Major breast reduction surgery is a technically complex procedure since the goal is not just to downsize the breast in order to provide immediate relief from neck and back pain, constant skin irritation, and other physical symptoms. Most patients are also concerned about getting a perkier, natural-looking breast contour.
However, the more breast tissue and skin excised during surgery, the more difficult it is to achieve a good shape and projection. Furthermore, the risk of poor healing and other complications increases as well, says leading Los Angeles plastic surgeon Dr. Tarick Smiley.
Nonetheless, great results from major breast reduction surgeries can be achieved with meticulous dissection and deep understanding of the anatomy, he says in his recent Snapchat posts.
He has shown a female patient with hugely disproportionate breasts that hung too low, drooping over her tummy area.
Aside from the disproportionate appearance, prior to surgery the patient also complained that her overlarge breasts were causing “rounded” and painful shoulder, back pain, skin breakdown, and discomfort when doing exercise and other physical activities.
(Note: Because a good number of breast reduction patients have physical symptoms, it is not surprising that the surgery has one of the highest patient satisfaction rates among plastic surgery procedures. According to a 2012 survey released by the American Society of Plastic Surgeons, about 90 percent of patients rated their results “good” or “very good.”)
Dr. Smiley says major breast reduction requires the standard or anchor technique, which is named after the shape of its resulting scar. It uses an incision around the areola, which goes down the midline, and then across the bottom of the breast.
A modified form of breast reduction eliminates the horizontal incision across the bottom of the breast; hence, the resulting scar resembles a lollipop. This technique is referred to as lollipop or vertical reduction, says the celebrity plastic surgeon.
The patient required the anchor breast reduction technique, which has allowed for the removal of more than 600 grams of breast tissue on each side.
Meanwhile, the lollipop breast lift only suits patients who require smaller reductions, between 300 and 500 grams of breast tissue on each side.
One of the main issues with major breast reduction is the scar appearance, particularly the vertical scar because of its more obvious location (the scars around the areola and within the submammary fold are more discreet). But with meticulous wound suturing technique, Dr. Smiley says most patients can expect “almost invisible” or “very faded” scar after 6-18 months.
He highlights the importance of closing the incisions in several layers, while just allowing the skin to “kiss each other” instead of closing their edges with stitches. The idea is to eliminate tension on skin, which promotes favorable scars and good healing, he says.