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Breast reduction

About the procedure

Overly large breasts, or macromastia, can cause significant health problems. Large breasts can cause back and neck pain, and the excess weight of the breasts can lead to grooving from bra straps. The extra skin and weight of the breasts can also cause irritating rashes beneath the breasts. Not only can it be difficult for Los Angeles breast reduction candidates to find clothes that fit properly, but physical activities such as running can be impaired as well. Fortunately for women with overly large breasts, breast reduction surgery can help improve these symptoms! Patients often find that when the excess skin and breast tissue is removed, back/neck/shoulder pain is significantly improved. In addition, during breast reduction surgery, the extra skin and breast gland is removed and the remaining breast tissue is reshaped to give a youthful, more aesthetically pleasing breast appearance.

During breast reduction surgery in Los Angeles, Dr. Hirsch will first draw markings which will serve as a guide for surgery. The markings for breast reduction can be done in many different ways depending on the size of the breasts and the amount of breast tissue to be removed. The most common skin pattern is the inverted “t” or anchor pattern (Wise pattern). In the operating room, Dr. Hirsch will use his preoperative marks as a guide, and will elevate skin flaps and remove extra breast tissue as necessary to achieve the desired result. He may also perform liposuction of the breasts in order to better contour the shape of the breasts.

The videos below illustrates the typical breast reduction markings, as well as a breast reduction surgical procedure.

Breast Reduction Markings

Breast Reduction Procedure

Dr. Hirsch usually performs breast reduction surgery as an outpatient procedure, so patients are able to go home the same day as their surgeries. Most patients do not experience significant pain or discomfort after breast reduction surgery and are able to resume their normal activities in 1-2 weeks.

For existing patients, click HERE to download breast reduction post-operative instructions.

Frequently asked questions about breast reduction:

What is the difference between a breast reduction and a breast lift?

A breast lift (mastopexy) is very similar to a breast reduction (reduction mammoplasty) in that the nipple is moved upwards in both procedures and the sagging, drooping appearance of the breast is corrected. However, in a breast reduction, there is a significant decrease in the size of the breast and breast tissue is removed while in a breast lift, the breast is reshaped and only skin (and occasionally some breast tissue) is removed. Insurance plans will generally cover breast reductions but not breast lifts, which are considered to be cosmetic procedures.

What will my scars look like after breast reduction surgery?

There are several different possible scar appearances following a breast reduction in Los Angeles depending on the amount of breast tissue that is present and the amount that you would like to be removed. In general, the most common scar patterns are the vertical (scar around the nipple and extending vertically down the breast) and the anchor scar (scar around the nipple, extending vertically down the breast, and horizontally under the breast). The type of skin pattern depends on the amount of breast tissue that is present and the amount that you would like to be removed. Dr. Hirsch will discuss scar patterns and surgical approaches at the time of your consultation.

What will happen to my nipple sensitivity after breast reduction surgery?

It is difficult to predict how nipple sensitivity will change after breast reduction surgery. Women who have large breasts may have less sensitive nipples before surgery because the nerves that give sensation to the nipples are stretched and do not function well. Sometimes, breast reduction surgery will improve nipple sensation. Other times, nipple sensation will decrease following surgery.

Is breast reduction surgery covered by insurance?

Most major health insurance companies will cover the cost of breast reduction surgery, although documentation of symptoms may be required. Dr. Hirsch’s office will work with you to verify that your breast reduction surgery is covered by your insurance carrier. Click HERE to learn more about insurance coverage of breast reduction surgery.

Will I be able to breast feed my baby after breast reduction surgery?

The ability to breastfeed a baby after breast reduction surgery depends more on how much breast tissue is left remaining than how much breast tissue is removed. In general, most studies indicate that ~60% of women will be able to breastfeed after breast reduction surgery, although some supplementation with formula may be necessary to fully feed your baby.

When can I start exercising again after breast reduction surgery?

In general, you can start light movement such as walking immediately after breast reduction surgery.  Once your incisions are well healed, you will be able to increase the intensity of your exercises.  This usually takes 4-6 weeks.  Dr. Hirsch will let you know when it is ok to resume more strenuous exercises.

When can I go back to work after breast reduction surgery?

Most people are off work for 1 week after breast reduction surgery, although the time may be more or less depending on the physical demands of your job.

Will I have drains after breast reduction surgery?

Typically, Dr. Hirsch does not use drains during breast reduction surgery although he will occasionally use them. If drains are placed, please record their output on the sheet that Dr. Hirsch's office provides for you so that he knows when they can be removed.  You may shower as you normally would when the drains are present and wash their insertion sites with soap and water.

Along with breast reduction, Dr. Hirsch also offers breast augmentation, breast implant revision, breast lift, inverted nipple repair and male breast reduction for patients in the Los Angeles area.

Meet Dr. Elliot Hirsch

Dr. Elliot M. Hirsch is a Board Certified Plastic and Reconstructive Surgeon who specializes in both cosmetic and reconstructive breast surgery. He is one of the busiest and most sought after plastic surgeons in the Los Angeles area, and has published over 40 papers in the breast surgery field. Dr. Hirsch has been educated at some of the most prestigious institutions in the country, including Johns Hopkins University, the University of Southern California, and Northwestern University.

To read more about Dr. Hirsch, please visit his extended biography page.
Read Dr. Hirsch's Biography