As a plastic surgeon who specializes in the breast reduction operation, I experience the journey with patient after patient. I know all of the stories and share in all of the joy. This is my daily path for understanding the benefits of breast reduction – the data proves it, too.
Research proves breast reductions don’t just improve confidence, they improve women’s quality of life. How? The procedure improves women’s physical and mental well-being after years of chronic pain and reduced self-esteem. It’s no wonder breast reductions have one of the highest satisfaction rates of all procedures.
Yet, too often, women are dissuaded from the procedure by myths and false realities.
I’ve seen it time and time again in my own practice in New York City. A patient will arrive at her initial consultation full of worry and questions shaped by misconceptions she’s read in the news or seen on TikTok — some even attribute the latter to their delay in making the appointment.
It’s time to address these misconceptions head-on and empower women to make informed decisions about their bodies and their health.
Contents
Myth 1: Breast Reductions are Not Medically Necessary
Contrary to public belief, breast reduction surgery isn’t solely a cosmetic procedure; it has significant health benefits. More often than not, many women undergo this procedure not out of vanity but to alleviate physical discomfort and emotional distress caused by disproportionately large breasts.
From chronic pain in the neck, back, and shoulders that bras don’t help, massages can’t fix and physical therapy can’t undo to chafing, rashes, and skin break-down under the breasts and bra straps that no ointment or powder can solve. Did you know that even your migraine headaches could be related to the weight and position of your breasts? Adolescent and young women with oversized breasts draw unwanted attention that they cannot avoid. Large breasts can profoundly impact a person’s overall well-being, causing limitations in daily activities and self-esteem issues.
Myth 2: It’s a Lengthy, Painful Process
When patients visit my office, one of the first questions they ask is: “How long will I be out of commission?” with a grimace on their faces, imagining the pain.
While any surgical procedure is likely to involve some degree of discomfort and recovery time, surgeons who have undergone specialty training for breast reduction are prepared to perform this operation with modern techniques and pain management strategies to reduce both.
The operation is performed under general anesthesia, but during this, I add my own method of long-acting regional anesthesia that blocks most of the perception of pain to the breast. No one wakes up in pain. Everyone goes home comfortably, and throughout the recovery, most of my patients do not take a single pain pill. The benefits are immediate, the moment you wake up from anesthesia, you feel the difference.
I never use drains in breast reduction surgery. There’s simply no need for them, it’s an antiquated thought process. Drains aren’t helpful in this surgery, they’re more trouble than they’re worth. You wake up with a special type of waterproof tape covering your incisions, and you’ll be in a surgical support bra. Two days after surgery, you can take a shower and use your favorite soap and shampoo. Even on the first night after surgery, you can sleep flat on your back or on your sides, but you can’t sleep on your belly for a few weeks. I know how sad this news is for belly sleepers.
Most patients are back to work or school in 4-5 days. This can vary depending on the physical requirements of your job. Some people take off a week to be safe.
You can return to light exercise (think cardio) at two weeks and unrestricted physical activity (yoga, impact exercise, helping your friend move her apartment) at four weeks.
Myth 3: Your Nipple Will Be Removed or Lose Sensation
While the image of a nipple falling off post-reduction can stoke fear, it’s completely unfounded, just as the misconception of lost nipple sensation is grossly overstated.
When you do this operation more than any other, with that comes an enhanced understanding of how to do it safely, even in the most challenging cases. Your operation is designed for you on your day of surgery and I design it based on your anatomy. This allows me to optimize the amount of reduction and the shape and position of the finished breast while maintaining the critical dimensions of breast tissue to ensure your breast mound and nipple will get the blood flow it needs to heal without incident.
Most patients maintain normal nipple sensations after surgery. However, the specialized nerves that lead to the nipple are sometimes too small for the naked eye; their course to the nipple is variable, they cannot be identified, and thus they cannot always be preserved. Fortunately, there are multiple nerves that contribute to nipple sensation. Some patients do have some changes in their nipple sensation, and if there is some loss of nipple sensation, it usually improves as time goes by. When performing this operation with the most progressive technique, permanent sensation loss is rare.
Myth 4: You Can’t Breastfeed Post-Reduction
Hand in hand with lost nipple sensation, one of the most common fears I hear in my office is: “Does this mean I won’t be able to breastfeed?” With the right surgical approach, the answer is no.
During the procedure, techniques utilized to preserve glandular tissue and milk ducts can help ensure women will be able to breastfeed post-surgery successfully. One of the most impactful innovations in breast reduction surgery in the last century was the redesign of the procedure to preserve the upper-inner breast tissue, which remains as one continuous piece of the breast with gland and ducts that lead uninterrupted to the nipple. This means you should be able to produce and deliver at least some breast milk. Remember, your breast is also going to be about a third of the current volume so there’s going to be less breast for milk production.
This is a major departure from the procedure designed in 1949 and still most commonly performed across the US, which keeps only a portion of mostly fat from the underside of the breast and uses it to make a breast mound. Still, there is very little actual breast tissue in the lower part of the breast and the nipple becomes nearly detached from the ducts that should lead to it.
Just as with any procedure, it’s important for patients and their surgeons to have an open, honest conversation to alleviate anxiety and guide informed decision-making – especially when it relates to something as important as the impact on motherhood.
Myth 5: The Older, the Better
Many times, I’ve had women walk into my practice and express regret for waiting so long to go forward with the procedure. Nine times out of ten, it’s because of the misconception that women should wait until they’re older to undergo a reduction. I’ve heard from patients that their primary care doctors told them they’re too young to have breast reductions. I tell them that they should tell their primary care doctors to carry the breasts around for a while and see for themselves what it’s like.
While the ideal age for a breast reduction is determined by individual circumstances, some women may qualify for a reduction even in their teens. That’s because, ultimately, our focus is reducing the physical and psychological impact of overly large breasts on a patient’s well-being.
I’ve heard that sometimes women are told they need to wait until after they are finished with having children to have breast reduction surgery. This just isn’t reasonable advice. In fact, I am told quite frequently after surgery that patients wish they had done it sooner. I have had a number of patients who thought they should wait until after their last child was born. They all say by the time you add up all of the years from the first pregnancy until they’re ready for surgery after the last pregnancy, it’s always several years longer than they thought it would be, and they wished they didn’t wait.
Whereas it’s true that pregnancies may change the breasts after surgery, the pregnancy-related size and weight changes associated with a massive breast are likely to be much more difficult to bear than that of a reduced breast. When performed correctly the first time, it’s safe to do a second surgery later in life if it’s even necessary.
To those who advocate putting the surgery off, I ask the question … Why shouldn’t a young woman undergo an operation with an incredibly low-risk profile and benefit from an immediate alleviation of back, neck and shoulder pain, an improvement in their posture, fewer headaches, no more sweaty rashes or shoulder grooves, better fitting clothing, less unwanted attention, improved self image, etc., etc. for all of the days from today until sometime after her last child is eating solid food?
I have never had a patient share that she has regretted doing this operation and I am told daily how much it improves your life.
Breast reductions are a personal choice – make the right decision for you
Deciding to get a breast reduction is not always an easy choice. It often comes after years of pain, doubt, and lowered self-esteem.
The best we can do as surgeons (and peers) is to dispel the misconceptions and myths we observe in daily life that make the decision that much harder. By replacing myths with medically grounded information, we can empower women to make informed choices for a more comfortable and confident life.