1. Will my insurance cover the cost of breast reduction?

Each insurance plan has its own criteria for covering breast reduction surgery. If there is a medical condition or symptom that the surgery may cure or improve,the surgery may be covered. Some of these common conditions are neck and back pain related to the breast weight, skin ulcerations, dermatitis or other infections. Obesity is often a contraindication and insurance plans may require patients to be within a certain percentage of their ideal weight. The amount of tissue removed may play a role but this is quite controversial since absolute weight in grams can cause problem relative to overall weight. 250 grams may be significant in a 100 pound patient but not in a 175 pound patient. Pre-authorization is often required, without which, the surgery may be excluded from insurance. Sometimes an examination from an orthopedic surgeon or chiropractor is required to rule out intrinsic back conditions.


2. Why are some women unhappy with their breast reduction surgeries?

Contrary to public impression, breast reduction is highly successful and gratifying. In some past studies, over 95% of patients were satisfied with their surgery. Obviously complications can occur, especially in extremely large reductions. If these complications occur, or if scars are unsightly, patients can become unhappy.


3. What are the different Breast Reduction Procedures and Incision Patterns?

Breast reduction techniques are categorized by scar patterns and by the pedicle that carries the nipple-areola complex. The scar can range from small puncture ones when using only liposuction to ones around the areola, down the center of the breast (vertical or lollipop incision) to under the breast in the inframammary fold (anchor, inverted-T, or Wise-pattern incision). There are too many pedicle patterns to mention but the The size of the nipple-areola complex can be determined by various shaped disc devices, by tape measurement, or by free-form design. Depending on the technique of the reduction, there can be a discrepancy between the size of the areola and the circular skin pattern it is sutured to, so that skin tension may cause the size of the areola to change, usually enlarged, post-op. Finally, the patient and the surgeon should discuss relative size to fit the patient' s individual desires. Popular patterns include medial, inferior, central, and superior.


4. How do you determine the size of the nipple/areola complex?

I usually use a tape measure and draw the pattern free-hand taking into consideration the individual preference of the patient and the technique used.The size may change depending on the relative amount of skin tension during the closure.


5. Do you prefer to use drains? If so, when will the drains be removed

While some doctors use drains routinely, and especially if liposuction is used, I do not always find the need. By using electrocautery and meticulous attention, bleeding is usually very minimal. If drains are used, they are usually removed within 1-2 days.


6. Will I stay overnight?

The vast majority of breast reductions are performed in an out-patient surgery center. The patient may stay one night at a post-op care facility. Very large reductions may need to be performed in a hospital.


7. Is anesthesia used during the Reduction procedure?

The anesthesia is determined by patient preference and safety consideration. While it might be possible to do some reductions using local tumescent techniques and sedation, most surgery is done with general anesthesia. I also use a generous amount of local anesthesia to prolong the pain relief post-operatively.