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Breast Reduction (for women and men)

For Women

Women seeking breast reduction may be experiencing back, neck or shoulder pain because of the size of their breasts. Their breasts may be too large in proportion to their body or may hang heavily, pointing downward causing bra strap indentations. Skin beneath the breasts may be irritated due to their size. Overly large breasts also may restrict physical activity or cause self-consciousness.

Breast reduction can be performed at any age once the breasts are fully developed. Some women opt for the procedure before childbirth, others wait. Women who intend to breast feed should discuss this with the plastic surgeon. Breast reduction should be performed only after women have completely discussed their concerns and expectations from the procedure. Women should also share their medical history during the consultation, including any breast biopsies or previous procedures, any plans for future weight loss, as well as discussing any current medications.

About the Procedure 
The procedure is conducted under anesthesia. Three incisions are usually used in breast reduction: one around the areola, one under the contour of the breast and one vertical incision. The nipple and areola usually remain attached to underlying tissue and moved upward as the breast is reshaped. This helps to preserve sensation and the ability to breast feed, though that cannot be guaranteed. After excess tissue, fat and skin is removed, the breast is reshaped using small stitches that will fade somewhat over time. Some may be hidden by skin pigment and the curve of the breast itself. Liposuction may be used to remove some of the fat leading to the arm, so the contours are consistent. All individuals are different and may require alternate techniques. In some cases, the vertical or horizontal incision might be unnecessary.

Concerns 
In rare cases, if breasts and areolas are unusually large, the nipple area may have to be removed completely and moved. In those cases, the woman would have decided to agree to the loss of sensation and breast feeding. As with any surgery, there is the risk of excessive bleeding, infection and complication. In some cases adjustments may need to be made in a later procedure. Candidates should fully discuss any concerns and understand the risks as well as the benefits before undergoing breast reduction.

For Men (Gynecomastia)

Gynecomastia is the clinical term for male breast overdevelopment. It can happen because of certain drugs or medical problems, but in most cases there is no known cause. It is not uncommon, affecting 40-60% of men. Plastic surgery to correct gynecomastia should be considered only after a complete physical exam excludes other possible reasons and more appropriate solutions. Men who are overweight or those who drink alcohol excessively or smoke marijuana are not good candidates for the procedure because those same factors often the cause of the problem and would contribute to it returning after surgery. After weight loss, one should wait at least a year before considering corrective surgery to ensure the body has stabilized.

About the Procedure 
The surgeon will usually order an x-ray to check the status of the breast and chest area, check for any other problems and help in determining techniques to be used. Smokers will be asked to refrain from smoking for at least six weeks before and some time afterwards to aid in healing. The procedure is usually performed under local anesthesia, but for extreme cases is done under general anesthesia in the hospital.

In most cases, the surgeon makes a small incision near the edge of the areola or in the underarm area and removes glandular tissue with a scalpel if that’s the cause of the problem. This is sometimes done by or in conjunction with liposuction. If larger amounts of tissue and skin need to be removed, more conspicuous scars may result. If the main cause is fat, then it is removed through liposuction. A tube attached to a vacuum pump is inserted in the incision and the fat is suctioned out. If large amounts of fat or tissue are removed, some skin may also be removed to adjust the contour of the breast. The incisions are closed with stitches, but a small drain may be inserted to eliminate excess fluids. The chest is wrapped with bandages to keep the skin in place.

After surgery, expect swelling and discomfort. Medication will help with pain and an elastic pressure garment may be used to help reduce swelling. It may be three or more months before the results of the procedure are apparent. Non-physical work can be resumed in about two days, but sexual activity should be avoided for a week, and any physical activity that could impact the chest should be avoided for six weeks.

Considerations 
Along with the risks of all surgery, breast reduction may leave noticeable scars or permanent pigmentation change. Sometimes breasts will not be symmetrical and a second procedure will be required to make them more balanced or remove more tissue. Some numbness or loss of sensation may be experienced for up to a year.

View a short animated video describing breast reduction procedures.

Contact Us

OMC's plastic surgery department can be reached Monday through Friday, 8:00 AM to 5:00 PM (except on holidays), at:

tel: 507.529.6740 

fax: 507.529.6741

Mailing address:

Olmsted Medical Center
Attn: Plastic Surgery 
1650 Fourth Street SE 
Rochester, MN 55904

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