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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.
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.
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.
We make sure you have the information you need to feel informed about your decision, from your inquiry about our practice through consultation and recovery.
The first step is a thorough, collaborative consultation. Before surgery, we provide:
- 60- to 90-minute in-depth initial consultations with a complete medical history review and physical assessment by Dr. Maman
- Multiple pre-op visits to answer all your questions
- Specialized surgery coordinators to help you navigate scheduling, financial, and insurance processes
Once you have decided to move forward with surgery, we emphasize convenience, comfort, and a smooth recovery. This includes:
- Convenient NYC operating facilities
- Luxury recovery room options at NYC hotels
- Complimentary, custom post-operative support garments and scar treatment regimens
- Attentive and routine aftercare visits
Personalized, Holistic Patient-Centered Approach
Understanding each patient’s personal and clinical needs is central to our practice. We customize treatment plans for each patient, and each patient receives Dr. Maman’s personal contact information along with direct round-the-clock access to our nurse and surgical coordinator.
“He is the authority in his field and has my trust and loyalty from now on. I love my refreshed, natural results.”
Results and Recovery
Our priority is to provide the highest degree of comfort for our patients throughout their breast reduction procedure and recovery.
We schedule multiple pre-op appointments to make sure that our patients are fully informed and know exactly what to expect from the procedure. We also stay in close contact during the pre-op period in order to ensure that each patient receives prompt and personalized care.
Once surgery is complete, local patients have the option to recover at home in NYC or in one of our luxury recovery rooms located in select hotels in the city. Recovery timelines vary depending on procedure, and our thorough aftercare options ensure optimized recovery and results.
For more information, read our FAQs below.
See our results. Contact us to find the right approach for you.
Breast Reduction Gallery
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 and is 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 experienced surgeon who is a partner in your care.
Contact us today to request a consultation.
Breast Reduction FAQ
How much do you charge for a breast reduction surgery?
The price for breast reduction surgery depends on the amount of reduction and time it will take. After your initial consultation with Dr. Maman, our specialized surgical coordinators will provide you with an itemized price quote.
Am I a good candidate for breast reduction surgery?
Although meeting with Dr. Maman is the best way to determine if you are a good candidate for a breast reduction procedure, patients who are generally healthy non-smokers and whose breasts limit their physical activity or cause back, neck, and shoulder pain qualify.
There is no “perfect” age for breast reduction surgery. As long as your breast size has not changed for six months, a consultation can help you decide if you are ready for surgery. Younger patients with macromastia often benefit greatly from reduced breasts, as it allows them to avoid years of skeletomuscular pain and skin irritation.
Do insurance plans cover a breast reduction?
Every insurance company is different, and the best way to see if your plan covers reduction mammaplasty is to meet with our surgical coordinators.
But generally speaking, breast reduction surgery is only covered if you can demonstrate your breasts are causing medical issues that cannot be resolved with less invasive treatment. You will be more likely to receive approval if you can provide documentation of treatment from physical therapists, chiropractors, dermatologists, and/or orthopedists as well as the purchase of specialized bras and other supportive garments.
Will my breast reduction be permanent?
Breast reduction surgery is considered a permanent surgery, but it is important to know that your breasts can change size and shape as you age or if you gain/lose significant amounts of weight.
Surgical Procedure FAQs
Does breast reduction include areola reduction?
Many women with large breasts have stretched, distended, puffy, or protruding areolas. Because a breast reduction almost always involves incisions around your areola, it is easy to reduce the diameter of your areolas before repositioning them higher on the breast and closing incisions.
Do breast reductions affect nipple sensation?
It is common to experience some numbness in your nipples immediately after your surgery, but most patients find sensation returns within a few months. If preserving nipple sensation is important to you, make sure you bring it up in your consultation with Dr. Maman. He can make sure your surgical procedure plan uses techniques more likely to preserve feeling in your nipples.
Can I still breastfeed after a breast reduction?
As long as your nipple-areolar complex is not fully removed, you should expect to be able to breastfeed after your surgery. It is important to let Dr. Maman know if you hope to breastfeed in the future, as that will impact the techniques used for your surgery.
Where will my surgery be performed? How long does breast reduction surgery take?
Dr. Maman usually performs breast reduction surgeries at an in-office, AAAASF-certified facility or an outpatient ambulatory surgery center (ASC). He also has operating privileges at Mount Sinai Hospital, Lenox Hill Hospital, New York Eye & Ear Infirmary, and Englewood Hospital. We work with you to select the best facility for your needs.
How long your breast reduction surgery will take depends on how much of a change you are hoping for, but you can generally expect to spend around three hours in the operating room under general anesthesia. Combining your reduction with another procedure like a breast lift or tummy tuck will obviously make your surgery longer.
Can I combine my breast reduction surgery with other surgical procedures?
While it depends on what type of procedures you are hoping to combine, the answer is generally yes. Combining procedures can minimize overall recovery time and reduce costs. Dr. Maman will work with you to find the best way to achieve your cosmetic goals with the least amount of operating time so you can get back to living your life.
How long does recovery take?
While you may notice instant relief from your back, neck, and shoulder pain, and while patients usually find their recovery easier than anticipated, breast reduction is still a major surgery. To get the best results, it is critical that you strictly follow all Dr. Maman’s post-operative instructions.
Patients generally return to light office/home life within a week of surgery and an almost regular schedule after approximately three weeks, but it is normal to experience swelling, soreness, and tingling for up to three months. It is also normal for your breasts to heal at different rates, so do not let initial differences in size or shape between them alarm you. We recommend patients wait to splurge on an entirely new bra collection until the swelling is fully resolved.
When can I work out after a breast reduction?
As excited as you might be to wear only one sports bra to work out, easing back into your fitness regimen will ensure proper healing. You can resume light, lower-body only workouts after two weeks and full exercise without restriction after four weeks.
How do I treat scars after surgery?
Dr. Maman will provide you with detailed scar treatment protocols, medical-grade creams, and tapes to minimize your scarring.
Will the surgery require follow-up visits?
Because we value our patients’ health and satisfaction above everything else, we do not charge for post-operative visits, whether they are part of your detailed follow-up plan during the first year after surgery or the annual visits that we recommend to ensure your final results are maintained.
General FAQ page
For questions about scheduling a consultation or more information about our practice, please visit our frequently asked questions page.
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