Breast Reduction
Breast reduction illustrates the essence of cosmetic and reconstructive plastic surgery. The removal of excess breast tissue can help balance body proportions and improve the aesthetics of the breasts. And at the same time, it can reduce or eliminate back and neck pain symptoms that are often the result of redundant breast tissue weight. Many patients also have improvement in headache pain, are able to more effectively exercise, and can function more effectively in social situations.
Why choose Dr. Stoeckel?
Dr. Stoeckel uses a technique for his breast reductions that is similar to that described by Dr. Elizabeth Hall-Findlay. It is a modified vertical pattern technique that he believes to be superior in many ways to the more common technique used by most surgeons (inferior pedicle or Wise pattern breast reduction). The vertical reduction has a more robust blood supply that lowers the risk of both nipple compromise and fat necrosis, and it utilizes internal suturing methods that both improve the shape of the breast and lower the risk of the shape flattening over time. In most cases, the horizontal scar along the crease of the breast is not needed with this technique. Avoiding this scar improves the aesthetic result, decreases the recovery and healing time, shortens the length of the surgery, and lowers the surgical risk of post-operative complications.
Dr. Stoeckel's Breast Reduction ResultsWhat conditions can breast reduction surgery improve?
Gastric lap band patient who had breast reduction and abdominoplasty surgery
Effects of massive weight loss
Many patients that have undergone significant weight loss notice that much of their heavy breast tissue remains even after they have reached their weight loss goals. The breast and body skin is often quite lax. These patients often combine a breast reduction surgery with other skin removal surgeries such as a tummy tuck.
Right breast reduced slightly more than the left
Breast asymmetry
Almost all women have one breast that is slightly larger than the other. When the asymmetry is significant, breast reduction surgery can correct the disparity in breast size. This can make shopping for both bras and clothing much more pleasant. Although breast augmentation with variable sized implants is also a method of correcting size asymmetry, it is typically not as effective as breast reduction procedures.
Conservative breast reduction with correction of asymmetry
Slightly too big for body frame
Some women’s breasts are just slightly bigger than ideal and these patients want to undergo a conservative reduction in volume so that they can just feel more comfortable in their own skin. Many of these patients have back and neck pain symptoms, but many of them do not. A conservative reduction can still make a large impact on improving quality of life.
Removal of over 5 lbs of breast tissue with vertical reduction procedure
Severe breast hypertrophy
Others have breast sizes that are almost debilitating and completely out of proportion to the rest of their bodies. Breast reduction surgery for these patients can be truly life changing. Many patients with severe hypertrophy have back and neck pain symptoms that completely alleviated with the breast reduction surgery. Insurance often covers the cost of surgery for these individuals.
Repeat breast reduction 20 years after a Wise pattern reduction. Notice the improvement in shape and areolae size with the vertical technique.
Recurrent breast hypertrophy
Most patients that have breast reduction surgery have permanent improvement and results. But some breast reduction patients find that after either weight gain or pregnancy, their unwanted breast volume can recur. Repeat breast reduction surgeries can be completed safely and the vertical technique can be used even if another technique was used for the first reduction.
Will insurance cover the procedure?
Many patients are interested in obtaining insurance coverage for their breast reduction procedure. And many are able to do so. But there are a few steps that need to be taken in order to obtain insurance approval. Not all insurance companies or insurance plans are the same. But most of the criteria for medical necessity are similar between them.
- Patients need to either have significant back and neck pain that is affecting their daily lives or have rashes under the crease of the breast that can not be improved with topical therapies or medications in the form of powders or creams.
- There is sufficient documentation of the severity of the above conditions by a physician, physical therapist, chiropractor, physician assistant, etc.
- Non-surgical treatments have been attempted that have not been effective such as appropriate support bras, anti-inflammatory medications, exercises, and heat and cold application. Documentation of these therapies is required and often needs to encompass a certain amount of time, often greater than 6 weeks.
- If the patient is overweight (typically with a BMI greater than 27), either the weight must be lost or attempts at weight loss must be documented. Usually the weight loss attempt must be for at least 3 months and needs to be documented by a physician, weight loss specialist, nutritionist, or other medical professional
- The amount of breast tissue to be removed is enough to be considered medically necessary based on a scale utilizing the height and weight of the patient.
- More information about BCBS coverage of breast surgeries can be found at: https://www.bcbsnc.com/assets/services/public/pdfs/medicalpolicy/breast_surgeries.pdf
Patients that do not meet these requirements and cannot obtain insurance coverage can still benefit from the surgery as a self-pay procedure. And most patients are pleasantly surprised that the costs are not as much as might be expected in Dr. Stoeckel’s practice.
Can breast reduction alter nipple sensitivity?
Breast reduction surgery rarely causes problems with nipple sensitivity. The statistical reports suggest that nipple sensation could be affected in as many as 5-20% of patients, but Dr. Stoeckel sees this issue much less frequently. The chances of altering sensation are more likely with greater tissue resections. But interestingly, in many extremely large reductions, the sensation actually improves. This may be a result of relieving the tension on stretched nerves associated with very large breasts.
Can patients breast-feed after breast reduction?
Breast reduction surgery does not affect breast-feeding in the vast majority of patients. Although inability to breast-feed after surgery is a risk, the vertical technique that Dr. Stoeckel uses typically preserves the milk ducts, glandular tissue, and nervous structures required for breast-feeding. It should be noted that up to 10% of women are unable to breast feed even without having breast surgery.
Does breast reduction affect breast cancer detection or treatment?
Breast reduction surgery does not increase the incidence of breast cancer. The internal scarring from surgery can be seen on radiographs and can minimally complicate the interpretation of mammograms. Dr. Stoeckel recommends obtaining a baseline mammogram for patients over the age of 35 to help minimize this issue. The more important thing for patients to know is that having a breast reduction can certainly affect the choices for treatment if breast cancer is ever detected. Breast cancer patients that have had breast reduction should almost always have a complete mastectomy and are not good candidates for lumpectomy surgery.
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