What is breast reduction?
One of the happiest and most grateful patients in plastic surgery is the patient who has undergone breast reduction (or reduction mammaplasty). Reduction mammaplasty reduces the size of excessively large breasts causing numerous symptoms, including back or neck pain, skin irritation, physical discomfort, infection in the breast fold, and shoulder grooving from bra straps.

Good Candidates for Reduction Mammaplasty
Ideal candidates for breast reduction surgery are adult women who have large, heavy, or pendulous breasts that cause physical discomfort or embarrassment. Candidates should be in good health and have realistic expectations about the results of the procedure.
It is important to note that Reduction Mammaplasty surgery does not correct drooping breasts; a breast lift may be recommended in addition to the mammaplasty procedure. Patients should also be non-smokers, as smoking can interfere with proper healing after surgery.
How is the breast reduction procedure?
Reduction Mammaplasty is an ancient technique that has gone through incalculable cycles of refinement over the years. Most reductions performed in the US implement a Wise pattern technique (or anchor incision). Through this procedure, cuts are inscribed around the areola and nipple with a vertical section across the middle of the inferior breast, connecting perpendicularly to a cut in the inframammary crease. The majority of excess breast tissue (glandular tissue) is removed with this series of cuts to meet approximately the patient’s desired breast size.
In a vertical mammaplasty, the incisions are limited to the border of the areola and a vertical midline incision along the lower breast, down to the inframammary fold. The benefit of this approach is to limit the amount of scarring on the breast while achieving similar reductions in size as with the Wise pattern technique. To refine the final appearance of the breast, the surgeon performs liposuction.
Another commonly used incision style is the circumareolar incision (around the areola). This incision may be used for a limited reduction, although it is more commonly employed for breast lift surgery. This incision can reposition a slightly downward-pointing nipple to a more normal, appealing position. It often works in conjunction with breast implant placement (augmentation mastopexy).
Other less common methods of reduction mammaplasty include a hockey stick-shaped incision (Lejour technique) and straightforward liposuction in select cases.
Dr. Panossian has extensive experience in these techniques and will review the approach most likely to give you the best possible result. During your mammaplasty consultation, the feasibility of this particular reduction technique will be assessed. On the day of surgery, Dr. Panossian will spend a long time precisely measuring and marking the breasts in the standing position prior to entering the operating room.
Benefits
Benefits of Breast Reduction
The benefits of mammaplasty surgery are numerous and can have a profound impact on the quality of life for many women. The most common benefit is a significant reduction in physical discomforts, such as back or neck pain, skin irritation, and shoulder grooving from bra straps. Additionally, patients may experience improved posture due to the reduced weight of their breasts.
Other benefits include improved self-esteem and body image, increased clothing options, and improved overall physical health. Reduction Mammaplasty can also reduce the risk of developing certain medical conditions associated with large breasts, such as macromastia or gigantomastia. Finally, mammaplasty surgery can help improve breast symmetry and create a more aesthetically pleasing shape.
Recovery
Reduction Mammaplasty Recovery
Breast reduction is an outpatient procedure. A family member or friend should be present to care for the patient on the day of surgery and for at least 24 hours following surgery.
The surgeon will cover the area with a thin gauze and an elastic bandage, which can cause some discomfort for a couple of days. However, taking medications can suppress pain. After a few days, the firm dressing will be substituted by a delicate bra. This must be worn constantly over a thin layer of gauze for up to four weeks. After one week after the operation, your surgeon will take off the sutures.
During the recovery process, reducing physical activities substantially during the first week after surgery is critical. Having a family member or friend to help during this time with daily activities is essential. This first week is critical for the healing process and in the avoidance of postoperative complications. Approximately two weeks after surgery, light walking and similar activities are not risky, but there is strict avoidance of strenuous activities such as upper body workouts, heavy lifting, running, and aggressive exercise.
There is usually some loss of sensation in the nipples and breast skin after surgery. This numbness will improve over the next six weeks. Sometimes, the nipples will undergo a period of increased sensitivity as well. In some patients, these sensory changes may last a year or more and can be permanent.
Risks and Complications
What are the risks and complications of breast reduction?
Reduction Mammaplasty is a complicated procedure but is typically safe when done by a board-certified and knowledgeable plastic surgeon. There are dangers associated with virtually every kind of surgical operation, consisting of bleeding, infection, and complications with anesthesia, which can be considerably lessened with full observance of Dr. Panossian’s pre-and postoperative regulations.
A bra line usually covers breast reduction scars. An individual’s tendency for keloid or thick scarring is sometimes unpredictable and genetically predetermined. Steroid injections or surgical revision can treat these scars if they occur.
Slight breast asymmetry between the breasts can also occur in relation to breast shape, nipple position, or differences in sensation. In the worst-case scenario, the vascularity of the nipple and areola may be compromised, and a portion of the nipple-areola complex may die. This is a treatable problem, but surgical correction may be necessary. Finally, the ability to breastfeed is affected in most patients since the removal of the milk-producing portions of the breasts.
Dr. Panossian’s staff is available 24 hours a day to answer your questions and concerns in order to avoid complications. Los Angeles breast reduction patients must call immediately in case of a suspected problem.
Why choose Dr Panossian
- He received his medical education at Tufts University School of Medicine.
- Graduated at the top of his class at UCLA, receiving Phi Beta Kappa and Summa Cum Laude honors.
- Was accepted into an elite combined general surgery and plastic surgery residency at the Keck School of Medicine of USC.
- Completed subspecialty training in craniofacial surgery at the Hospital for Sick Children in Toronto and Harvard Medical School.
- Was mentored by Dr. Ron Zuker in the practice of facial paralysis reconstruction. This prestigious fellowship position was available to only one surgeon in the United States.
- Is affiliated with various charitable and educational organizations, including Operation Smile and Mending Kids.
- Is a member of the American Society of Plastic Surgeons and the highly selective American Association of Plastic Surgeons, reserved for only a select group of individuals nationally who have demonstrated excellence in academic plastic surgery.
- Holds memberships in several other professional societies including the American College of Surgeons and the American Society of Reconstructive Microsurgery.
- He serves on the Board of Directors for Mending Kids and the Gondobay Manga Foundation, a non-profit organization dedicated to the improvement of lives in Sierra Leone.
- Has been nominated by his peers annually since 2012 as a “Super Doctor.”
- Served as an expert medical consultant and appeared on The Doctors, Grey’s Anatomy, and Nip/Tuck.
- Has been featured as “Top Doctor” in US News and World Report, Pasadena Magazine, and Los Angeles Magazine.
Frequently Asked Questions About Breast Reduction
These surgical procedures typically take two to four hours, depending on the extent of the surgery.
Generally, general anesthesia is used for this procedure. Your doctor will discuss your options with you prior to your cosmetic surgery.
Yes, there will be some scarring after the procedure. However, your doctor will make every effort to minimize the visibility of the scars.
The results of reduction mammaplasty surgery are typically long-lasting. However, it is important to note that pregnancy and weight fluctuations can affect the results.
The cost of mammaplasty surgery varies depending on the extent of the procedure and other factors. Your doctor will be able to provide you with an estimate of the cost prior to your surgery.
During your consultation, your doctor will discuss your medical history and examine you to determine if you are a good candidate for the procedure. Your doctor will also discuss the risks and benefits of the procedure, as well as any other options that may be available to you.
If you live near Pasadena, CA, Dr. Panossian offers breast reduction among its services, and is conveniently located at 39 Congress St., Suite 402 Pasadena, CA 91105
Last modified by Dr. Andre Panossian