What are the benefits of Breast Reduction?

Breast reduction is a surgical procedure used to reduce and resize disproportionately large, drooping breasts. A breast reduction not only improves the way a patient looks by giving a more youthful appearance to the breasts, but it also relieves weight-bearing pain in the neck, shoulders and back to allow for more comfort during physical activity.

Breast reduction by Dr. Lowenstein can be performed with two different types of incisions—a “keyhole” type of incision and scar or the “anchor” type of incision and scar. During your consultation with Dr. Lowenstein, he will provide you with a thorough understanding of your options for breast reduction based on your situation and aesthetic goals.

Dr. Lowenstein is a board-certified plastic surgeon who performs breast reductions in Santa Barbara. He has a reputation for creating a positive experience with results that patients enjoy for many years to come. In fact, the most common complaint Dr. Lowenstein hears after breast reduction surgery is, “I wish I would have done this sooner!”

Keyhole Incision Breast Reduction

Also called vertical breast reduction, a keyhole incision breast reduction gets its name because the scar resembles a keyhole or lollipop. This type of breast reduction is similar to a vertical breast lift but with more tissue removal than in a purely cosmetic lift. The vertical breast reduction allows for the removal of a small to moderate amount of tissue and creates a breast that is higher and smaller than the preoperative breast mound.

This operation is termed a “vertical reduction” because most of the breast tissue resection occurs through the vertical incision below the areola. In all breast reduction operations, there is an incision around the areola as well, which allows repositioning of the nipple to an improved location.

The advantage of this vertical approach is that it does not use an incision underneath the breast. Therefore, there is no resulting scar across the inframammary fold or underside of the breast. The disadvantage of vertical breast reduction is that a limited amount of breast tissue can be removed because the smaller incision provides less access to the breast tissue.

In some cases, Dr. Lowenstein may perform another breast reshaping surgery in addition to a breast reduction to remove more tissue. Liposuction, in particular, is helpful for removing excess fatty tissue on the side of the breast and chest wall when a vertical breast reduction alone is not enough.

Anchor Incision Breast Reduction

This type of breast reduction goes by many different names, including Weiss pattern, Wise pattern and anchor pattern. In this type of breast reduction, the incisions are similar to the vertical technique, with an additional incision along the inframammary fold underneath the breast.

While many patients are unnerved at the thought of this scar, the scar in the inframammary fold is usually well-concealed by the breast tissue when the patient is upright. This incision allows for greater access to the breast tissue, making this type of breast reduction the better option for shaping a significantly drooping, sagging breast or removing more tissue from a very large preoperative breast.

Many patients complain about breast tissue around the side of their chest and sometimes toward their underarm. The anchor breast reduction allows for direct removal of this extra tissue without the use of other fat removal procedures, which can be a significant advantage for women with larger breasts.


How is breast reduction performed?

Breast reduction can be thought of as breast lifting with the removal of more tissue to significantly reduce the breast’s size. Breast reduction and breast lift are very similar in terms of surgery details. Primary incisions for breast reduction are either the vertical breast reduction which leaves a keyhole or lollipop scar, or a Weiss pattern breast reduction which leaves an anchor type of scar. The latter operation is usually used for large reductions.

What is a pedicle?

When we discuss breast reductions, we often use the term “pedicle“ when referring to how the operation will be performed. The pedicle refers to the tissue between the chest wall and the nipple that carries the blood supply to the areola and nipple complex.

What is the difference between a superior and inferior pedicle?

The superior pedicle breast reduction technique is when breast tissue is removed below the nipple so that the nipple can receive blood supply from its connection to the breast above it.

Older breast reduction surgeries often used an inferior pedicle technique. In this case, the nipple is left attached to a column of breast tissue that is attached at the base to the lower, or inferior, region of the breast. Operations using the inferior pedicle technique are known to “bottom out” over time, which means that while the nipple stays in the same place, the breast tissue tends to droop and creates a long, sagging breast where the nipple seems to be too high.

Dr. Lowenstein most often uses a superior pedicle breast reduction operation in which the nipple remains attached to the upper breast. This approach tends to provide a better overall look in the long term while allowing for excellent tissue removal.

How long does a breast reduction take?

The length of time a breast reduction takes depends on the amount of tissue removed, the incision technique and the surgeon’s experience. Dr. Lowenstein performs breast reductions frequently at his private practice in Santa Barbara. On average, a breast reduction with Dr. Lowenstein takes two to three hours.

How much tissue is removed during a breast reduction?

Breast reduction surgery is tailored to your body to maximize your breast shape according to your personal aesthetic goals. No two patients are the same. Dr. Lowenstein will evaluate your breast size and body shape to determine how much tissue should be removed from each breast to result in an attractive and comfortable breast size.

What can I expect after breast reduction surgery?

Breast reduction patients are some of the most satisfied patients in plastic surgery. Recovery often involves minimal pain, and breast reduction patients are often very surprised that they are so comfortable so soon after their procedure. Dr. Lowenstein does not use drains in his breast reduction surgery, so there is little postoperative care needed compared to other surgical procedures.

You will see Dr. Lowenstein the day after your surgery and then in the following weeks. Showering is permitted on the first day after surgery. Most patients are able to return to school or work in about a week, though vigorous exercise must be avoided for a three-week period.

What is the nipple amputation technique?

While rarely used, the nipple amputation technique is used when the breast is too large to provide adequate blood supply to the nipple once the breast is made smaller. A nipple amputation requires the removal of the areola and nipple from the breast altogether. Once the breast mound is reduced and properly shaped, the nipple and areola can be reattached in the correct location on the smaller breast mound.

This operation reattaches the nipple and areola as a skin graft, and therefore the nipple will completely lose sensation and its ability to produce milk. This operation is only used in the most extreme cases of macromastia, or large breasts.

Will I have feeling in my nipple after a breast reduction?

The answer to this question varies with the shape and size of the patient’s breasts. The nerves to the nipple come from the side of the chest wall. The more tissue that needs to be removed in this region, the higher the risk that these nerves will be cut. Nipple sensation is more likely to remain intact with smaller breast reductions.

Can breast reduction be combined with other operations?

Absolutely! A breast reduction can often be combined with other operations as long as the combination of procedures can be done in a reasonable amount of time and the patient is healthy. Breast reduction is frequently combined with abdominoplasty in a Mommy Makeover to provide mothers with a completely new figure.

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