Breast reduction surgery can improve quality of life

For most women with enlarged breasts, the benefits of breast reduction surgery far outweigh the risks

By: Alan Bienstock, M.D. in Collaboration with Gloria N. Beck
   In our culture, large breasts are often associated with beauty and femininity, and are symbolic of a woman’s sexuality. However, the women who endure unwanted stares and attention and varying degrees of pain and physical debilitation brought on by their condition do not share this simplistic and idealized view.
   Far from being a symbol of beauty, many women who suffer from macromastia — abnormally large breasts — know first hand that too much of a good thing can have a negative impact on their mental and physical well-being.
   These women may experience a number of challenges and health concerns. Many have poor posture and suffer from chronic back, neck and/or shoulder pain that worsens over time. The heavy weight of the breasts can cause indentations or ulcerations in the shoulders from bra straps that dig into the skin.
   Women with pendulous breasts may also struggle to maintain good hygiene, as they are prone to bacterial and fungal infections in the skin under the breasts. They may tire easily, and their heavy chests can make the simple act of breathing a difficult task. Large breasts can also interfere with daily activities and limit a woman’s participation in sports or other exercise, leading to a more sedentary lifestyle — and ultimately to weight gain.
   In addition to the negative effects on a woman’s physical well-being, the impact on a woman’s emotional health can be equally devastating. Finding clothing or bras that are flattering to the figure and fit comfortably is a challenge.
   Some women with abnormally large breasts struggle with self-esteem issues and feelings of sexual inadequacy. They may suffer embarrassment, sexual harassment and shame as they cope with the social consequences of macromastia. Though it may exact a heavy emotional toll on women of all ages, it can be particularly damaging to the psychological and social development of young teenage girls.
   Fortunately, the challenges associated with macromastia can be overcome — for teens and women of all ages — through breast reduction surgery.
   An increasing number of large-breasted women are turning to plastic surgeons for reduction mammaplasty — a reconstructive procedure designed to reduce the breasts to a more comfortable size. In fact, according to the American Society of Plastic Surgeons, more than 105,000 breast reduction procedures were performed last year.
   Surgical techniques to reduce the size of a woman’s breasts vary, but today’s most common procedures include the Wise Pattern Inferior Pedicle and the LeJour Vertical Reduction methods.
   The Inferior Pedicle approach involves a horizontal incision under the breast and a vertical incision up the breast and around the nipple, while the Vertical Reduction approach consists of only a vertical incision from the bottom of the breast up to and around the nipple.
   Both techniques successfully remove excess breast and fatty tissue. The nipple (including the areola) is elevated and repositioned, and the remaining skin is then sutured to reshape the breast.
   Incisions and sutures are usually located around the areola, in a vertical line extending down the center of the breast, and, in some cases, along the lower crease of the breast. While every effort is made to make scars as inconspicuous as possible, these methods of breast reduction can leave noticeable permanent scarring.
   Liposuction, while rarely used for breast reduction, is another technique. It is not suitable when the nipples and breast tissue have sagged significantly, but rather for women seeking to enhance the appearance of the breast by removing some fatty tissue. While there is little or no scarring, this procedure offers minimal to moderate reduction of breast tissue and does not elevate the nipple, areola or breast in any way.
   A new and promising breast reduction technique — vertical scarless breast reduction surgery — is now available at University Medical Center at Princeton. This new breast reduction procedure allows the surgeon to sculpt and suspend the breast tissue, offering women long-lasting results with no vertical scar. This "scarless" procedure uses only a horizontal incision that is well hidden in the natural fold of the breast. This procedure only has one incision and entails molding the woman’s own breast tissue to achieve the optimal lift, projection and shape.
   While each breast reduction technique has specific benefits and risks, not every technique is right for every woman or every breast type. The specifics of each technique may vary, but ultimately the goal is smaller, lighter breasts, that are more balanced and in proportion with the rest of a woman’s body. It is important to discuss expectations with the surgeon so that together the patient and the surgeon can choose the procedure that’s most suitable.
   For most women with enlarged breasts, the benefits of breast reduction surgery — eliminating chronic pain and enhancing self-esteem and body image — far outweigh the risks.
   For more information about breast reduction surgery, or to find a University Medical Center at Princeton plastic surgeon, call the Physician Referral Line at (888) 742-7496 or visit www.princetonhcs.org.