Several breast reduction techniques have been developed through the years, providing plastic surgeons with a variety of options for surgical treatment. Dr. Springer and Dr. Szczerba use two of these techniques most frequently the more traditional Wise pattern method and a newer scar reducing procedure (the SPAIR). In both, breast tissue and skin are removed from the lower and outer aspects of the breast. The remaining tissue is moved upward to create a smaller, more aesthetic shape. In some cases the size of the areola (the pigmented area around the nipple) is reduced as well in order to make it proportional to the smaller breast size. One of the major differences between these two procedures lies in the scar patterns that are left following surgery. The Wise pattern leaves an anchor-shaped scar pattern on each breast the scar encircles the pigmented part around the nipple, extends down to the crease under the breast and follows that crease from the inside portion of the breast to the outside. The SPAIR, on the other hand, eliminates the need for a long scar underneath the entire breast. Different breast and body types may require one technique or the other, so Dr. Springer and Dr. Szczerba will help you choose which one will provide the best result during your consultation.

Why consider breast reduction?

If you experience any of the following symptoms or conditions, you may be a good candidate for this procedure:

• Breasts that are too large for your body frame or are elongated or sagging.
  
• Pain in your neck, back, shoulders or even the breasts themselves due to their weight.
  
• Inability to participate in any physical activity due to the size and weight of your breasts.
  
• Inability to wear the clothing you would like due to the size of your breasts.
  
• Irritation of the skin beneath the breasts.
  
• Grooving in the shoulders from tight bra straps.
  
• Changes in posture due to the weight on your chest.
  
• Feelings of self-consciousness due to the size of your breasts.

While there are a few options available that can provide temporary or partial relief, none can take care of all of these symptoms. General weight reduction, although valuable to your health, affects only fatty tissue while leaving the breast tissue largely unchanged. Support garments are helpful in relieving some symptoms while they are worn, but often they are impractical and too uncomfortable for constant use. Many women use medication such as Tylenol or Motrin to provide temporary relief from their pain, but this is also an impractical long-term solution. Even liposuction removes only the fat, leaving the breast tissue, which is what largely makes up the size of the breast. Breast reduction permanently removes the excess breast and fatty tissue, allowing for long-term relief from the weight and size of the breasts.

Breast size is affected mostly by puberty and pregnancy, although other factors like menopause and weight gain can affect the size of your breasts. Breast reduction is very effective at any stage in life, although there may be specific circumstances that make it best to wait a short time before you undergo this procedure. Dr. Springer and Dr. Szczerba evaluate each case individually and will help you decide what time frame is best for your situation.

How do I select a competent plastic surgeon?

One of the most important components to your decision regarding breast reduction is the choice of your plastic surgeon. One way to ensure that you are with someone who can offer you the care you deserve is to select a physician who is certified by the American Board of Plastic Surgery. This is the only plastic surgery board recognized by the American Medical Association and the American Hospital Association in Plastic Surgery. The American Society of Plastic Surgeons (ASPS), and the American Society of Aesthetic Plastic Surgery (ASAPS), two prestigious national associations, require that all of their members pass the plastic surgery board exams. Choosing a surgeon who is a member of one or both of these associations ensures that he or she is well taught and has years of experience in the field of cosmetic surgery.

An equally important factor is your comfort level with the surgeon you chose. Make sure that you feel he or she has spent enough time speaking with you in your initial consultation, and that the physician understands your wishes and desires. You are having surgery, therefore you should feel like your needs are being heard and met. Ask to see photos of before and after pictures of other patients that had liposuction done. He or she should be willing to show some to you – make sure they are his or her own patients.

Do you perform the breast reduction procedure in a hospital or clinic setting?

Our reduction cases are performed in a hospital setting. The staff is very knowledgeable and compassionate, and the hospital fees have been negotiated so that our patients don’t have to pay a premium for the hospital care that they receive. Breast reduction is usually performed as an outpatient procedure, so the patients are sent home a few hours following surgery. However, depending on how extensive the procedure, it may be to your advantage to stay overnight.

How large are the scars and where are they located?

The incision pattern largely depends on how much tissue has to be removed and which procedure you and the doctor have chosen. In all cases, there is an incision around the nipple and areola that then extends from the base of the areola to the crease beneath the breast. In some cases, there is also a scar extending along part or the entire length of the crease. Dr. Springer and Dr. Szczerba will do the best they can to minimize the amount of scarring that will result. At the end of the procedure, the incision locations will appear as fine lines. The quality of the scar that results is unique to each person and depends on how your body produces scars.

What can I expect after surgery?

A few days after surgery, many patients complain of discomfort in the form of pain or sensitivity in the chest area. Some experience a small amount of discoloration or bruising for a couple of weeks following the procedure. Swelling and numbness in the area may last up to six to eight weeks before subsiding completely, although a majority of the swelling is usually gone within a month. For those who feel the need to wear a bra in the first few weeks, we ask that they choose a comfortable bra with good support in order to help the breasts mold to their new shape. However, some patients are small enough that for the first couple of weeks after surgery a bra is not necessary.

Numbness in the area of the nipple and areola is completely normal, and may continue for a couple of months or longer. In most cases sensitivity in this area does return, although occasionally sensation is never fully regained.

We usually ask our breast reduction patients to take about a week off of work immediately following the procedure. After a couple of weeks, moderate activity should be possible with minimal difficulty. Heavy lifting or cardiovascular workouts, however, should be avoided for about six weeks in order to ensure complete healing in the breast area.

Dr. Springer and Dr. Szczerba work very hard to create the most balanced look possible, but perfect symmetry should not be expected. Even if they could provide every patient with perfection, everyone’s personal features are naturally asymmetrical to some extent, so a perfectly symmetrical result following surgery would not necessarily be ideal. If larger imbalances in shape or size should occur, revisionary surgery can be done in order to create a more natural appearance.

What are my payment options for this procedure?

In some cases health insurance companies will cover the cost of a breast reduction. Many health insurance companies require a specified amount of tissue to be removed from each breast in order to provide sufficient justification for coverage (referred to as “medical necessity”). During your consultation we will discuss your individual medical needs and insurance policy with you, and help you to obtain coverage for the procedure if at all possible.

If you do not have health insurance, or your insurance will not cover your breast reduction, full payment for your breast reduction is required prior to your surgery date. However, Dr. Springer and Dr. Szczerba do offer another payment option in addition to cash, personal check or credit card. For many years, they have offered financing to their cosmetic patients, in order to allow for more flexibility in a payment schedule. When you come into the office for a consultation, we will discuss all of the prices with you and, if you are interested, give you the names of the financing firms with whom we work.

When will I see my final result?

In many cases, we don’t expect to see the final result until quite a few months have passed, due to some settling of the breast tissue and a small amount of residual swelling. The scars will continue to become lighter and thinner, long after the procedure is complete. However, relief from the symptoms caused by your breast size is immediate, allowing you to feel free from the size and weight. And as the days and weeks progress following surgery, you will feel lighter and more youthful. You will be able to participate in activities you’ve long since given up and wear clothing that you were previously unable to wear. Our hope is that this surgery will give you a newfound confidence in yourself and your body and will remove many limitations to your activities and your lifestyle.