Breast Reduction Surgery
Breast reduction — also called reduction mammaplasty — is a variation of mastopexy in which breast tissue is also removed. The same incision patterns used in breast lifting are applied, but significant amounts of breast tissue, fat, and skin are excised to reduce size and alleviate the physical symptoms associated with macromastia (excessively large breasts).
Patients with large breasts frequently experience chronic neck, back, and shoulder pain, bra strap grooving, skin rashes in the inframammary fold, difficulty exercising, and limitations in clothing choices. In many cases, breast reduction is considered a medically necessary procedure and may be covered by health insurance.
“Breast reduction also called reduction mammoplasty is a variation of mastopexy, when breast tissue is removed. The same patterns can be used as in mastopexy. Most often, we use the vertical or the inverted T pattern or anchor pattern. Dr. Rafizadeh has the biggest experience in breast surgery and knows how to keep the scars the shortest possible and still achieve the best breast shape.”
— Dr. Farhad Rafizadeh, MD FACS
Surgical Techniques
Dr. Rafizadeh uses a big variety of breast reduction techniques depending on the specific needs of the patient. For most reductions, he uses either the vertical (lollipop) pattern or the inverted-T (anchor) pattern. The larger and more ptotic the breasts, the longer the scars need to be to achieve optimal shape. The nipple and areola are elevated to a higher, more youthful position carried by a pedicle of tissue that preserves their blood supply and sensation.
Insurance Coverage
Patient with large breasts who have documented problems with their back and shoulders may qualify for insurance coverage for breast reduction, because the operation is considered functional rather than cosmetic. Dr. Rafizadeh's office assists patients in navigating the insurance authorization process. Documentation of symptoms, prior conservative treatments, and BMI requirements typically apply.
Risks & Considerations
The scars are the main side effect of any breast reduction procedure. Dr. Rafizadeh keeps scars the shortest possible while still achieving the best breast shape. There can be some reduction in nipple sensation, especially if the nipples are moved a long distance from their original position. Postoperative bleeding is the most common short-term complication; a suction drain is typically used and removed the following day. There are other complications that Dr. Rafizadeh has never experienced in his practice, such as nipple loss and fat necrosis. Hypertrophic scars or keloids are rare, and patients with a history of this type of scarring are counseled before surgery.
Recovery Timeline
Days 1–3: Soreness and swelling. A surgical bra is worn. A drain may be present.
Days 4–7: Drain removed. Most patients feel significantly more comfortable.
Weeks 1–3: Return to desk work and light daily activity. Driving resumes at 1–2 weeks.
Weeks 4–6: Return to full exercise. Final breast shape becomes apparent over 3–6 months.
