Medically known as reduction mammaplasty, a breast reduction lifts and reduces the size of the breasts. It is ideal for women whose breasts are too large. Common reasons include feeling self-conscious, back pain, neck pain, shoulder notching (where the bra straps cause an indent on your shoulder), breast sagging, difficulty with exercise, and difficulty finding bras and clothing. It is one of the highest patient satisfaction surgeries I perform.
PLEASE KNOW WHAT TECHNIQUE YOUR SURGEON DOES
Having completed a fellowship in breast surgery after my plastic surgical training at Stanford, and because many of my patients are interested in a female plastic surgeon, this is an area of particular expertise in my practice. The goal is to give you smaller, lighter, firmer breasts with a nice shape. Frequently, the areola size is reduced. Many women notice following the procedure their posture is better, their neck and back pain subsides, and they feel more confident about their bodies. There is no typical patient. Your breasts should be fully developed. Occasionally when a young woman has serious physical discomfort, a breast reduction is done in the mid-teens, with the caveat a second reduction may be needed in the future.
Your breast surgery consultation begins at my office, where I discuss the procedure in detail, review photos of typical results, and examine you to find differences between the size and shape of your breasts. At that visit we discuss types of reduction. I specialize in the short scar vertical breast lift breast reduction.
Again, this is an area of expertise in my practice.
"When she shared photos of breast reductions she performed I could see the passion she has in her work when she commented on the photos." - K.M., San FranciscoView More Testimonials*Individual results may vary
Breast reduction surgery is three hours under general anesthesia. You will go home the same day.
Recovery time is one to two weeks. For the first few days you will be on regular pain medication and slowly wean off. By a week out most patients are off all pain medication and are back to normal daily life.
Dr. Greenberg performs these procedures at the Menlo Park surgical hospital and the private outpatient plastic surgery center in Palo Alto.
I do a vertical short scar breast lift and reduction technique. The surgery itself usually takes around 3 hours.
The day of surgery you arrive at the surgical center. The nurse will have you change. I will see you and do marking on you (yes, just like on the TV shows). Then anesthesia will see you and start your IV. All this is done before you go back to the operating room.
Once in the operating room we will hook you up to monitors, put on warming blankets and leg massagers, and the anesthesiologist will start giving you plain oxygen to breathe and medications through your IV. You will gently fall asleep. Next thing you know, you are done.
During the surgery I will sit you up. I will even out asymmetries of the breasts. I do liposuction of the axilla bra strap area. When you wake up, you will be wrapped in your garment. There are no bandages to change. I like to say you are a “Christmas present,” and no peeking until your appointment. I tend not to use drains. In rare cases I will still use a drain (usually if a really fatty breast or a lot of liposuctioned area).
The surgery is under general anesthesia. I only use board certified MD anesthesiologists.
Scars. It is the achilles heel of breast reductions. There is no way to move the areola, reshape the tissue, and remove skin without scars. I love the vertical shorter scar lift because it has a significantly smaller scar.
How do you get a good scar?
I wish I were magic.
Breast reductions without surgery or scars sound magical. I wish I could do it. It seems like it should be able to work- the breast is made up of breast tissue and fat… So the fat should be able to be removed by liposuction or coolsculpt or kybella or something. Right?
Wrong.
When you have large breasts, you have the issue of breast volume, but you also have the issue of loose skin. The droop. The National Geographic, bungy jumping when you take off your bra, sagging breasts. If you were to remove the fat without reshaping the breast tissue and tightening the skin, then you will be smaller, but also looser and droopier.
The lift is part of the beauty of a breast reduction. There is an old study showing the act of lifting the breast- not removing any volume, just lifting- significantly helped posture, back strain, and neck issues. The lift makes the breasts cute and perky. The lift is what will allow you, one golden afternoon, to wear a sundress. So sadly, there is no non invasive, non surgical, or liposuction only way to fix large breasts.
Mesh is a man made material which people are using to create “an internal bra.” ADM is dermis used to do the same. The theory is that your tissue is weak, so we want to support the tissue with an additional layer. Most mesh and ADM are incorporated or replaced by your body’s own tissue.
MOST OF THE TIME THIS IS USED IS WITH THE ANCHOR TECHNIQUE. When you do the anchor scar breast reduction, there are two major flaws: 1. you are leaving all the tissue in the bottom of the breast, which makes the breast bottom heavy, and 2. you are relying on the tightening of the skin to do the lift, and skin tends to stretch and bottom out over time. The vertical lollipop breast reduction I do has tons of internal sutures, it keeps the cleavage breast tissue and “hollows out” the inferior tissue which raises the entire breast, and it does not rely on the skin tone to lift you.
PROs: It can help support the breast tissue. The recent addition of mesh seems to have advanced this as a technique, as the mesh tends to be more supportive over time and is much cheaper than ADM.
CONS: It adds additional cost (even the mesh will add about $1600 – $2000 to your cost), it can be palpable, it is a foreign object which can get infected or encapsulate, and it adds another factor which can go awry.
When would I recommend it? If you have had major weight loss and have incredibly poor skin tone, if you have had an anchor breast reduction or lift before so you must redo that technique, or if you have had a lift or reduction before and failed due to bottoming out, it is a good option.
No. Just no.
This has never made sense to me. When we are doing a reduction and REMOVING tissue, it makes no sense to add volume back in.
PROS: The only pro is it particularly for the anchor lift which hollows out the breast volume in the upper breast, an implant can add volume in the cleavage area. As I repeat often, this is a major issue with the anchor lift and part of why I do not do that technique.
CONS: How long do you have?
If your surgeon is recommending a reduction with an implant, see a few more surgeons. If you have terrible tissue quality and want to reinforce your lift, I would much rather see you spend the money on mesh.
What is the cost of a breast reduction?
First let’s talk about cosmetic breast reduction – not insurance coverage. The national average surgeon fee according to the ASPS (our national society) 2020 statistics is the surgeon fee is $5900-this does not include operating room or anesthesia. Here at the heart of the Bay Area in Palo Alto, breast reduction cost likely is in the $15,000 range.
What causes difference in the cost?
Insurance coverage.
Please see my notes above on insurance coverage. I, your surgeon, do not determine if you are covered. Every plan is different. We submit a preauthorization to get some idea if your insurance will help pay. Even if “covered,” I am out of network, and your copay and deductible varies from plan to plan. I have had patients who would have saved money doing the breast reduction as a “cosmetic” case, as they had high deductibles and copays. My fee is constant whether you are insurance or cosmetic, but operating room fees and anesthesia fees tend to be higher for insurance cases.
BREAST REDUCTION – WHAT SIZE DO YOU WANT TO BE?
BREAST REDUCTION- HOW SMALL SHOULD I GO? WHAT DO I REALLY HAVE?
BREAST REDUCTION, THE SCHNUR SCALE, AND INSURANCE COVERAGE.
CAN I GO TO A B WITH A BREAST REDUCTION?
CAN WEIGHT LOSS AFFECT YOUR BREAST REDUCTION?
Insurance will sometimes cover the surgery depending on your height, weight, and approximate volume to be removed.
If you are not going down at least 2 cup sizes, about 300g, it is unlikely your surgery will be covered. The fat in your axilla (your armpit area) is not considered breast tissue. The weight of the breast tissue is tricky. I could operate on two women and drop them both 2 cup sizes- from 34 DD to 34 C. On one patient I could remove 300g of tissue, on the other I could remove 100g. Same size change, different weights. The breast is like a pillow, and when I do a reduction I am compacting your tissue. For some, the breast lift and compression alone will reduce them in size without any removal of tissue.
Please know I am your advocate. The decision on coverage comes from the insurance company. I have been doing breast reductions for almost 20 years. When I started, most of my reductions were covered by insurance. Now fewer are. The short scar technique I use “cuts” out less tissue, as I am using more liposuction. And the amounts insurance companies require have gone up. We will review all of this at your consultation.
To those prospective patients who are reading the testimonials on breast reduction surgery, I hope my experience will be helpful.
Like you, I was looking for a surgeon with not only exceptional professional skill, but someone who makes you feel as if you’re her most important patient. I found Dr. Greenberg through my gynecologist, also a former patient of Dr. Greenberg. She was/is everything I had heard. My concerns were paid attention to with a mixture of courtesy, honesty, and humor. Her education is top notch, and is the daughter of a plastic surgeon. After scheduling my surgery, I left the office with the utmost confidence. Her experience and professionalism affords her a unique insight into her patients’ needs.
I’m delighted with the results! Dr. Greenberg, THANK YOU!
Compliments to the staff!
Jill
Anonymous
October 07, 2011