Breast reduction: For some women, comfort and cosmetic benefits

Breast reduction, also called reduction mammoplasty, can help Breast reduction, also called reduction mammoplasty, can help women feel more comfortable with their breast size and reduce the pain associated with breasts that are too big for their frame. Photo Credit: Fotolia

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These days, Sandie Kerrigan wears only two bras when she goes out for a run. That may seem like one too many to most women, but Kerrigan is more than fine with just two, because she used to require more than that whenever she went jogging.

Breast reduction changed this and more for Kerrigan, 47, an Oyster Bay resident.

The 5-foot-4 Kerrigan once needed a DD or even an E bra, available at specialty bra shops. Today, she's a C cup and couldn't be happier.

"Women often think the bigger the better when it comes to breast size, but the bigger you are, the bigger you look and the worse your back and neck feels," she said.

Breast reduction, also called reduction mammoplasty, can help women like Kerrigan feel more comfortable with their breast size and reduce the pain associated with breasts that are too big for their frame. It's considered a reconstructive procedure with cosmetic benefits. Last year, 22,838 women had breast reduction, according to the American Society for Aesthetic Plastic Surgery.

Kerrigan said she'd been unhappy with the large size of her breasts since she was 11, but she waited until she was done having her family to undergo the procedure.

During breast reduction, a surgeon removes excess breast tissue, fat and skin. The remaining breast tissue is then lifted and shaped. Occasionally, the nipple and areola may be removed and placed in a higher position. But, if most of the breast is fatty tissue and there's no excess skin, liposuction alone may be all that's needed. In general, breast reduction surgery takes three to five hours.

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Dr. Alan Gold, a plastic surgeon in Great Neck and past president of the plastic surgeons organization, said breast reduction is an option for women of all ages and in all life stages, though young candidates should discuss future breast-feeding issues with their doctors.

"We see some older teens who have abnormally rapid early breast growth and are impaired physically and/or socially as a result, but we wait until breast growth has stopped to perform the surgery," Gold said. "We also see women well into their 60s who always wanted a reduction and never did it until now."

AN IMPROVED LIFESTYLE Women who have had a breast reduction are often a plastic surgeon's happiest and most satisfied patients, said Dr. Lyle Leipziger, chief of plastic surgery at North Shore University Hospital in Manhasset and the Long Island Jewish Medical Center in New Hyde Park. "Their quality of life is significantly improved from being able to work out and buy clothes," he said. "They can get out of bed without carting all that extra weight around."

For most women who seek breast reduction, it's a proportion issue, he said, because they're not overweight or obese. "A woman who is 5 feet tall, 100 pounds, and has very large, pendulous breasts will have problems exercising and complain of back, neck and shoulder pain," Leipziger said. Some also experience irritation under their bra straps. Still, he said, a woman should be close to her ideal body weight before scheduling a breast reduction. "If someone is planning to lose weight, we like them to lose it first because, if they lose weight after, their breasts could become too small," he said.

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In fact, going too small is always a risk, said Dr. Tracy Pfeifer, a plastic surgeon with offices in Quogue.

"Most breast reduction candidates are younger women who want to wear backless tops and show off their midriffs," she said. "But a lot of times, even without pregnancy, their breasts change in their 20s; so, if we reduce too much, they may be too small in five or 10 years."

Exactly what would happen if a woman were to gain weight after breast reduction, Gold said, would depend on the composition of her breast -- how much is fat and how much is breast tissue. The fat will increase with weight gain, but the breast tissue won't, he said.

RISKS OF SURGERY As for risks, which come with all surgeries, breast reduction is no exception. These could include infection or problems with anesthesia. Scarring is another possibility. This may be hidden under the inframammary fold, the line where the breast and the abdominal wall skin meet, Gold said, and some scarring should fade over time.

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Pfeiffer said most women will be able to breast-feed, but probably not exclusively.

Also, nipple sensation could be lost as a result of breast reduction, though Pfeiffer said some women say it's heightened after the procedure.

Whether insurance covers the procedure varies. If large breasts -- macromastia, in medical terms -- are deemed a medical problem, usually based on symptoms such as back pain, insurers may cover the surgery. Gold said some insurers suggest women try physical therapy or more supportive bras before approving the procedure. If breast reduction is considered more aesthetic than medically necessary, some insurers won't cover it, and some policies specifically exclude the surgery. Without insurance, the surgery typically costs about $6,000, according to the society for plastic surgery.

Gold said most women can bathe or drive the day after the surgery -- and they leave the hospital in a sports bra. "You can't go to the gym, but you can do normal daily activities the day after the surgery and go bra shopping in two weeks," he said.

That's the best part, Kerrigan said: "Bra shopping is fun, when before it was a horror."

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