UVA Aesthetic Plastic Surgery
650 Peter Jefferson Parkway, Suite 200, 2nd Floor
Charlottesville, VA 22911
Phone: (434) 924-5078
Monday–Friday | 8 a.m.–4 p.m.
Breast reduction is a breast surgery that decreases breast volume while reshaping and lifting the breasts to relieve physical and emotional discomfort. The nipple and areola are usually repositioned, and an enlarged areola can be reduced when appropriate.
| Term | Definition |
|---|---|
|
Breast hypertrophy |
Breasts that are disproportionately large and may cause physical or functional symptoms. |
|
Nipple-areola complex |
The nipple and surrounding pigmented skin. |
|
Vertical incision |
An incision extending from the areola to the breast crease. |
|
Inframammary incision |
An incision placed within the crease beneath the breast. |
|
Pedicle |
The bridge of tissue that preserves blood supply and nerve connections to the nipple-areola complex during surgery. |
|
Free nipple graft |
A technique used in selected very large reductions in which the nipple and areola are transferred as a skin graft. |
Breast reduction can address a range of concerns, which commonly include:
Breast reduction may be appropriate for patients who:
Your consultation includes an assessment of breast size, skin quality, nipple position, asymmetry, chest-wall anatomy, symptoms, and desired breast size. These factors help determine the safest surgical plan and the amount of tissue that may be removed.
At UVA Aesthetic Plastic Surgery, our highly regarded surgeons offer expertise and personalized care for a rewarding patient experience.
Our surgeons using the following incision patterns, personalized to the patient’s needs and cosmetic preferences:
The vertical or “lollipop” incision extends around the areola and down to the breast crease. It is commonly used for selected reductions.
The anchor incision pattern, which goes around the areola, vertically down, and along the breast crease, is often used when a larger amount of tissue or skin must be removed.
Your surgeon will recommend the scar pattern that safely allows the necessary reduction, lift, and reshaping. Breast reduction scars are permanent, but they generally soften and fade over time.
Breast reduction is performed under general anesthesia, usually as an outpatient procedure. Excess breast tissue, fat, and skin are removed, the remaining tissue is reshaped, and the nipple and areola are moved to a more youthful position while typically remaining attached to their underlying blood supply. It combines a reduction in volume with many of the same principles used in a breast lift.
For very large reductions, the nipple and areola may need to be removed and repositioned as a free nipple graft. This approach can reduce the risk of tissue loss but results in loss of breastfeeding ability and significant loss of nipple sensation. It is not needed for most patients.
Once the reduction is complete, the incisions are then closed in layers. Liposuction may be used to refine fullness near the sides of the breasts or chest.
Depending on your goals, breast reduction may be combined with:
Women also combine breast reduction with tummy tuck or liposuction as part of comprehensive body contouring. Our surgeons may stage procedures when combining them would impact the safety of the surgery or recovery.
Patients can expect 1 to 2 weeks of downtime after a breast reduction before being cleared to return to nonstrenuous jobs and activities.
Week 1
Weeks 2-6
Long Term
Potential risks include bleeding, infection, delayed healing, widened or raised scars, asymmetry, contour irregularity, changes in nipple or breast sensation, loss of nipple or skin tissue, fat necrosis, fluid collections, difficulty breastfeeding, recurrent sagging, and the need for revision surgery. Perfect symmetry and an exact cup size cannot be guaranteed.
Breast reduction does not eliminate the need for routine breast health screening. Patients should continue age- and risk-appropriate mammography and tell the imaging center about prior breast surgery. The ability to breastfeed may be reduced after breast reduction and cannot be guaranteed. Pregnancy, breastfeeding, and major weight changes may also alter the surgical result.
Breast reduction can provide both functional and aesthetic benefits. Many patients notice improvement in neck, shoulder, or back discomfort and find it easier to exercise and wear clothing. While the surgery can improve differences in size, shape, nipple position, and areola size, perfect symmetry is not possible; some differences commonly remain after surgery.
The amount of reduction depends on your anatomy, symptoms, goals, and the amount of tissue that can be safely removed. Bra cup sizing is not standardized, so an exact postoperative cup size cannot be guaranteed.
Liposuction alone may be appropriate for a small group of patients with fatty breasts, good skin elasticity, and little sagging. It does not reshape or reposition the nipple or remove excess skin and is not suitable for most standard breast reductions.
Temporary changes in nipple or breast sensation are common. Permanent decreased, increased, or absent sensation can occur, particularly with larger reductions, although many patients retain useful sensation.
Some patients are able to breastfeed after breast reduction, but milk production may be reduced and the ability to breastfeed cannot be guaranteed. Surgical technique, the amount of tissue removed, and individual anatomy all play a role.
Coverage varies by insurance plan. Some insurers require documentation of symptoms, nonsurgical treatments, and a minimum estimated tissue-removal amount. Authorization does not guarantee payment, and patients should confirm benefits directly with their insurer.
It is often helpful to be near a stable, maintainable weight before surgery. Future pregnancy, breastfeeding, or major weight loss may change the result, but timing is personal and can be discussed during consultation.
To learn more about breast reduction at UVA Aesthetic Plastic Surgery in Charlottesville, request a consultation with one of our plastic surgeons or call (434) 924-5078 to schedule an appointment.
