Types of Breast Reduction SurgeryThere are a few different types of breast reduction procedures, and the type that you get will depend on your surgeon’s preference and what your desired outcome is. In the United States, breast reductions are most commonly done using either the vertical incision technique or the inverted-T incision technique.
Vertical Incision (aka the “Lollipop” Incision)The “lollipop” incision got its nickname because, well, it kind of looks like a lollipop. It is sometimes also called a keyhole procedure. Using this technique, your surgeon would make an incision around the areola and then vertically down the center of the lower half of your breast. This type of incision typically results in less scarring than anchor-type incisions simply because there are fewer incisions made, and it’s becoming more popular over time. Still, this type of procedure is only recommended for folks who have minimal to moderate amounts of breast tissue to remove. It can lead to some puckering of the skin at the base of your breast — often this reduces over time, but if it doesn’t, you might want a scar revision procedure.
Inverted-T Incision (aka the Wise Pattern Incision)This type of incision is also called the anchor incision, and it’s the most common type of incision used in breast reduction surgeries. This type of incision uses the same basic pattern as the vertical incision, then adds an additional horizontal line at the bottom fold of the breast. Dr. Alexis Parcells, a board-certified plastic surgeon who prefers inverted-T procedures in her practice, shares that “The best way to think about a reduction is to understand that your breast is a sphere.” The inverted-T method is popular because it gives your surgeon the most control over the final shape and position of your breasts, and as Dr. Parcells notes, most people who want a reduction don’t just want a size decrease — they also want to change the position of their breasts, too. “In order to reduce symptoms, we need to not only remove volume (reduce), but lift at the same time, and this requires the removal of skin, which requires scars.” If you’re seeking a reduction because your breasts are proportionately much bigger than your body, and if you have a lot of sagging, then your surgeon will likely opt for the inverted-T method.
LiposuctionYes, you can technically use liposuction to reduce the size of your breasts. This is sometimes called “scarless breast reduction” because you only have a small incision rather than an open surgery. It also has a faster recovery time than other types of reductions. Liposuction only removes a small amount of fat, so if you’re looking for a big change, lipo isn’t going to do it. A liposuction procedure doesn’t involve a lift or skin removal, so if sagging is something you’re worried about, then liposuction likely isn’t the best procedure option for you. Another thing to note is that your surgeon has no way of knowing how much of your breast volume is made up of glandular tissue and how much is made up of fat before they begin the procedure. Liposuction only removes glandular tissue, not fat, so it’s possible that they might start the procedure, then see that most of the breast tissue is glandular, and only be able to remove a very small amount of fat, resulting in minimal reduction.
Round Block Technique (the Benelli Technique)This technique uses only one incision — a circle around the areola — and was designed to result in very little scarring. This type of procedure is less common in the United States and is only recommended for people seeking a small amount of tissue removal. It isn’t recommended for people with extensive sagging, either.
What Happens to Nipples During a Breast ReductionDuring many breast reduction surgeries, the nipples stay attached to the breast’s blood and nerve supply and are then repositioned on the breast at the end of the surgery. Sometimes, extra skin might be removed from the outer edge of the areola. Not having to remove the nipples means that you’re less likely to experience changes in nipple and areola sensation after surgery, but it doesn’t completely eliminate that risk, since most reduction surgeries involve incisions around the areola. If you have very large breasts and are seeking a significant reduction, your surgeon will likely entirely remove and resize your areolas and nipples, then reattach them at the end of the procedure — this is called a free nipple graft. If a free nipple graft is done, you may have a complete loss of nipple sensation, at least for some time. That being said, one study found that most patients eventually regained some amount of sensation after a free nipple graft.
Breastfeeding After Breast ReductionIf you’re planning on becoming pregnant, you may wonder if you’d be able to breastfeed if you get a breast reduction. In short, yes — most people who undergo breast reduction surgery should be able to successfully breastfeed later on, but it depends on the type of procedure done. That’s because breastfeeding relies not only on the presence and function of the mammary gland but also on nerve responsiveness and function (not to mention the psychological components). A 2017 review of 51 papers on breast reductions and breastfeeding found that only 4% of patients who had experienced free nipple grafts were still able to breastfeed. So, if breastfeeding is important to them, patients who are seeking breast reductions might opt to wait until after they are done having children to undergo a reduction, especially if they are seeking a significant size change. No matter what, if you’re considering having children and breastfeeding in the future, talk with your surgeon about your hopes and expectations. They can talk you through all of the options and together, you can decide what the best option is for you.
How Much Breast Reduction Surgery CostsWhen we think of surgery in the United States, we think of hefty price tags and stacks of bills. Figuring out how much a breast reduction surgery will cost you can be confusing. Ultimately, it will come down to one big factor: whether your breast reduction is required for a medical condition, or if it’s considered an aesthetic procedure. According to 2020 data from the American Society of Plastic Surgeons, the average cash price of a breast reduction is $5,913 — but that’s just for the actual surgical procedure. It doesn’t include facility fees, anesthesia or the anesthesiologist’s fee, or other expenses that may come with the surgery (like medications or the post-surgical bra you’ll have to wear). When you include all of those factors, the cash price of breast reduction surgery in the United States is between $12,000 and $15,000 — but it will vary based on your location and the complexity of the procedure. Your health insurance may cover breast reduction surgery if…
- You have back, neck, or shoulder pain caused by the weight of your breasts
- Your bra straps leave lasting indentations in your shoulders
- You have a skin rash underneath your breasts