Cosmetic Surgery Blog

Mae West once said, “Too much of a good thing is wonderful.” For many things, this is not true. For example, it is not true for breasts.

Although many women long to have larger breasts and undergo breast augmentation to get them, there are also many women who got a bit too much in that department. For them, too much of a good thing is a problem.

Overly large breasts can lead to unwanted attention, which can be embarrassing or worse for a girl in her teens whose breasts get too big. Other young people may make fun of her, boys crack bad jokes about her, and she may get even worse attention from strangers. She may avoid wearing anything that is not baggy and start to hunch over to hide her bosom. Take part in sports and have her breasts bounce about? Forget that. Her self-esteem can plummet severely.

I speak as one who understands that embarrassment. I developed very early and was the first girl in my class to get a training bra: First by a whole year! I still remember some of the dumb jokes I got. I hunched over a lot. Although I’m not so large that I need reduction, I can certainly relate. (I am also not out of proportion. I carry some extra weight around both top and bottom, so imagine an hourglass, ummmm, one with a lot of sand.)

Large breasts can also be just plain uncomfortable. Women with large breasts have a hard time getting bras that fit correctly and may develop trenches in their shoulders and even sores from their bra straps. They may also develop rashes under their breasts because sweat gets trapped there and bacterial and fungal infections set in.

Women with very large breasts also develop backaches, neck aches, and even headaches from the large weight on their chests.

Luckily, there is breast reduction surgery, which is also called reduction mammoplasty. Plastic surgeons can remove breast tissue and skin and reshape the breasts so that they are more compact. They can reconstruct them so that they are in line with the rest of the woman’s body and she is no longer top heavy.

The American Society of Plastic Surgeons (ASPS) does not consider breast reduction surgery to be cosmetic surgery. The ASPS considers it to be reconstructive surgery because it is usually done to correct a medical or physical problem, such as the backaches or recurrent rashes. In many cases, health insurance companies will cover breast reduction surgery if the woman can document that she has health issues due to overly large breasts. Usually, however, a health insurer will cover the surgery only if a certain amount of weight is removed.

One down side is that breast reduction is major surgery. Sometimes several pounds of breast tissue and skin are removed from each breast! A breast reduction procedure can create scars that are extensive, sometimes running around the nipple, down to the crease under each breast and then along the crease, forming an anchor shape. Some breast reductions are done on an outpatient basis, but very extensive reduction surgeries may require a night or two in the hospital. The risks of the breast reduction surgery include infection, hematomas and seromas (pockets of clotted blood or blood serum), and asymmetry.

Another serious consideration is that breast reduction surgery can interfere or even completely prevent future breastfeeding. Although some surgeons will make every attempt to keep the milk ducts that run from the lobes and lobules of the breast tissue intact, these ducts may be interrupted, or cut completely. For some patients, the surgeon must remove the nipple and then reattach it in a new, higher location.

Still, some women have been able to breastfeed their babies, at least to some extent, after having breast reduction. They may be able to produce at least some breast milk, which is very beneficial to babies, and then supplement with formula if their supply is not adequate. There is an excellent resource on breastfeeding after breast reduction at http://www.bfar.org.

Breast reduction surgery can be performed at any time after the breasts have stopped developing. Women who have enlarged and drooping breasts after they breastfed their babies can have a surgery that combines breast reduction and a breast lift.