Are heavy, sagging breasts
weighing you down?
Do you have large, pendulous breasts that are causing:
- Deep bra-strap grooves in your shoulders?
- Back or neck pain?
- Pain or discomfort while you exercise?
- Rashes under your breasts?
Breast reduction surgery, or reduction mammoplasty, can give you a higher, firmer, more youthful bustline. Women who have had this procedure are also freed of the physical and emotional discomfort of heavy, sagging breasts.
Imagine yourself running, exercising and wearing the fashions
you've always dreamed of wearing, without the burden of large, drooping breasts.
How is breast reduction surgery performed?
A breast reduction removes excess breast skin, tissue and fat and sculpts the breasts into a tighter, smaller shape. The nipples are repositioned to match the new breast shape and the areolas are usually reduced in size.
Although the nipple is relocated, it remains attached to the blood vessels and nerves and sensation may be affected. In breast reduction cases involving extremely large breasts, the nipple and areola may be removed and reapplied as a graft.
Dr. Rappaport often performs liposuction as part of a breast reduction to further sculpt the chest and underarm area.
Where are breast reduction incisions placed?
Dr. Rappaport uses several breast reduction incision techniques:
- The anchor technique—also called the Wise pattern or the inverted T—involves three incisions: one around the areola, one running vertically from the bottom edge of the areola to the crease under the breast, and a horizontal incision that follows the natural curve of the breast crease.
- The circum-vertical or lollipop technique involves two incisions—one around the areola and the other running from the bottom of the areola to the crease under the breast.
Is breast reduction an outpatient procedure?
In most cases, yes. Dr. Rappaport normally performs breast reduction surgery on an outpatient basis using general anesthesia, so you will be asleep during the entire procedure.
How fast is the recuperation after breast reduction?
Breast reduction is considered more extensive surgery than an augmentation or lift. Some patients may leave the surgery center with suction drains in the chest area to help reduce swelling, bruising and blood clots. These drains are normally removed a few days after surgery. In most cases, drains are not necessary.
Your stitches will be removed one to two weeks after surgery. You can expect to go back to work within a few days, depending on the type of work you do. Your scars will slowly fade over the next six to 12 months.
Does insurance cover breast reduction surgery?
In some cases, yes. You must meet two conditions to qualify for benefits for breast reduction surgery:
- Breast reduction must be a covered expense under your insurance plan; and
- If your plan covers breast reduction, you must meet the plan's criteria—and these requirements can vary greatly from one insurer to another.
How do insurance companies set their criteria for breast reduction coverage?
Insurance companies will cover breast reduction surgery only when it is deemed medically necessary, but each company has its own definition of “medically necessary.”
Requirements for coverage tend to fall into several categories:
- There is a national standard that the amount of body tissue removed in a breast reduction in relation to body surface area must be greater than the 22nd percentile to be considered as an indication for coverage.
- One insurer has set a requirement of 150% of the 22nd percentile standard.
- Some insurers have minimum requirements for the amount of breast tissue removed during a breast reduction, for example, 500 grams.
Can Dr. Rappaport's office help you apply for benefits?
Yes. To help you get pre-certified for insurance benefits, we will measure your height and weight and calculate your body surface area. From that number, we will calculate the amount of tissue for the 22nd percentile and make a clinical judgment on whether we think you will meet the standard for coverage.
Then we will submit that information, along with required photographs, to your insurance company.
If the insurance company authorizes the procedure, will it guarantee benefits?
An insurance company's authorization to proceed with breast reduction surgery is not a guarantee of payment.
There is no way to pre-determine the exact amount of tissue that will be removed in a breast reduction procedure—thus, it is impossible to know in advance whether a patient has met the insurance company's standard for coverage.
If the insurance company does not pay for the procedure, the patient is responsible for the cost of breast reduction surgery.
How can you speed up the insurance
pre-certification process?
Before you come in for your personal consultation with Dr. Rappaport, find out whether your insurance plan covers breast reduction—and if so, what the requirements are.
For example, you might need to go through a trial of conservative therapy, such as chiropractic care for back pain or treatment for skin rashes under your breasts, before your insurance company will consider you for breast reduction benefits.
You also might need a letter from a chiropractor or your OB/GYN to apply for breast reduction benefits. In that case, you can speed up the pre-certification process by bringing those letters with you to your consultation with Dr. Rappaport.
Dr. Rappaport answers questions
about breast reduction
How much scarring can I expect from breast reduction?
“Breast reduction does produce more noticeable scars than breast augmentation, but the incision lines will fade over time. Because the scars are at the level of the nipples or below, they will be easily concealed under clothing—even under most swimsuits and
low-cut tops.
“Keep in mind that the skin of an enlarged breast has been stretched over time. This increases your risk for raised, wide or irregular scars. But many women are willing to accept the trade-off of physical scars over the psychological burden of living with heavy, pendulous breasts.”
Will my breasts ever grow big again?
“Breast reduction is considered a permanent procedure. However, if you gain a significant amount of weight or become pregnant, it can affect the results of your surgery. It is very important to follow a healthy diet and exercise program after your breast reduction to help maintain your results.”
Can a breast reduction improve nipple sensation?
“In some cases, yes. The weight of a large, sagging breast can stretch the nerves to the point that there is no nipple sensation. If this is true for you, you might have sensation in your nipples after breast reduction surgery.”
Can a nipple die?
“Despite appropriate planning to maintain the circulation and nerve supply to the nipple when it is relocated, it is possible that the nipple can partially or completely die and/or sensation can be lost. This is very unlikely and if it did happen, there are
reconstructive options.”
Is there a minimum age for breast reduction?
“No. Although there is no minimum age for breast reduction, it is a good idea to wait until a young woman's breast growth is stabilized before having breast reduction surgery.”
