Breast Reduction Procedure

What is Breast Reduction?

Reduction mammaplasty or as it is more commonly known, breast reduction, is a surgical procedure that removes extra breast fat, skin and glandular tissue to realize a more proportionate breast size with your body and to relieve the discomfort related to breasts that are overly large.

Improving Your Appearance With Breast Reduction

Breasts that are overly large can cause emotional problems as well as health problems. Along with feeling uncomfortable with your self image, you are probably also experiencing physical pain and discomfort.

Excess breast tissue's weight can lessen your ability to have a healthy and active lifestyle. Both the emotional distress and your self-consciousness are equally important to the physical pain you feel. You may want to view Dr. Bruce Van Natta’s breast reduction before and after photos to help in your decision-making process.

Should I Have Breast Reduction Surgery?

Breast reduction surgery is a personal decision only you can make for yourself. You should have this surgery only if it meets your goals and expectations, and not to please someone else’s desires for you or for you to try and fit an unrealistic ideal image for yourself.

Consider a breast reduction surgery if:

  • You are physically in good health
  • Your expectations of the surgery results are realistic
  • You are a non-smoker
  • You are uncomfortable emotionally and physically because of your large breast size
  • Your breast size limits your ability to be physically active
  • You experience pain in your neck, shoulder, and back because of the heaviness of your breasts
  • You regularly have bra strap indentations from supporting heavy breasts
  • Your skin is irritated consistently beneath your breast crease
  • Your breasts are stretched and sag 
  • Your nipples are lower than your breast crease when not wearing breast support
  • Your areolas are enlarged because of 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 Your Breast Reduction

After researching the basics about breast reduction, many patients want to know what to expect before their 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 by surgical incisions on your breasts that remove the excess fat, glandular tissue and skin. Sometimes, the excess fat can be removed by using liposuction along with removal and repositioning techniques. However, if the size of your breast is mostly due to excess fat and there isn't excess skin involved, Dr. Van Natta may utilize only liposuction to achieve a smaller breast size.

The technique that Dr. Van Natta will perform for your breast reduction will be determined by several factors including your physical condition, composition of your breasts, how much reduction is necessary, your goals in achieving your desired result and Dr. Van Natta’s recommendation.

Step 1 - Anesthetic

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

Step 2 - Incision Type

The incision used in a breast reduction surgery is an inverted T or an anchor-shaped pattern.

Breast reduction 1 Breast reduction 2

(Illustrations courtesy of the American Society of Plastic Surgeons)

Step 3 - Repositioning and Removal

Once the incision is made, the nipple is repositioned while remaining attached to its blood and nerve supply. If the areola is enlarged, it will be reduced by removing skin around its perimeter.

Next, the underlying breast tissue is reduced, shaped and lifted. In some cases where the breasts are extremely large and pendulous, both the nipple and areola may need to be removed in order to transplant them higher on the breast. This is called a free nipple graft and in Dr. Van Natta’s practice the need for this procedure is extremely rare.

Step 4 - Incision Closing

The incisions are gathered together, reshaping the new smaller breast. Layered deep within the breast tissue are the sutures, and skin adhesives and/or surgical tape are used to close the skin. Although the lines from the incisions are permanent, they will fade significantly and in most cases, will improve over the course of time. The sutures used are absorbable, and the knots will be clipped at your first post-operative visit.

Step 5 – Your Results

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

Facts You Should Know About Breast Reduction Surgery Risks and Complications

Only you should decide whether or not to have breast reduction surgery. You’ll have to consider the benefits you will achieve versus the risks and possible complications of breast reduction surgery and whether the benefits outweigh the risks.

Dr. Van Natta and/or his plastic surgery staff will discuss thoroughly with you, the risks and potential complications associated with breast reduction surgery. Once you fully understand the procedure and have decided to move forward with the surgery, you will be asked to sign consent forms.

Risks and Complications of Breast Reduction Surgery are:

  • Scarring
  • Infection
  • Temporary or permanent changes in the sensation of your nipple or breast
  • Risks of using anesthesia
  • Hematoma, or bleeding
  • Extremely rare occurrence of blood clots
  • Incision site that heals poorly
  • Irregularities in your breast shape; asymmetry
  • Discoloration of the skin, swelling, bruising and changes in the pigmentation that are permanent
  • Accumulation of fluids
  • Excessive firmness of the breast
  • Unable to breastfeed
  • Potential loss of breast skin and/or tissue where the incisions meet
  • Extremely rare instance of partial or total loss of your nipple and areola
  • Extremely rare occurrence of cardiac and pulmonary complications and deep vein thrombosis 
  • Persistent pain
  • Allergic reactions to sutures, tape, glues, blood products, topical medications or injectables.
  • Fat necrosis, where deep fatty tissue could die
  • Possibility of an additional surgery to make revisions

Other Important Considerations:

  • Breast reduction surgery can impede certain diagnostic procedures.
  • Infections may be caused by breast and nipple piercing.
  • Ability to breastfeed following breast reduction may be limited; let Dr. Van Natta know if you are planning on getting pregnant and nursing a baby during your initial consultation.
  • Although breast reduction surgery can be performed at any age it is best performed when your breasts are fully developed.
  • Changes in the breasts due to pregnancy as well as major weight fluctuations can reverse the results of your breast reduction surgery.

Although you should expect good results with your surgery, there is unfortunately, no guarantee. In some cases, it may not be possible to achieve your desired results with one breast reduction procedure, making an additional surgery necessary.

Where Will Your Surgery Take Place?

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. Dr. Van Natta and his assisting staff will pay close attention to your safety and make you as comfortable as possible.

When You Go Home

As with any medical procedure, seek medical attention immediately if you experience any of these following symptoms: pains in your chest, unusual heart beats, and/or difficulty or shortness in your breathing. It may become necessary for you to be hospitalized and receive additional treatment.

Your Recovery

Following Dr. Van Natta’s instructions is critical to the success of your surgery and recovery. Do not subject your surgical incisions to excessive motion, force or abrasion while they are healing. Dr. Van Natta will provide detailed instructions on how best to care for yourself and minimize breast reduction surgery risks.

While it is completely natural to feel anxious about your surgery, whether it's excitement for you to see your results or stress about undergoing the procedure, please address all your questions directly with Dr. Van Natta.

Breast Reduction Recovery Time

Many patients have questions about their recovery from breast reduction surgery. After completion of your surgery, your incisions will be dressed and bandaged. You may wear an elastic bandage or a support bra to minimize any swelling and to support your breasts as they heal. In addition, a thin tube may be placed temporarily under your skin to drain any excess blood or fluid that may collect.

Your detailed instructions for your breast reduction recovery include:

  • Caring for your breasts following your procedure
  • Applying or taking oral medications that will encourage healing and minimize the possibility of infection
  • Looking at your surgical site to notice any concerns, and being aware of your overall health
  • Following-up with Dr. Van Natta and asking him any questions you have regarding your individual recovery period

Breast Reduction Results

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

Your new, smaller breast size should help relieve you from the discomforts and  limitations you previously experienced. Your newly proportioned figure will help with improving your self image and 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. A surgeon's fees can vary based on factors such as his or her level of experience and where geographically, the office is located. Please ask us about our patient financing plans if this will help in budgeting the expense.

Costs of a breast reduction may include:

  • Fee charged by the surgeon
  • Cost of the hospital or surgical facility
  • Fees for anesthesia
  • Prescription medication
  • Post-surgery clothing
  • Medical tests

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

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 Breast Reduction Satisfaction Is More Than a Fee

When you are in the process of choosing a plastic surgeon for your breast reduction, keep in mind that the surgeon’s experience and your comfort with him or her are equally important as the total costs of the surgery. 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 for 25 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.