Excessively large, heavy, and pendulous breasts may often be painful, and frequently cause women significant back, neck, and shoulder pain, postural problems, skin rashes beneath their breasts, and even restrict their normal physical activities. In such cases, breast reduction, also known as reduction mammaplasty, can provide a more attractively shaped, better supported, more comfortable breast which is more proportionate to the rest of the body.
Because of the significant improvement in patient comfort which it can usually produce, insurance companies most often consider breast reduction to be a medically necessary reconstructive procedure, and may provide some degree of coverage according to individual considerations. The surgical approach for breast reduction is very similar to that of mastopexy, except that breast tissue (both gland and fat) is removed.
The nipple and areola must be moved to a higher position at or above the fold beneath the breast. This may be accomplished either by sliding the nipple and areola upward while attached to the underlying tissue (a “pedicle” technique) or by detaching the nipple and areola (a “free nipple graft” technique) according to the distance it needs to be moved and the consistency of the breast tissue itself. With either approach, an incision encircles the areola, extends vertically to the fold beneath the breast, and then extends horizontally along that fold. Dr. Gold does not use drains in his breast reduction surgery, and your only dressing afterwards is a supportive bra. Rarely, if the nipple position and skin tone is satisfactory and the breast volume is predominantly composed of fat and not glandular tissue, a “liposuction only breast reduction” may be performed through only a tiny incision in the crease beneath the breast. This approach is only used for rather minimal reductions in selected patients.
Men may also seek breast reduction surgery or recontouring of their chest because of excessive development of breast tissue on one or both sides, or because of excessive deposition of fat in the chest area. This condition, known as gynecomastia, may be treated either by liposuction alone (if due to fat deposition, or a “pseudogynecomastia”) or may require an “open” approach and surgical resection through an incision around the lower margin of the areola (if due to dense glandular tissue, a “true gynecomastia”). In extreme cases, excessively loose and sagging skin may have to be removed as well.