Breast Reduction Techniques
Your plastic surgeon should review with you what your expectations are. Whether your insurance company is paying or you’ve had it fighting with your insurance company and have decided to pay for the procedure yourself, you should have realistic expectations of what the breast reduction can do for you. After all, it is surgery, and you don’t want to go into it lightly.
Breast reductions are most often performed under general anesthesia, on an out-patient basis. The procedure itself typically takes 2-3 hours, and in most cases the patient will not require an overnight stay in the hospital, unless complications arise, or you have an aggravating condition such as diabetes.
Details on the various breast reduction methods and techniques:
Free Nipple Graft: Traditional Method Breast Reduction
Anchor Method Scar Photo
This is often the technique used with especially large breasts because it allows for maximum removal of breast tissue and breast fat. The removed breast fat will be sent to a pathology lab while the patient is still under anesthesia to ensure there are no abnormalities in the breast tissue.
Patients who have a traditional breast reduction will likely see their breasts settle into their new shape within a month. Scarring is at a maximum with this method. Sometimes the scar under the crease of the breast can take longer to heal, and infections there are not uncommon.
Free Nipple Graft – Anchor Method
“Anchor method” is another name for the traditional method of breast reduction. When employing this method, the surgeon makes an anchor-shaped incision around the areola. The incision extends down from the bottom midpoint of the areola and outward in each direction of the underside of the breast.
Through this incision, the patient’s excess breast tissue is removed. Next, the remaining breast tissue is moved into a higher position, and the nipple resized so that it looks more natural with respect to the new, smaller breast size. Typically, the higher position is within a maximum of 6 cm or 2.36 inches from its initial location.
Lollipop Incision
The Free Nipple Graft – Anchor Method is often the breast reduction technique used with very large breasts because it allows for maximum removal of breast tissue and breast fat.
When the breast fat is removed, it will be sent to a lab. The lab typically performs the tissue analysis while the patient is still under anesthesia to ensure there are no abnormalities in the breast tissue that would require additional action.
Women who have their breasts’ size reduced using the anchor method will generally see their breasts settle into their new shapes and sizes within a month.
Scarring is at a maximum with this method. Sometimes the scar under the crease of the breast can take longer to heal, and infections there are not uncommon. Your surgeon may prescribe a course of prophylactic antibiotics to help prevent infection.
The Vertical Method Of Breast Reduction
Pedicle Techniques for Breast Reduction
The definition of “pedicle” is the part of a skin or tissue graft left attached to the original site during the preliminary stages of union.
Your plastic surgeon may opt to use a “lollipop” incision, which eliminates the incision under the breast creases, where scarring is most difficult to heal.
The technique may also be referred to as the LeJour Technique, in honor of Madeline LeJour, the plastic surgeon who developed the procedure.
This is also called a Vertical Breast Reduction, because the skin is pleated up onto itself. Because the skin is pleated, this method relies on the elasticity of the skin (and a bit of gravity as well) to smooth out (and down) over the new shape of the breast. This can take about 6 months, so your plastic surgeon should be upfront and warn you that your breasts may look slightly deformed until your skin recovers. The advantage is a more natural shape and appearance of the breast over time.
Traditional Method Breast Reduction Scar Photo
Because this procedure does not allow as much breast tissue to be removed, this is considered for women with moderate cases. Again the nipple is moved to a higher position, but only to a maximum of 3cm (1.2 inches) from its current location.
Lollipop Technique Method of Breast Reduction
The lollipop technique is so named because the incision used in this breast reduction technique is shaped like a lollipop. Unlike the traditional method of breast reduction, the lollipop technique does not leave a scar under the breast. This is helpful because scars in the breast crease, while hidden, do take longer to heal.
Your plastic surgeon is limited in the amount of breast tissue that can be removed during a lollipop breast reduction, which is why the lollipop technique is not recommended for women who need to have a large amount of breast tissue removed during their breast reduction surgery.
Vertical Method Of Breast Reduction Photo
Vertical Method of Breast Reduction
The vertical method of breast reduction employs a vertical incision through which the excess breast tissue is removed. The skin of the breast is pleated over onto itself to close the incision. The vertical method of breast reduction requires that the patient has good skin elasticity. Women who need a large amount of breast tissue removed may be advised to steer clear of this method, since only a moderate amount of breast tissue can be removed with the vertical breast reduction method.
The nipple can be repositioned up to approximately 1 1/3 inches higher (3 centimeters) using this method. While the amount of breast tissue that can be removed is limited, the vertical method typically provides for faster healing than the traditional (anchor) method, since there is no incision in the breast crease area where healing is usually slower.
Pedicle Technique
Lejour Method of Breast Reduction
Madeline Lejour described the Lejour reduction mammaplasty in 1998.
The Lejour method of breast reduction is based on the Lassus reduction that was first performed in the 1960s.
You will often see the terms “vertical breast reduction” and “lollipop technique” used interchangeably with “Lejour Method.”
Scarless Breast Reduction (SBR)
If the primary means to reduce the weight of the breast is the removal of breast fat (as opposed to breast tissue), a “scarless” breast reduction may be performed. An SBR involves small scars under the folds of the breast, where liposuction is applied. SBR does not remove excess skin and does not correct sagging or significantly alter the shape and position of the nipple.
To correct these symptoms, a breast lift must also be performed. A breast lift requires the same scarring as in a vertical breast reduction; however, no excess fat is removed. For patients who opt for SBR, liposuction will be the primary method of breast fat removal. Because liposuction can damage the tissue when it is removed, the removed tissue may not be able to be sent to the pathology lab to be checked for abnormalities.
The advantages of SBR are minimal scarring and immediate results. Patients who have SBR are most likely to maintain nipple sensitivity and have the greatest chance of being able to breast feed.
Breast Reduction And Body Contouring Using Liposuction BeforeAnd AfterWith Doctor Mary Lee Peters, MD, Seattle Plastic Surgeon
Mastopexy or Breast Lift
Women who don’t have large breasts but who do have sagging breasts may opt for a breast lift or mastopexy. Women who have breast fed a few children often find themselves in this situation.
Mastopexy requires a lollipop-type incision, where new nipple placement is defined. The excess skin is removed and then the skin surrounding the areola is brought down and together to reshape the breast.
Mastopexy takes between 1.5 and 3 hours to perform.