As a plastic surgeon, one of the most rewarding procedures I perform is breast reduction surgery. Patients who have overly large breasts, also known as “macromastia,” often find the surgery to be a positive, life changing decision. In addition to self-image issues, patients who suffer with macromastia experience physical pain and discomfort.
The weight of excess breast tissue can impair a woman’s ability to lead an active life. The emotional discomfort and self-consciousness often associated with having very large breasts can be as important an issue as the physical discomfort and pain. Breast reduction surgery removes the excess breast fat, glandular tissue and skin to achieve a breast size more in proportion with your body. The goal of the surgery is to alleviate the discomfort associated with macromastia.
Women who are otherwise healthy and don’t smoke are good candidates for surgery, especially if they are bothered by the feeling that their breasts are too large, that they limit physical activity, and if they experience back, neck and shoulder pain caused by the weight of the breasts. Many women develop shoulder indentations from heavy bra straps. Skin irritation beneath the breast crease is common.
Most health insurance plans cover breast reduction surgery. Authorization is required before the surgery can be scheduled, which usually requires a letter and the submission of photographs. Once an authorization is obtained, the patient is still responsible for any co-pays or deductible required by the insurer. If the patient’s health plan does not cover breast reduction surgery, the patient may decide to pay for the procedure herself.
When I meet with a patient for the first time to discuss breast reduction surgery, I ask her why she wants the surgery, and to tell me about her expectations and desired outcomes. I need to know about any medical conditions, drug allergies, current medications, vitamins, herbal supplements, alcohol, tobacco and drug use. Knowing about a family history of breast cancer and the results of any mammograms or previous biopsies is also helpful information to provide during the consultation.
During the visit, I evaluate the patient’s general health status and any pre-existing health conditions or risk factors. I take detailed measurements of the size and shape of the breasts and of the skin quality. I take photographs for the medical record. I’ll discuss surgical options, likely outcomes and associated risks, and recommend a course of treatment. The decision to have breast reduction surgery is extremely personal. My goal is to help my patients to decide if the benefits will achieve their goals and if the risks of breast reduction surgery and potential complications are acceptable to them.
It’s natural to feel some anxiety when considering surgery, whether it’s pre-operative stress about the unknown, or excitement about the anticipated outcome. My best advice to women who are considering breast reduction surgery is to be sure to ask questions! It's very important to address all of your concerns directly with your plastic surgeon before surgery, so that you can feel confident that you are making the best decision possible.
Julia Toto, MD, is a member of the Bristol Hospital Medical Staff, and a plastic surgeon with ProHealth Physicians Plastic Surgery, which is located at 291 Queen St, Bristol, and 21 South Road, Farmington. Dr. Toto will be hosting a free seminar entitled, "Plastic Surgery Myths 'Busted.’” This free presentation is open to the public and takes place at 5:30 pm, Tuesday, April 17, in the Bristol Hospital Hughes Auditorium, 41 Brewster Road. TO RSVP or for more information, please call 860-583-1845.