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Breast Reduction Beverly Hills

What is a breast reduction?

A breast reduction is a surgical procedure that partially removes and decreases extra breast tissue. As part of the reduction process, the procedure addresses sagging or abnormally positioned breast tissue. The procedure involves repositioning the breast tissue and nipple into a more pleasing shape and moving it higher onto the chest.

Frequently, the areola is made smaller in diameter because it has enlarged with the changes in the breast.

Why would someone want to have a breast reduction?

Breast reduction is a procedure where that is largely patient driven not only because of the appearance of the breast but also of the symptoms related to the breast. Enlarged breasts can cause a diminished quality of life when they cause upper back pain, result in rashes below the breast, or social embarrassment. The effects of breast drop and breast widening diminish the aesthetics of the breast.

In addition to the sheer weight of the breast tissue, changes in weight, genetics and breast feeding/pregnancy are just some of the reasons that can lead to a decrease in strength of the soft tissues supporting the breast. Because of the large size, gravity has more of an effect on the breast tissue and they tend to age faster than typical. These changes lead to an appearance of the breast “sliding” down the chest.

The breast begins to flatten and widen, the upper portion of the breast loses volume, and the breast itself develops a droop that many women find less attractive. Because all breasts start at least a little asymmetric, the changes that occur can enhance the asymmetry and the patient’s anxiety about the appearance.

Because a significant portion of the lower portion of the breast is now laying on the chest, it is very common to develop rashes from both the moisture that can develop under the breast as well as rubbing and chafing of the skin when the patient is walking. Some patients even develop significant skin changes and fungal infections despite their best efforts to keep the area dry and clean.

What kinds of changes to the breast occur with a breast reduction?

A breast reduction is procedure whose primary goal is to reduce the “breast burden” of the patient. The breast is typically large, wide, flat on the upper pole, and with low pointing nipples. Therefore, in addition to actually removing breast tissue to make the breast lighter, rearrangement of the tissues is performed in order to lift the breast into higher position, raise the nipple, and improve its overall appearance.

What is the difference between a breast lift and a breast reduction?

Breast lift and breast reduction are related to one another. Both procedures result in a rejuvenated breast that sits higher on the chest. They may also have similar scar patterns such as a scar around the areola, a scar around the areola and down the lower part of the breast (also known as a lollipop incision), and a full anchor pattern that adds a horizontal scar under the breast.

Both surgeries will also result in some volume reduction in the breast because at least skin is removed to tighten and rejuvenate the breast. In a breast reduction significant amounts of breast tissue is removed in order to decrease the heaviness and size of the breast. Frequently, these large breasts have caused the patient significant discomfort, self-consciousness, or have been difficult to find clothes for. Occasionally, unlike breast lift, in some surgical practices, breast reduction can be covered by insurance.

To qualify, usually there needs to be significant documentation over several months of attempts to reduce discomfort non-surgically.

About Nicholas Lahar, M.D. – Lahar Plastic Surgery

Plastic Surgeon Beverly Hills

Lahar Plastic Surgery

Nicholas Lahar, MD

Plastic Surgeon located in Beverly Hills, CA

Breast Reduction is one of the many procedures that bring women to the care of Nicholas Lahar, MD, of Lahar Plastic Surgery in Beverly Hills, California. Dr. Lahar has trained with some of the best cosmetic surgeons in the nation and has refined his reduction techniques to create the most beautiful and natural-looking results. Come in for a one-on-one consultation and a discussion of how breast reduction can help you feel great about your body. Scheduling takes just moments online or over the phone.

Do you take insurance for breast reduction?

While breast reduction can be covered by insurance, I currently do not accept insurance for breast reduction procedures.  The companies have extremely strict guidelines for patient weight, how much breast tissue must be removed, how long the procedure must be, and offer little to no reimbursement for the procedure. My goal is to reduce symptoms as well as create a beautiful breast after surgery. I do not want to have my decisions affected by insurance companies who don’t always have the patient’s best interest in mind.

What other procedures are combined with breast reduction?

I use liposuction to help shape the chest and breast. Frequently as we get older, we accumulate fat in the lateral chest and armpit area. By using liposuction to remove these fatty areas, it can help shape the breast further, helping the breast narrow and give it an improved shape.

In somewhat rare cases, it may be prudent to perform a breast augmentation with the breast reduction.  While this may sound counter intuitive, it can be helpful in cases where there is significant flatness of the upper part of the breast but most of the breast is hanging in the lower pole and droopy.  In these cases, I prefer to remove much of the hanging breast tissue and revolumize the upper

Breast Reduction FAQs

There are multiple reasons why the breast begins to droop over time. Genetics frequently play a major role in how large your breasts become.  The breast tissue’s response to hormones found circulating in the blood can have an effect on the growth of breast tissue.

Pregnancy or weight gain can change the size and shape of the breast. A less common reason may be the development of some sort of tumor (usually benign) that may cause accelerated growth in one breast.

A common misconception in breast reduction is that the nipple is completely removed and placed higher on the breast. There are some rare occasions in which this occurs when the breast is extremely large (we’re talking about reaching the waist) and movement into a “normal” position will put it at risk for having wound healing problems. In typical cases, the nipple is kept on a “leash” of breast tissue that allows it to swing into a higher position.

The remaining breast tissues is then closed around this tissue and the skin is closed.  The nipple will have maintained its nerve sensation and blood supply to be able to survive in its new position.

The nipple gets its sensation from multiple nerves that travel around the body from the sides of the breast. It is my goal to maintain the main nerve supply to the nipple when I perform a breast reduction. However, on rare occasions, the anatomy of the patient is different than the textbooks and the nipple sensation can diminish or even go away.

This is a relatively rare complication, but needs to be addressed prior to surgery.  On occasion, the nipple sensation can actually increase because the heaviness of the breast that caused nerve stretch (and decreased sensation) is relieved and now the nerve sensation functions properly.

Similar to the nerve anatomy, the blood supply to the nipple is also from multiple areas on the chest. I maintain at least two of the main blood supplies to the nipple to reduce the risk of nipple loss after surgery.

This is an extremely rare complication but can have an increased risk in patients who may be undergoing a very large breast reduction with lift, in smokers (who I don’t operate on), or in patients who have had multiple breast lift surgeries.

All of these patients potentially have decreased flow of blood to their tissues. I have a lot of experience with revision breast lift and secondary breast surgery and I take extra care to maintain the blood supply in these scenarios.

Breast reduction generally use one and done procedure. However, there is a possibility of needing a second breast reduction. Some factors that may increase the chance of having a second breast reduction include having significantly enlarged breasts at a younger age, inadequate reduction of the breast tissue at the first surgery, significant weight gain, pregnancy, and hormonal changes that may stimulate breast tissue regrowth. It is quite uncommon to require a second breast reduction but it can occur.

Yes, it absolutely is! Fewer people are smoking these days, but there are still a good number of people who are smoking or have replaced smoking with vaping. Vaping is still a problem because it frequently contains nicotine. Nicotine is a very toxic substance that greatly hurts the blood supply to your tissues, even if you are not having surgery. This is why people who smoke have an increased risk of wound healing problems and in the case of breast lifts, death of the skin and death of the nipple.

Nicotine clamps down on the blood vessels feeding the healing tissue and reduces their ability to bring oxygen-rich blood to the surgical area. If you are an absolute smoker, I cannot operate on you. If you are able to stop for at least a month prior to surgery, then I can consider operating on you. But for your health and wellness, please stop smoking!

Learn more about breast reduction in Beverly Hills during a personalized consultation, which you can book online or over the phone today.

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