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 Wake Plastic Surgery?

Our board certified plastic surgeons use a technique for their breast reductions that is similar to that described by Dr. Elizabeth Hall-Findlay. It is a modified vertical pattern technique that we believe 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 some ways, breast reduction surgery is more difficult to perform well than breast augmentation surgery. The surgeons at Wake Plastic Surgery perform a very high volume of breast reduction surgeries and we humbly believe our results to be better than most. Please compare the before and after photos with those of other practices and we think that you will agree.

Our Breast Reduction Results

What conditions can breast reduction surgery improve?

breast reduction before and after at wake plastic surgery cary nc

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

Dr. Stoeckel and Dr. Purzycki have recently stopped accepting insurance for breast reduction surgery, but most patients are pleasantly surprised that the out of pocket costs are not as much as might be expected at Wake Plastic Surgery.

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 and Dr. Purzycki see 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 our surgeons use 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 and Dr. Purzycki recommend 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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