The woman who has decided to proceed with breast reduction surgery is faced with other important decisions such as; when to have surgery, who will she depend on for assistance, how to pick her surgeon, and what breast reduction procedure will she opt for?
Dr. Delgado presents this blog to help women understand what their options are for the different approaches to breast reduction surgery.
The traditional (also known as the anchor or inverted T) breast reduction is considered the “gold standard” and is most often used for a woman with very large breasts. The incision goes around the nipple areola complex (NAC), then vertically down to the breast crease and continues horizontally along the breast crease. The resulting scar would be in the shape of an anchor or inverted T. The amount of breast tissue that needs to be removed will determine how the nipple is to be treated. Preferably, it will be what is referred to as the inferior pedicle technique. The inferior pedicle technique allows the NAC to remain attached by a bridge of breast tissue called a pedicle and is moved up on the breast mound after the reduction. This technique keeps intact nerve and blood supply and, therefore, in most cases the woman will have preservation of her nipple sensation. Unfortunately, a woman with very large breasts may not have this option and may need what is called a Free Nipple Graft; in this case the NAC is completely removed and after the reduction, is grafted back into the desired position. The downside to this procedure is that sensation and the ability to breast feed are lost.
This is a 57-year-old, female resident of Santa Rosa, California who presented to the Novato office in Marin County for an evaluation for a breast reduction. She has size DD breasts. She underwent a breast reduction using an inverted-T technique. In addition, she also had a tummy tuck with liposuction of the flanks for improvement of her post-childhood years. She underwent the inverted-T breast reduction and tummy tuck with liposuction at Marin Cosmetic Surgery Center in Marin County, California. Note the nice shape to her breasts and her overall improved body proportions. These photos were taken one year after surgery.
The short scar (also known as the vertical) breast reduction is a popular procedure for women with moderately sized breasts. There is less scarring as the horizontal incision at the crease of the breast is avoided, resulting in what is referred to as a lollipop incision. This incision goes around the NAC and then vertically from the base of the nipple to the crease.
Scarless (liposuction) breast reduction is becoming increasingly popular as the technique for reduction with liposuction continues to improve. The advantages are many, scarring is minimal, recovery is much easier and the possibility of complications is greatly reduced. This option is usually for a woman with mild to moderate breast tissue that has a high fat ratio. However, if a large amount of fat is removed the skin will only contract to a limited extent and then will sag. When reducing the breasts by liposuction alone, there will not be any lifting of the breasts as can be achieved with traditional breast reduction.
This information is not meant to further confuse a woman as to what procedure is best for her, but to point out that there are various options and decisions to be made. A Board Certified Plastic surgeon that specializes in breast surgery will be able to inform a woman as to which choices she may be a candidate for and what results she can expect. It is a very individualized procedure; a consultation and exam will provide answers to your questions.