procedure are permanent but can become less visible over time. In some cases, the breasts might be asymmetrical or misshapen after the procedure, requiring additional surgeries.
For many women with excessively large breasts, the benefits of the procedure outweigh the risks. A successful reduction mammoplasty can alleviate back, neck and shoulder pain and enable a woman to engage in physical activity more easily. The surgery also can result in improved self-confidence and body image. Insurance coverage varies, but many companies cover reduction mammoplasty if the procedure is medically necessary to reduce pain or other symptoms.