Breast Reduction

Why Breast Reduction?

Many women seek out Dr. Fiala and Dr. Rhee for help with excessively large and heavy breasts.  Typical symptoms related to the weight of large breasts include pain in the upper back and neck, bra strap grooving, rounded-over posture, as well as difficulty exercising, feeling self-conscious about one’s appearance, and difficulty finding clothes that fit properly.

Breast reduction surgery can make the breasts smaller, lighter and give them a more uplifted shape.  The improvement in proportion, body posture and physical relief can be a dramatic transformation – breast reduction patients are some of the happiest patients!

I’m a DDD cup now. How small can I safely go with the breast size?

Typically, we aim for a proportional, feminine breast shape.  Often, we can get the breast size down to a small to medium C cup.

Will breast reduction guarantee that my back pain will go away?

Since there are many other causes of back pain besides breast size, no surgeon can absolutely guarantee that you will be pain free after breast reduction surgery.  However, if you get significant pain relief in your back when the breasts are totally supported, you should get a similar amount of relief after surgery.

Are there scars with breast reduction?

With the exception of liposuction-based breast reduction, yes, there are scars with breast reduction surgery.  The incisions are the trade-off we have to make in order to make the breast smaller, lighter and more uplifted.  Most commonly, the traditional “inverted T” pattern is used for women with large breasts and significant droop (ptosis).  We make every effort to make our incisions neat & tidy, setting the tissue up for optimal healing.

One breast is larger than the other. Can you fix that?

This is a common issue.  Often, the larger breast is also more droopy.  Correcting breast asymmetry is routinely performed at Fiala Aesthetics during a breast reduction operation.

Does the nipple stay attached to me, or is it removed and put back on?

In most cases, the nipple stays fully attached to you during the entire operation.  It lives on a bridge of tissue called a “pedicle”, which provides the nipple tissue with the necessary blood and oxygen.  Rarely, for women who are very, very large in their breast size, the nipple is removed.  This is called a “free nipple graft”, but as mentioned, is used less than 5% of the time.

Do I need to get a mammogram first?

We recommend a pre-op mammomgram for all women over age 35 prior to breast reduction surgery.

Do I need to stay overnight in the hospital for breast reduction surgery?

Not necessarily.  If you are in good health, breast reduction can be performed as an outpatient procedure, so you can go home the same day.  If you would prefer an overnight stay, this can be arranged for you.

I’m a smoker. Can I have breast reduction surgery?

Only if you quit smoking.  Smokers have a dramatically increased risk of wound healing problems, especially a bad complication called “nipple necrosis” – in which the nipple can turn black and die.  Dr. Fiala and Dr. Rhee both strongly recommend that you completely quit all smoking and use of nicotine for 2 months prior to surgery to reduce these risks.

I’m overweight. Should I lose weight first or have my breast reduction surgery first?

It’s far better if you can lose weight first.  As your weight decreases, the breast size and shape will change.  For most people, a 15-20 pound weight loss will make them about one cup size smaller.  When you are close to your ideal weight, Fiala Aesthetics can make a much more accurate assessment about how to re-shape your breasts, so that you will be happy with the final size and appearance.

I have stretched-out areolas. Can this be fixed?

Yes.  During the breast reduction, we can reduce the areolar size back to a normal, youthful-looking diameter.

Is the recovery from breast reduction painful?

Happily, no.  Most women are pleasantly surprised about the recovery.  Most women take a week off from work, and feel quite normal by this time.  Avoid physical activities that use the upper body until your incisions have fully healed, and Fiala Aesthetics gives you the OK to return to the gym.

One doctor says he can do breast reduction without scars. What do you think? Is that for real?

Yes – we offer that too. The so-called “scarless breast reduction” is essentially liposuction of the breast.  It is good for patients who need only a small reduction, who don’t have a lot of breast droop, have good skin elasticity and a breast that is mostly fatty rather than glandular in its composition.  It works better for post-menopausal women, rather than young adults.

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