Macromastia is the medical term that describes an overly excessive breast size.

This is a condition that may cause a woman to have neck pain, back pain, shoulder pain, shoulder grooving, excessive sweating around the breast, and chronic rashes of the breast crease. Excessively large breast size can affect a woman’s ability to perform certain types of jobs, limit exercise tolerance, and even make it harder to breathe.

The purpose of breast reduction surgery is to remove the excess breast tissue and skin and restore the breast to a size more proportionate to one’s body. In most cases this will help to alleviate strain on the neck and shoulders, as well as enhance one’s body image, and perhaps even make it easier to find clothing that fit properly.

The type of incision most commonly used for this surgery resembles a “key-hole” pattern. (In select cases, depending on the size and shape of a woman’s breast, alternative types of incision patterns may be employed.) The nipple is usually left attached to a pedicle of breast tissue underlying it and placed onto a higher position on the breast. Thus, a breast lift is incorporated as part of the procedure. (In unusual cases where a woman has an exceptionally long breast, it may be necessary to reposition the nipple using a skin grafting technique.) The surrounding excess breast tissue and skin are removed.

Using this technique it is possible to make an enlarged or stretched-out areola more circular and proportionate to the size of the breast. When the incisions are closed, the resultant scar resembles that of an “anchor shape,” with there being a circular incision around the areola, a small vertical incision from the bottom of the areola to the crease, and a longer horizontal incision along the crease underneath the breast. The scars usually fade well over time, but certainly there is no expectation that they will be invisible. Therefore, a woman must take into consideration the degree of discomfort she is having and the need for the surgery in view of the potential for permanent scarring on the breast. Also there is a small risk of loss of sensitivity in parts of the breast, including the nipple, though the vast majority of patients tend to maintain their sensation.

This surgery is performed under general anesthesia, and most patients will be able to go home the same day as the procedure. It is wise to plan a 2-3 week period out of work for re-cooperation, and we advise waiting a minimum of 6 weeks after surgery before resumption of any aerobic exercise or strenuous activity.

Most women report that they have fairly good nipple sensation after they are healed from their surgery, and it may even be possible to breast feed. However, no physician could ever guarantee intact nipple sensitivity or lactational function postoperatively. If a woman is planning future pregnancies and/or breast-feeding, she should discuss this with her physician prior to surgery. Women who smoke may be at an increased risk for healing complications, and so it is necessary to advise us if this is the case prior to surgery.

In some cases health insurance will cover the cost of breast reduction surgery. This will depend on one’s health insurance plan, presence of symptomatology, overall breast size in comparison to one’s height and weight, and the amount of breast tissue one has removed. Different insurance companies have different requirements for member services to be covered, and not all insurance plans cover breast reduction operations. Also, there is no way any surgeon could ever guarantee a specific postoperative bra size, since there are so many variations in the sizing of bras and in the degree of tightness that women like in the type of bra they wear.

The health benefits that result from this surgery can be remarkable for women that have very large breasts. Many women come back and say they wish they had not chosen to put off having the surgery done for so long!