Cassidy Mitchell, MD

Breast Reduction

Breast reduction surgery is designed not only to reduce the size of the breasts and eliminate the excess weight leading to symptoms such as back, neck and/or shoulder pain, but also to restore the overall shape of the breasts and place the nipple/areola back into a more youthful position.

Candidates for breast reduction surgery include those patients with large breasts that are often pendulous in nature with the nipples and areolas that lie low on the breast. Often, women will have symptoms of back, neck, and/or shoulder pain secondary to their breast size that may limit their ability to exercise. Some women develop skin irritations or rashes beneath their breasts which occur most commonly during summer months. Indentations in the shoulders from the bra straps (i.e. shoulder grooving) may also be present. On occasion, some women seek breast reduction surgery for breasts which they feel are too large and out of proportion to the rest of their bodies.

Breast reduction can be performed at any age, but it is usually recommended to wait until breast development is complete. Pregnancy and breastfeeding may have significant effects on the size and shape of your breasts. Some women may elect to have breast surgery prior to having children.  Breast reduction surgery may affect your ability to breastfeed; this point will be discussed at your consultation.

During the consultation, you will be asked about your desired breast shape and size. Dr. Mitchell will examine you, taking measurements and perhaps photographs for your medical record. The size and shape of your breasts, the quality of your skin, and the placement of the nipples and areolas will be carefully evaluated.  Other important factors that will be discussed include any personal or family history of any breast problems or diseases, previous surgery, plans for significant weight loss or pregnancy, and any breast imaging studies you may have had. Depending of your age and risk factors for breast cancer, a screening mammogram may be needed before surgery.

Once the examination is complete, Dr. Mitchell will discuss your options regarding different techniques and the placement of incisions. Potential risks and complications related to breast reduction surgery will be outlined. Dr. Mitchell will spend as much time as necessary to make you feel completely comfortable about your decision and answer all of your questions.

Surgical Technique / Incisions

There are numerous techniques for performing a breast reduction. In essence, all techniques remove breast tissue to reduce the weight of the breasts and help eliminate the symptoms caused by your enlarged breasts, as well as removing some skin to tighten the skin envelope covering the breast tissue. In addition, all techniques address the nipple and areola position by elevating the nipple/areola complex to a more proper position on the breast. The most common method of reducing the breasts involves three incisions. One incision is made around the areola. Another runs vertically from the bottom edge of the areola to the crease underneath the breast. The third incision follows the natural curve of the breast crease.  Dr. Mitchell commonly performs breast reductions without the horizontal scar (i.e. the vertical breast reduction). In addition, he utilizes the latest techniques of internal breast reshaping to give the best possible postoperative breast contour and longest lasting result.

Breast reduction surgery is typically performed as either an outpatient procedure or with an overnight stay in the hospital. All sutures are placed internally to avoid any painful suture removals. Dr. Mitchell always attempts to eliminate the use of surgical drains, however, for some, these may be necessary depending on the technique best suited for you. Some bruising and swelling can be expected, however, this is typically resolved within a couple weeks. With all procedures, the breasts may appear to sit initially high on the chest wall, but will descend over the course of the first month into a natural breast contour. Recovery is excellent, with most women returning to their normal activities within a few weeks. Furthermore, the pre-operative pain as well as potential rashes women experience are typically eliminated.