Breast Reduction Procedure

What is Breast Reduction?

Also known as reduction mammaplasty, breast reduction surgery removes excess breast fat, glandular tissue and skin to achieve a breast size that is proportionate to your body and to alleviate discomfort associated with overly large breasts.

Enhancing Your Appearance With Breast Reduction Surgery

Overly large breasts can cause you to have both health and emotional problems. In addition to self image issues, you may also experience physical pain and discomfort.

The weight of excess breast tissue can impair your ability to lead an active life, and the emotional discomfort and self-consciousness just as important as the physical pain. You may want to view Dr Bruce Van Natta’s breast reduction before and after photos to help in your decision-making process.

Is Breast Reduction Surgery Right For Me?

Breast reduction surgery is a highly individualized procedure and you should do it for yourself – not to fulfill someone else’s desires or to try to fit any sort of ideal image.

Breast reduction is a good option if:

You are physically healthy
You have realistic expectations
You don’t smoke
You are bothered because your breasts are too large
Your breasts limit your physical activity
You experience back, neck and shoulder pain caused by the weight of your breasts
You have regular indentations from bra straps that support heavy, pendulous breasts
You have skin irritation beneath the breast crease
Your breasts hang low, and have stretched skin
Your nipples rest below the breast crease when your breasts are unsupported
You have enlarged areolas caused by stretched skin

What You Should Know Before Your Breast Reduction Procedure

A safe and successful breast reduction procedure depends very much on your being completely candid during your consultation. Be sure to address any problems, concerns and questions with Dr. Van Natta. He will ask you a number of questions about your health, desires and lifestyle.

Be Prepared to Discuss:

Why you want breast reduction surgery, your expectations and desired outcome
Medical conditions, drug allergies and medical treatments
Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs
Previous surgeries
Family history of breast cancer and results of any mammograms or previous biopsies

Dr. Van Natta May Also:

Evaluate your general health status and any pre-existing health conditions or risk factors
Examine your breasts and take detailed measurements of their size and shape, skin quality, placement of your nipples and areolas
Take photographs for your medical record
Discuss likely outcomes of your breast reduction procedure and any risks or potential complications
Discuss the use of anesthesia during your procedure for breast reduction.

Preparing For Breast Reduction Surgery

After researching the basics about breast reduction, many patients want to know what to expect before breast reduction surgery.

Prior to Surgery, Dr. Van Natta May Ask You to:

Get lab testing or a general medical evaluation
Take certain medications or adjust your current medications
Get a baseline mammogram before surgery and another one after surgery to help detect any future changes in your breast tissue
Stop smoking well in advance of breast reduction surgery
Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding

Special Instructions You Receive Will Cover:

What to do the day of surgery
Post-operative care and follow-up

Your breast reduction surgery will be performed at Meridian Plastic Surgery Center, an AAAHC accredited facility utilizing seasoned anesthesiologists from St. Vincent Hospital in Indianapolis, Indiana.

You’ll Need Help

Be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery.

Breast Reduction Procedural Steps

Breast reduction surgery is typically performed through incisions on your breasts by surgically removing the excess fat, glandular tissue and skin. In some cases, excess fat may be removed through liposuction in conjunction with the excision (removal) techniques described below. If breast size is largely due to fatty tissue and excess skin is not a factor, Dr. Van Natta may utilize only liposuction to achieve breast reduction.

The technique used to reduce the size of your breasts will be determined by your individual condition, breast composition, amount of reduction desired, your personal preferences and Dr. Van Natta’s advice.

Step 1 - Anesthesia

You will have a general anesthetic administered by a board-certified anesthesiologist.

Step 2 - The incision

An inverted T or anchor-shaped incision pattern is utilized during breast reduction.

Breast reduction 1 Breast reduction 2

(Illustrations courtesy of the American Society of Plastic Surgeons)

Step 3 - Removing and Repositioning

After the incision is made, and the nipple (which remains tethered to its original blood and nerve supply) is then repositioned. The areola is reduced (if necessary) by removing skin around the perimeter.

Underlying breast tissue is reduced, lifted and shaped. Occasionally, for extremely large, pendulous breasts, the nipple and areola may need to be removed and transplanted to a higher position on the breast (free nipple graft). In Dr. Van Natta’s practice the need for a free nipple graft is extremely rare.

Step 4 - Closing the Incisions

The incisions are brought together to reshape the newly-shaped, smaller breast. Sutures are layered deep within the breast tissue to (along with skin adhesives and/or surgical tape) close the skin. Incision lines are permanent, but will fade significantly and improve over time in most cases. The sutures used are absorbable, and the knots will be clipped at your first post-operative visit.

Step 5 – Your Results

The results of your breast reduction surgery are immediately visible. You’ll realize the fulfillment of your goal for breasts that are now smaller and more natural looking. Over time, post-surgical swelling will resolve, and your incision lines will fade.

Important Facts about Breast Reduction Surgery Risks and Complications

The decision to have breast reduction surgery is extremely personal. You’ll have to decide if the benefits will achieve your goals and if the risks of breast reduction surgery and potential complications are acceptable to your personal situation.

Dr. Van Natta and/or his plastic surgery staff will explain in detail the risks associated with breast enlargement surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks or potential complications.

The Risks and Complications of Breast Reduction Surgery include:

Unfavorable scarring
Infection
Changes in nipple or breast sensation, which may be temporary or permanent
Anesthesia risks
Bleeding (hematoma)
Blood clots (Extremely rare)
Poor wound healing
Breast contour and shape irregularities
Skin discoloration, permanent pigmentation changes, swelling and bruising
Breast asymmetry
Fluid accumulation
Excessive firmness of the breast
Potential inability to breastfeed
Potential loss of skin/tissue of breast where incisions meet each other
Potential partial or total loss of nipple and areola (Extremely rare)
Deep vein thrombosis, cardiac and pulmonary complications (Extremely rare)
Pain, which may persist
Allergies to tape, suture materials and glues, blood products, topical preparations or injectable agents.
Fatty tissue deep in the skin could die (fat necrosis)
Possibility of revision surgery

Other Important Considerations:

Breast reduction surgery can interfere with certain diagnostic procedures.
Breast and nipple piercing can cause an infection.
Your ability to breastfeed following reduction mammaplasty may be limited; let Dr. Van Natta know if you are planning to nurse a baby.
The breast reduction procedure can be performed at any age but is best done when your breasts are fully developed.
Changes in the breasts during pregnancy can alter the outcomes of previous breast reduction surgery, as can significant weight fluctuations.

The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single breast reduction procedure, and another surgery may be necessary.

Where Will My Surgery Be Performed?

When You Go Home

If you experience shortness of breath, chest pains, or unusual heart beats, seek immediate medical attention. If any of these breast reduction complications occur, you may require hospitalization and additional treatment.

Your Recovery

Following Dr. Van Natta’s instructions is key to the success of your surgery. It is important that the surgical incisions are not subjected to excessive force, abrasion, or motion during the time of healing. Dr. Van Natta will give you specific instructions on how to care for yourself and minimize breast reduction surgery risks.

It is natural to feel some anxiety, whether excitement for the anticipated outcome or preoperative stress. Be sure to address all your questions directly with him.

Breast Reduction Recovery Time

Many patients have questions about their recovery from breast reduction surgery. When your procedure is complete, dressings or bandages will be applied to the incisions. An elastic bandage or support bra may be worn to minimize swelling and support your breasts as they heal. A small, thin tube may be temporarily placed under the skin to drain any excess blood or fluid that may collect.

You will be given specific instructions for breast reduction recovery that may include:

How to care for your breasts following breast reduction surgery
Medications to apply or take orally to aid healing and reduce the risk of infection
Specific concerns to look for at the surgical site or in your general health
When to follow up with Dr. Van Natta. Be sure to ask him any specific questions about expectations during your individual recovery period.

Breast Reduction Results

Your breast reduction surgery results will be long-lasting, however, over time your breasts can change due to aging, weight fluctuations, hormonal factors and gravity.

Your new breast size should help relieve you from any discomfort and physical limitations you experienced prior to breast reduction. Your newly proportioned figure will likely enhance your self image, boost your confidence and make you more comfortable in your clothes and bathing suit.

We encourage you to look at before and after photos of patients who had breast reduction performed by Dr. Van Natta.

Breast Reduction Costs

For many patients, the cost of breast reduction and other elective surgeries is a consideration. Breast reduction costs can vary widely. A surgeon's fee for breast reduction may vary based on factors such as his or her level of experience and geographic office location.

Our office offers patient financing plans, so be sure to ask us about this option. Cost may include:

Surgeon’s fee
Hospital or surgical facility costs
Anesthesia fees
Prescriptions for medication
Post-surgery garments
Medical tests

Breast reduction surgery is generally considered a reconstructive procedure and may be covered by health insurance when it is performed to relieve medical symptoms.

Many insurers determine whether to categorize breast reduction surgery as reconstructive surgery based on the amount of tissue that will be removed. Dr. Van Natta does not participate with any insurers as an in-network provider. He can do surgery for many plans as an out-of- network provider, but in many cases you will have a lower percentage of the fee covered and a higher deductible. If you like, would be happy to check on your insurance benefits before you come in for a consultation.

In any case, pre-certification is required for reimbursement or coverage. Insurance policies vary greatly, so carefully review your policy to determine coverage. It is important to understand that regardless of your insurance coverage, you will be responsible for Dr. Van Natta’s surgical fee in its entirety, and this will be payable two weeks prior to your scheduled surgery.

Your Satisfaction Involves More Than a Fee

When choosing a plastic surgeon for breast reduction, remember that the surgeon’s experience and your comfort with him or her are just as important as the final breast reduction costs. Dr. Van Natta has extensive experience with breast reduction and has an extremely low re-operation rate, while at the same time achieving outstanding cosmetic results. Breast reduction surgery is akin to sculpting, but in living tissue. Not all surgeons have the innate artistic ability to perform this procedure with consistently excellent results. We encourage you to view our before and after photos to see for yourself.

Breast Reduction Glossary

Areola: Pigmented skin surrounding the nipple

Breast reduction: Also known as reduction mammaplasty, the surgical removal of breast tissue to reduce the size of breasts

General anesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness

Hematoma: Blood pooling beneath the skin

Liposuction: Also called lipoplasty or suction lipectomy, a procedure that vacuums out fat from beneath the skin's surface to reduce fullness

Mammogram: An x-ray image of the breast

MRI (Magnetic Resonance Imaging): A painless test to view tissue, similar to an x-ray

Reduction mammaplasty: The surgical removal of breast tissue to reduce the size of breasts; also known as breast reduction surgery

Sutures: Stitches used by surgeons to hold skin and tissue together

Questions to Ask Your Plastic Surgeon

Are you certified by the American Board of Plastic Surgery?
Were you specifically trained in the field of plastic surgery?
How many years of plastic surgery training have you had?
Do you have hospital privileges to perform this procedure?
If so, at which hospitals?
Is the office-based surgical facility where you perform surgery accredited by a nationally- or state-recognized accrediting agency, or is it state-licensed or Medicare-certified?
Am I a good candidate for this procedure?
What will be expected of me in order to get the best results?
Where and how will you perform my procedure?
Is there a specific surgical technique recommended for me?
How long of a recovery period can I expect, and what kind of help will I need during my recovery?
What are the risks and complications associated with my procedure?
How are complications handled?
How can I expect my breasts to look over time?
What are my options if I am dissatisfied with the cosmetic outcome of my breast reduction?
Do you have before-and-after photos I can look at for this procedure, and what results are reasonable for me?

Use This Checklist As a Guide During Your consultation

Things You Should Know About Dr. Van Natta:

He is certified by the American Board of Plastic Surgery.
He was trained specifically in the field of plastic surgery and had 5 years of general surgery training as well as 2 ½ years of plastic surgery training.
He has been in practice more than 20 years.
His surgical facility, Meridian Plastic Surgery Center, is accredited by a nationally recognized accrediting agency, and it is state-licensed and Medicare-certified.
He also has hospital privileges to perform this procedure at St. Vincent Hospital.
He is known both locally and nationally as an expert in breast surgery.

How are complications handled? If you experience a rare complication requiring reoperation, Dr. Van Natta often won’t charge for his services, but you may well have additional expenses for the operating room as well as anesthesia.

If you are in Indiana, please visit our breast reduction in Indianapolis page for more information about the breast reduction procedure.