Are you considering breast reduction surgery? We’re here with our plastic surgery expert, Sabrina Pavri, MD, MBA, FACS, to walk you through all you need to know, from your candidacy for the surgery to recovery and results. Keep reading for Dr. Pavri’s expert insights.
Who are candidates for breast reduction surgery?
Dr. Pavri: Patients who have macromastia, or large breasts, and associated symptoms such as back/neck/shoulder pain from the weight of their breasts, rashes underneath the breasts and headaches and have tried conservative measures (such as medications, physical therapy, weight loss) to treat the symptoms associated with their large breasts without success, are candidates for breast reduction surgery.
What breast reduction techniques are there and for what purposes?
Dr. Pavri: In a breast reduction, part of the breast tissue is removed while preserving the blood supply to the nipple and areolar complex (NAC) and the remainder of the breast tissue, the NAC is elevated to the appropriate location, and the excess breast skin is removed.
Breast reduction techniques vary based on which blood vessels are used to preserve the blood supply to the NAC (inferior pedicle, superior pedicle, central mound pedicle), as well as which incisions are used to excise the excess skin (periareolar, lollipop/circumvertical, or wise pattern/anchor/inverted-T incisions).
How can patients prepare for breast reduction surgery?
Dr. Pavri: It’s important to stay healthy and eat a well-balanced diet with plenty of protein. Do not smoke or use any nicotine-containing products for at least four weeks prior to surgery.
What happens during the surgery and how long does it last?
Dr. Pavri: Breast reduction surgery is typically anywhere from 2 to 4 hours long. It’s an outpatient procedure using general anesthesia. During the surgery, the surgeon will remove part of the breast tissue, raise the NAC to the appropriate location, and remove excess breast skin.
What is recovery from breast reduction surgery like?
Dr. Pavri: Breast reduction surgery isn’t a particularly painful procedure, especially when regional adjuncts such as nerve blocks with long-acting local anesthetics and ERAS protocols are used.
You will have restrictions on heavy lifting and strenuous activity for about 4 to 6 weeks post-op. Depending on the intensity and physical demands of their job, patients may need anywhere from 1 to 6 weeks off work.
What are the benefits and risks of breast reduction?
Dr. Pavri: Benefits of the surgery typically include improvement or complete resolution of the patient’s neck/shoulder/back pain, and a breast size more proportional to their overall frame.
Risks are very unlikely, but include risks from general anesthesia, infection, pain, scarring, numbness, asymmetry, DVT/PE, hematoma/seroma, unsatisfactory aesthetic result, wound dehiscence, delayed wound healing, partial or complete loss of the nipple-areolar complex, fat necrosis resulting in areas of firmness, decreased or altered nipple-areolar complex and breast sensation, persistent neck and/or back pain, possible subsequent macromastia with time/pregnancy/hormones, and decreased ability or inability to breastfeed.
When will patients notice results?
Dr. Pavri: Most patients will notice improvement of their back pain immediately after surgery or within a few days. Swelling typically increases in the first 2 to 3 days and is completely resolved by six weeks.
Can you breastfeed after a breast reduction?
Dr. Pavri: Patients who undergo a traditional breast reduction and attempt breastfeeding later have the same success rates as women who have never undergone breast surgery, about 70%. The only exception is if the patient had a free nipple graft as part of their reduction (where the NAC is removed and reapplied in the correct position as a skin graft). These patients unfortunately won’t be able to breastfeed after surgery.
About Dr. Pavri
Sabrina Nicole Pavri, MD, MBA, FACS, is a board-certified plastic and reconstructive surgeon and the Medical Director of Breast Reconstruction at AdventHealth.
A highly experienced surgeon, Dr. Pavri has special expertise in both autologous and implant-based breast reconstruction after mastectomy, breast conservation techniques, cutaneous oncology and melanoma, and primary and revisional aesthetic breast surgery.
Dr. Pavri is a Diplomate of the American Board of Plastic Surgery, a fellow of the American College of Surgeons, and a member of the American Society of Plastic Surgeons, the American Society of Reconstructive Microsurgery, and the Society of Surgical Oncology. She is the author of multiple peer-reviewed publications, six book chapters, and is involved in both clinical and outcomes research, in addition to translational research through the UCF Biionix Cluster, investigating novel methods to mitigate radiation side effects in the oncology patient.
Schedule an appointment with Dr. Pavri today.
