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Breast reduction surgery (medical term: reduction mammoplasty) is the removal of excess fat, glandular tissue and skin from the breasts. It is generally performed as a treatment to macromastia (i.e. having breasts that are disproportionately large with respect to the body size). Macromastia can have the following negative effects on the health and lifestyle of women:

• 1. Back neck and shoulder pain
  2. Irritation beneath the breasts (rashes)
  3. Deep furrows in the shoulders, caused by bra straps that have been weighed down by the heavy breasts
  4. Low-hanging breasts and stretched skin
  5. Chronic back, neck and shoulder pain
  6. Poor posture
  7. Restricted activity
  8. Low self-esteem
  9. Difficulty fitting into bras and clothing

Women who experience the above symptoms are good candidates for breast reduction surgery. Additionally, women who have one breast larger than the other might also wish to undergo breast reduction. The added advantage of reducing the amount of tissue in the breasts is the reduction of breast cancer risk (although this is not a method to reduce cancer risk).

The breast reduction surgery can be a very simple procedure, depending on your personal situation. It can be over in a matter of hours or you may have to stay overnight. The procedure is as follows:

• 1. Anesthesia (usually general anesthesia is needed).
  2. Incision (various techniques are used)
  3. Removal of tissue and repositioning of nipple and areola
  4. Closing of incisions (placing of sutures deep inside the breast tissue)
  5. Managing post-operative pain and swelling

After the surgery, dressings and bandages are applied to the incisions. A surgical bra may be used to support the breasts during the healing process. A small tube may be inserted in the breast skin to drain away excess blood or fluid that may collect. The surgeon is likely to give you specific instructions on how to care for your breasts during the healing process. This includes movement restrictions (less exertion), medications to apply or take orally and daily observation to look for signs of infection. Complete rest is needed after the intervention. Thus, you should be prepared to take at least one week off work. It you are able, more rest will accelerate the healing process. Moreover, after surgery, you should wear non-constrictive clothes and bras (loose-fitting and soft).

The results of breast reduction are usually long-lasting. However, the size of the breasts may fluctuate as a result of ageing, weight changes, hormonal changes and pregnancy. Breasts will normally increase in size during pregnancy and subsequent breastfeeding. Most women, however, return back to their original size after weaning their child.

As regards to costs of a breast reduction procedure, it is extremely variable. Most surgeons take the following factors into account in addition to their own fees:

• Surgical facility costs
• Anesthesia fees
• Medications
• Post-surgery garments
• Medical tests

If breast reduction is done in response to macromastia (and not solely for cosmetic reasons) the cost of breast reduction may be reimbursed by health insurance.

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