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Page 1 of 4 Another common plastic surgery procedure that yields consistently excellent results is breast reduction. Often, a woman whose breasts are very large experiences both physical and emotional discomfort, and is an excellent candidate for breast reduction surgery. Women with naturally large breasts can be bothered with severe neck pain, back pain, shoulder strap tenderness, indentations from the bra straps, and the psychological effects of having such large breasts. Girls who develop large breasts at a young age are often teased and may become the object of jokes. Breast reduction can help these women, both physically and emotionally. Breast reduction procedures, available for many years, are becoming more and more refined. Prior to this operation, it is very important that a patient not smoke, as there can be problems with poor wound healing and poor blood supply to the nipple areolar complex. A patient who does smoke must stop at least two weeks ahead of time and not resume for at least two weeks after surgery.  Courtesy of Kimberly A. Henry, M.D. Figure 13-1. Before breast reduction, the patient was a size 38DD and complained of severe back and neck problems.  Figure 13-1. After breast reduction, she is now down to a size 38C and much more comfortable. The most common type of reduction is the McKissick breast reduction, which involves removing breast tissue from the right and left sides of each breast and repositioning the nipple, which remains attached to breast tissue throughout the procedure. After surgery, a patient will have an incision around the nipple areolar complex and underneath the breast. (See Fig. 13-1.) WILL MY INSURANCE COVER THIS? Breast reduction is frequently covered by insurance companies, and after a consultation, the surgeon will obtain pictures and send them to the insurance company with an explanatory letter to obtain preauthorization for the procedure. If the patient is significantly debilitated as a result of large breasts, the plastic surgeon will express those concerns when presenting the case to the carrier. Although some insurance companies are becoming stricter about authorizing breast reduction, it is a type of surgery that is usually medically necessary for the well-being of the patient. Often, the company asks the patient to lose weight or to attend physical therapy sessions prior to authorizing the surgery. The goals and expectations of both patient and doctor should be discussed in detail. One of the main concerns will be the patient’s ability to accept the scars that normally result from this procedure. Most women are so happy at the thought of improved body contours and relief from neck and back pain that they don’t focus on or mind the scars. | | |  |  | | Figure 13-2. Breast assymetry is common to many women. | Figure 13-2. Breast reduction improves the symmetry and size. These incisions are typical of breast reduction procedures. | Courtesy of Kimberly A. Henry, M.D VitaDocs Medical Reference from "The Plastic Surgery Sourcebook"
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