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Breast Reduction

Breast reduction is a procedure designed to relieve the discomforts caused by large, heavy breasts including:

  • Back, neck, and shoulder pain
  • Shoulder discomfort and indentations from bra straps
  • Skin irritation beneath the breasts
  • Enlarged areola (dark area around the nipple)
  • Restricted physical activity
  • In severe cases it can even affect nerves that go to the arms

Excess breast tissue, skin, and fat are removed to make the breasts smaller and to improve the associated conditions that are associated with large breasts.

Surgical Options

Several operations have been described for breast reduction over the years. Operations can be classified in several ways. Some are defined by the external scars that are left in the breast while others may be classified by various technical parts of the operation such as the way the blood supply is left or returned to the nipple.

Incision classifications

Inverted "T": This can also be called the anchor shaped incisions. These are the current standard incisions for breast reduction in the United States. They involve incisions that go around the nipple areolar complex(colored area) continuing vertically down the breast, and then horizontally along the crease underneath the breast. The excess breast tissue and skin is removed, the nipple is repositioned, and the breast is lifted and shaped.

Vertical incision: In some classes the reduction can be done without the horizontal component beneath the breast. This is called a vertical reduction mammaplasty. This operation is most popular in Europe and South America. It does limit the scars but is typically only applicable to smaller and medium breast reductions.

Apron Technique (elimination of the vertical portion): The Apron technique was actually published in the late 1980's by Dr Yousif, It was a variation of another technique previously described which eliminates the vertical portion of the anchor incisions. In Dr. Yousif's variation the breast must be low or "ptotic" to make it suitable for this operation. This technique is well suited for very large breast or very low breasts.

Blood Supply Classification

In the early days of breast reduction surgery, one major way of reducing the breast was to take the nipple areolar complex completely off the breast, reduce the breast size and place the nipple back on a s a skin graft. This is called nipple amputation. This operation is done very infrequently now and in most instances the nipple can be left on the breast and never leaves the body. In any surgery to the breast the blood supply to the nipple areolar complex must be maintained or regained. Currently, this is done by retaining a connection of the nipple to the body where the blood vessels are located. If this does not happen, the nipple will not survive. The connection of the nipple to the body is called the pedicle. The connection or the pedicle can be located beneath the nipple and this is called an inferior pedicle. The connection can be upward from the nipple and this is called a superior pedicle. These the most frequent but there is also an central pedicle and lateral pedicles.

The pedicle is only important to the patient on a technical sense to maintain the connection and therefore the blood supply and nerve sensation to the nipple.

Patient Testimonial

"Dr. Yousif does miracles. A few years back, I had a mastectomy and a lumpectomy on different breasts, leaving me uneven. Dr. Yousif fixed mistakes that were done by another surgeon. I'm very happy with my results. He has a passion for perfection!"

Dr. Yousif's Breast Sculpting Technique

Dr Yousif's breast reduction technique is a technique that he has developed over the last 15 years in which the tissue beneath the skin is anchored and shaped before the skin is draped over the newly position and sculpted breast tissue. Dr Yousif believes that this gives improved superior fullness and longer lasting results.

Initial Consultation and Insurance Coverage

At the initial consultation the patient's symptoms are discussed and an exam is done. If it is determined that this is an operation that may reduce symptoms and if the patient would like to proceed, photographs are taken and a request for coverage is made to the insurance company. Most insurance companies have their own criteria for coverage and the case is evaluated by symptoms, duration size of reduction and previous attempts at nonsurgical treatments are done. The length of time for approval depends on each insurance company. Once the approval is in hand the surgical date can be finalized.

Anesthesia and Surgery Facility

Breast reduction surgery is most comfortably performed under general anesthesia in a surgery center or hospital setting. Operative time for breast reduction is between 2 to 4 hours.

Most patients stay in the hospital overnight and are discharged the next morning.

Post-Surgery Care and Healing

Once your procedure is complete, bandages and light compression is be applied to your incisions. Small, thin tube(s) may be temporarily placed under the skin to collect any excess blood that may collect. These tubes are usually removed on your first post-operative visit following surgery.

Initial healing may include swelling and discomfort at the incision sites that can be controlled with pain medication. A support garment will be worn around the clock for the first two weeks following surgery, then an additional two weeks during the day only.

Limiting activity after surgery is extremely important. In fact, it may be the most important factor in achieving and maintaining a good result.

Final healing typically takes 4 to 6 weeks.