Large breasts, medically known as macromastia, is associated with a range of musculoskeletal symptoms involving back, shoulder, and neck pain. The weight of the breasts eventually causes grooving of the skin across the shoulder from the straps of a bra which is weighted down. While insurance companies often insist on conservative treatment measures such as weight loss and physical therapy before approving surgery, only actual breast reduction surgery can truly alleviate the associated medical symptoms.
In my Indianapolis plastic surgery practice, breast reduction is a highly successful procedure that in every patient provides an immediate and long-term relief of painful back, shoulder, and neck issues. Having performed many breast reductions, I am convinced that the relief comes as much from the breasts being repositioned back up higher on the chest wall as it does from the amount of breast tissue and weight removed. A frequent question from some patients is whether the breasts are lifted up at the same time as they are reduced. The answer to that is…..absolutely! The design of a breast reduction (it is a very geometric operation) is such that a lift and reduction is performed at the same time. Like making a cone out of a flat piece of a paper, a wedge of skin and breast tissue is removed from below and the breast is brought together with the nipple being moved higher. (it is not quite this simple but this is a good way to think about it) This forces the remaining breast tissue higher up on one’s chest. While initially after surgery the breasts will look too full up on top (and the bottom of the breasts will look cut off or too flat), within weeks the breasts will round themselves out better. I never make a breast reduction look perfectly round at the end of the operation. If so, the breasts will bottom out later and no fullness on top will remain. You must factor in to the design of a breast reduction how the breasts will change after surgery to end up with a good-looking result.
All of this comes at a price….so to speak….and the price is the trade-off of extensive breast scarring. When I say, extensive breast scarring, I do not mean that the scars will look bad. I do mean that the amount (length) of the breast scars will be extensive. Fortunately, half of the breast scar lies along the lower breast fold where they are not seen. The visible remainder runs around the nipple and then vertically down to meet the lower breast fold. While I have performed very few breast scar revisions, patients need to have a good appreciation of the scarring to be certain that this is an acceptable trade-off.
Breast reduction is a very well accepted and successful surgery. The breasts can be reduced to almost any size that a patient prefers and one that is a better match to their body frame.
Dr. Barry Eppley