NYC Breast Reduction

Meet Dr. Daniel Y. Maman, Board-Certified NYC Plastic Surgeon

Dr. Maman completed a Harvard fellowship in aesthetic breast surgery as well as a 6-year plastic surgery residency at the Mount Sinai Hospital in New York City. He has appeared on The New York Times Top Doctors and Super Doctors in Plastic Surgery Lists.

Dr. Maman is certified by the American Board of Plastic Surgery-certified. This recognition is granted only after six years of rigorous education training in plastic and reconstructive surgery. He’s also a member of the American College of Surgeons, the American Society of Plastic Surgeons, and the American Society for Aesthetic Plastic Surgery.

Whether your reasons for breast augmentation surgery are personal, clinical, or both, you deserve an exceptionally well-trained, professional who is more than just a surgeon, but a partner in your care.

Contact us today to schedule your consultation.

What is a Breast Reduction?

According to the American Society of Plastic Surgeons, breast reduction surgery (reduction mammaplasty) is a hybrid cosmetic and reconstructive surgery procedure that removes excess breast tissue, fat, and skin from the chest to reduce the size of the breast. Breast reduction can also help reduce back and neck pain.

A reduction mammaplasty is both a medical procedure (eliminating chronic pain issues) and a cosmetic surgery (reshaping and improving breast appearance).

Reasons for reduction

Large breasts, known medically as macromastia or breast hypertrophy, can come with a host of negative side effects. For this reason, breast reduction patients are often eager to have surgery.

Poor posture and stressed musculature

Athletes get stronger by putting their muscles through a process called time under tension. Putting muscles under tension by lifting heavy weights in several sets of multiple repetitions causes microtears in your muscle fibers. After a workout, the body builds these fibers back stronger than before by sending nutrient-rich blood to repair them. That is why adequate rest is so important to an effective exercise program.

Large breasts can stress the body in a similar way. But unlike in a workout, having large breasts leaves the muscle fiber no time to repair. This constant extra pressure exerts tremendous downward force on the back (trapezius, rhomboids, latissimus dorsi) and shoulder (deltoid, teres major and minor, supraspinatus) muscles, weakening them and causing the shoulders to roll forward and the upper back to hunch.

This constant muscle fatigue increases the curvature in the spine, which in turn compresses the nerves of the thoracic spine and puts pressure on the tiny erector spinae muscles responsible for straightening your back. This skeletomuscular stress results in poor posture, tingling in your arms and hands, and intense back and neck pain.

Bad bras & skin grooves

Individuals with disproportionately large breasts also often find it difficult to find bras that provide enough support to ease the pressure on the muscles and spine. 

Even with properly fitted bras in the correct size, many people with macromastia find that their bra straps leave deep grooves, sometimes permanent ones, in the skin on their shoulders and/or around their back.

Rashes

Large breasts also constantly rub against the skin on the upper torso, creating the warm, moist environments that yeast infections thrive in. These infections, called intertrigo, appear as pink, red, or brown rashes that look like oozing, crusty skin and often are accompanied by burning, itching, stinging, and general sensitivity.

Exercise concerns

People with extremely large breasts often find exercise, especially high-impact exercise, uncomfortable. It can be difficult to find sports bras that provide adequate support, and some people have to wear two or three sports bras at a time. Exercising without sufficient support can also permanently damage breast tissue.

Large breasts can also make it harder to breathe while exercising because they weigh down the muscles and ribs, restricting the natural movement of your diaphragm. 

How does a breast reduction work?

Surgical breast reduction may employ any of the following techniques, which are similar to those used in breast lifts:

• A circumareolar incision is made around the areolas with a diameter large enough to excise the necessary tissue and skin. 
• An incision is made from the breast fold to the nipple-areolar complex, in a circle around the areola, and terminated at the breast fold to make a keyhole shape. The amount of reduction desired will determine the width of the keyhole. This is called a keyhole or lollipop incision.
• Three separate incisions (a circular one around the areola, a vertical one from the areola to your breast fold, and one horizontally along your breast fold) are connected to allow for the removal of a large amount of tissue and skin. This is called an anchor or T-incision.

Liposuction can be used as needed with any of the techniques above to remove excess fatty tissue. 

After the incisions are made and excisions are completed, the remaining skin and breast tissue is repositioned and sutured in place to support the new shape. The areolas are reshaped (if needed) and reattached higher on the breast, and then the incisions are closed. 

Breast composition and the amount of reduction desired determines the technique used in surgery.

How much smaller will my chest be after surgery?

Dr. Maman does not recommend reducing your breasts by more than three full cup sizes (for example, going from a DDD to C). While some women with extreme macromastia may want a larger reduction, removing too much breast tissue reduces the blood supply to the nipple and risks its survival.

A note about breast lifts

Most patients do not have to have a breast lift with their reduction mammaplasty because most breast reduction techniques include breast lift techniques. If you have extraordinarily large breasts, however, you may find that combining these two procedures is necessary to eliminate extra skin and tissue.

Breast reduction for men

Male breast reduction surgery, or gynecomastia, is similar to but slightly different from reduction mammaplasty. Visit our male breast reduction page for more information.