Breast Reduction in Boston


Named Among the Best Plastic Surgeons in Boston

Helena O. Taylor MD, PHD, FACS & Stephen R. Sullivan MD, MPH, FACS

Dr. Taylor & Dr. Sullivan, Board-certified Aesthetic, Plastic and Reconstructive Surgeons and Experts in Breast Reduction in Boston, Massachusetts

Large breasts, or macromastia, can cause significant physical pain and limit physical activity. Breast reduction surgery helps alleviate the physical and psychological issues associated with large breasts. While breast reduction may be considered medically indicated to remove excess weight from the chest, it simultaneously lifts and enhances breast shape and position on the chest wall.

Breast Reduction Boston

What is Breast Reduction?

Breast Reduction is reconstructive surgery for women with breasts that are disproportionately large relative to their body, and who have significant, back, neck and or shoulder pain. Breast reduction decreases the size of a breast by removing excess breast glandular tissue, fat, and skin. At the same time, similar to a breast lift, the breasts are lifted to a more youthful position with improved projection and lift.

Breast reduction has one of the highest levels of patient satisfaction among all plastic surgical procedures. It can significantly improve a woman's quality of life, enhance breast appearance, and restore breast harmony and proportion, while simultaneously reducing breast weight and discomfort. Breast reduction can also help restore a sense of confidence by improving asymmetries when one breast is larger than the other.

Benefits of Treating Macromastia with Breast Reduction

  • Decreased breast weight
  • Improvement in back, neck and shoulder pain
  • Decreased skin on skin contact
  • Reduction in grooving from bra straps
  • The ability to buy “off the shelf” bras
  • Wear just one sports bra while exercising
  • Better fit in clothing
  • Improved breast shape and position
  • Reduction of large pendulous areola
  • Reduction in headaches for many patients

Procedure for Breast Reduction

Breast reduction is most commonly performed as an outpatient surgery under general anesthetic. There is a multitude of techniques for breast reduction which can be distinguished by the scar pattern on the skin, as well as the blood supply to the nipple. Most breast reductions will necessitate a lollipop or anchor / inverted T scar. Most commonly, the inverted-T or anchor breast reduction is used for women who need significant tissue removed, correction of significant sagging, and skin tightening.

During the procedure, skin is removed from the inferior breast and around the areola to help create a narrower, better contour of the breast. The areola are usually reduced in size and relocated more superiorly while maintaining their connection to the breast tissue beneath. The anatomy of your breasts, chest wall and the amount of breast tissue will determine the best technique. It is often beneficial to use liposuction to contour excess fat deposits laterally and in the armpit area. Long-acting local anesthetic is instilled for post-operative comfort, and the incisions are closed with dissolving sutures. We rarely use drains. Our Boston breast reduction patients are placed in a soft surgical bra and typically go home that same day feeling good.

Breast Reduction Boston
Breast Reduction Boston

What is the recovery with breast reduction?

Dr. Taylor and Dr. Sullivan care about your recovery and want to ensure you have the most effective rehabilitation. They will talk to you about when you can expect to return to work depending on the specifics of what you do on a regular basis. On average, breast reduction patients take two weeks off from work, with some returning sooner, and some later.

You may shower the day of or the day after surgery. It will be normal to feel fatigued and not have the same amount of energy that you are used to. You can expect some tightness in your breasts and soreness for a few days. We often infuse the tissues with a long-acting numbing medicine (Exparel™) and pain medication will be prescribed for your comfort. We encourage a non-narcotic regimen, with narcotics reserved for breakthrough pain. More than half of our patients do not require narcotics postoperatively.

You may have a reduced range of motion in your chest and shoulders for a few days. You may also have some decreased feeling in your breast skin and nipples for a few weeks. We will provide a supportive bra, which can help reduce swelling and ease pressure.

Breast Reduction At A Glance

IDEAL BREAST REDUCTION CANDIDATE

  • Disproportionately large breasts
  • Body Mass Index <30

WHAT BREAST REDUCTION DOES

  • Lifts breasts
  • Removes excess breast weight
  • Repositions nipple and areola
  • Reduces areola

DURATION OF RESULT

Years

LENGTH OF PROCEDURE

2-3 Hours

TYPES OF ANESTHESIA

  • General Anesthesia (asleep)

RECOVERY

  • Comfortably at home
  • Most swelling to resolves – 2 weeks
  • Breasts settle into position – 6-10 weeks

TIME OFF SCHOOL OR WORK

  • 5-7 days

TIME OFF ACTIVITIES

  • Activities of daily living – 1 day
  • Light exercise – 2-3 week
  • Full exercise and contact sports – 6 weeks

Frequently Asked Questions

Am I a candidate for breast reduction?

If your breasts are disproportionate to your frame you may well be an appropriate candidate for breast reduction. Patients who have significant symptoms of back, neck, and shoulder pain, and or grooving from their bra straps, may qualify for insurance coverage depending on their plan’s requirements. The ideal candidate should be otherwise healthy, and with a body mass index (BMI) in the healthy range, ideally less than 30. Because breast reduction requires an adequate blood supply to the tissues, smoking, smoke exposure, steroid use, sickle cell disease, and systemic illness may disqualify you.

Can men get breast reduction too?

Many men suffer from gynecomastia or male breast growth. Gynecomastia is often genetic in origin and frequently runs in families. It can be a significant source of embarrassment, limiting wardrobe choices, activities, and time at the beach. Male breast reduction, or gynecomastia correction, can be an excellent option for men who have tried other approaches, like weight loss, without resolution of their gynecomastia. Most insurance policies consider gynecomastia surgery a cosmetic procedure.

How long do I have to wait to exercise after a breast reduction?

We encourage early gentle ambulation starting the day of, or a day after, surgery. This is good for the mind and body. Typically, we recommend avoiding heavy lifting or upper body straining for the first several weeks. When you do restart your exercise regimen, try low-impact activities like a stationary bicycle or Peloton to allow your breasts the proper time to recover. Our Boston breast reduction patients don’t typically have significant pain, but they feel tight, and sore, and tired. High impact activities are not desirable for the first few weeks after surgery.

What are the risks with breast reduction?

Patients who proceed with breast reduction are trading shape and size for scar. While the scars fade with time, there is significant individual variation in scarring. Bleeding and infection are risks of all operations but are thankfully rare with breast reduction. Changes in the nipple sensation and reactivity can occur but are also uncommon. Problems with wound healing, particularly at the T-junction of the anchor incision, are one of the most common issues that require attention in the postoperative period, but these can be managed with simple wound care. Loss of the nipple is the dreaded complication of breast reduction surgery. This is extremely rare but is the reason we avoid this operation in high-risk patients like smokers.

Will there be a scar with breast reduction?

Breast reduction trades the size, shape, asymmetry, and position of the breasts for scars. While scars are unavoidable, we work hard to position them in the most cosmetically appropriate locations and keep them as short as possible. To minimize scars during your breast reduction Boston plastic surgeons Dr. Taylor and Dr. Sullivan take care as much as possible, knowing that there is tremendous variability in scarring from one patient to another. Initially, the scars may be firm and pink, but as they mature they typically soften and fade. It may take up to one to two years for the scars to mature.

What are the types of breast reduction?

Breast reduction incisions and scars are determined by the type of procedure. The most common types are a Wise pattern (also known as inverted T or anchor pattern) and circum-vertical (also known as vertical or lollipop pattern). Dr. Taylor and Dr. Sullivan will meet with each patient to determine the ideal type of breast reduction.

Will nipple sensation change after breast reduction?

Most patients do not experience significant changes in nipple sensation, but some women may experience increased or decreased nipple sensation following breast reduction. Sensations like numbness, shooting pain, and burning are common during the healing process and may last several weeks, then gradually disappear. Some patients initially have nipples which are hypersensitive to touch or temperature. If the nipples are sensitive, it is best to desensitize them with gentle touch. If the nipples have less sensation, be patient as it may recover or improve with time.

Will I be able to breastfeed after breast reduction?

Many patients do successfully breastfeed after breast reduction surgery. The data on breastfeeding after breast reduction is inconsistent. Because we preserve the nipples’ connection to the breast tissue, we encourage patients to try breastfeeding if they want. Even with breast surgery, breastfeeding can be unpredictable. While breast reduction does separate the nipple from some of the breast tissue, often the remaining “pedicle” of tissue is adequate to produce sufficient milk supply. It is possible that after breast reduction a woman may have a hard time breastfeeding, but it is hard to know whether this is a result of the breast reduction or not.

Is breast reduction covered by Insurance?

Dr. Taylor and Dr. Sullivan can evaluate your condition to determine if you might qualify for coverage by your insurance company. Depending on your insurance policy, as well as the size of your breasts relative to body mass index and body surface index, you may qualify for coverage by your insurance company. If Dr. Taylor and Dr. Sullivan find your breasts are disproportionately large relative to your body, and you suffer from symptoms including neck pain, back pain, shoulder grooves from bra straps, or skin irritation, your insurance company may consider coverage for your procedure based on the amount of breast tissue that is removed. Each policy has its own requirements for coverage, so we will apply for preauthorization from your insurance carrier.

BREAST SURGERY (Breast Reduction, Breast Lift or Mastopexy) AFTERCARE INSTRUCTIONS

Preoperatively, In the week before your operation:

  • Consider eating pineapple, it may help reduce bruising
  • Consider supplementing with Arnica montana, it may help reduce bruising
  • Complete household chores and prepare meals for the first few days of postoperative recovery
  • Follow preoperative instructions with eating, drinking, and medications. Please have nothing to eat or drink after midnight the night prior to surgery, except for a sip of water with your medications

Postoperatively,

  • You will need someone to take you home, and ideally stay with you for the first 24-48 hours, as you may feel drowsy. You may require help the first few times you get out of bed.
  • It is important to get out of bed and walk (with assistance) every few hours after your breast operation to decrease the chance of postoperative problems such as blood clots.
  • Practice 15-20 deep breaths every hour to keep your lungs open.

Please take your medications as directed by Dr. Taylor or Dr. Sullivan to manage discomfort or symptoms.

You are likely to be given:

  •  Acetaminophen (Tylenol) 1000 mg every 8 hours, space doses 4 hours after Ibuprofen so one or the other is taken every 4 hours
  • Ibuprofen (Motrin) 800 mg or Colecoxib (Celebrex) 200 mg every 8 hours, space doses 4 hours after Acetaminophen so one or the other is taken every 4 hours
  • Gabapentin 300 mg every 8 hours for 7 days. If you have dizziness, double vision, or significant sleep disturbances, consider stopping the Gabapentin.

You may also be given:

  • Vitamin C 500 mg daily for 50 days
  • Oxycodone 5 mg – 1-2 tablets every 6 hours as needed for pain, though many patients may not need it
  • Colace 100 mg twice daily to prevent constipation, it is important to have a bowel movement each day. Prune juice may also be helpful.
  • Zofran 8 mg every 8 hours if needed for nausea
  • Scopolamine patch may be placed on the neck on the day of surgery and can stay for 3 days to prevent nausea

Eat a light diet for 2-3 days and avoid spicy food. Some suggestions to ease abdominal discomfort or indigestion after surgery:

  • Drink water or warm liquids
  • Prune juice to prevent constipation

WOUND CARE

  • If you had breast reconstruction following breast cancer, you may or may not have drains. The drainage bulbs connected to the end of the drains should be compressed at all times to keep suction. It is normal for red fluid and blood clots to form in the drains. Please record time and amounts of drainage over a 24-hour period – we will provide a form. Usually the drains will be removed when the drainage is 30cc or less in a 24-hour period. All patients heal differently and according to many factors. On average, drains remain for one to two weeks.
  • You may shower or sponge bath the day after the operation with assistance and wash your skin as you normally would with soap and water. Avoid soaking the incision, although It will not hurt to get a splash water from the shower on the wounds. Gently pat dry after washing.
  • You may wear a camisole, postoperative bra provided at the hospital, or no bra after surgery. Dr. Taylor or Dr. Sullivan will advise you when you may wear an underwire bra - usually a minimum of 6 weeks after surgery.
  • Most wounds will be closed with absorbable sutures that are buried and skin glue. The skin glue forms a barrier to water. Please do not remove the glue, it will fall off on its own after a few weeks. Do not apply any lotions, potions, ointments, creams or solutions (e.g. no hydrogen peroxide or alcohol) as they can be harmful to the fragile healing tissue.
  • Do not smoke or expose yourself to smoke, smokers or nicotine as wound healing will be compromised.
  • Infection is very uncommon, but please call Dr. Taylor or Dr. Sullivan at any sign of infection which would be signaled by fever, increased pain, spreading redness or significant swelling.

ACTIVITY

  • For the first few days following breast surgery, avoid raising your blood pressure or heart rate as it can cause bleeding. We recommend gentle range of motion exercises with your arms 3 to 5 times per day starting the day of the operation.
  • Please do not drive until turning the steering wheel can be done safely and without pain (usually 5 to 7 days). Do not drive while taking pain medications such as oxycodone.
  • Do not lift anything heavier than 10-20 lbs, run, lift weights, or perform strenuous exercise for 7-10 days. Do not perform chest muscle exercises or strenuous bouncing exercises for 6 weeks.
  • Massage to the breast and areas of liposuction can help increase circulation and soften firm areas under the skin. Please wait at least 3 to 4 weeks after surgery to start massage to avoid increased swelling.

GENERAL OUTCOMES

  • Moderate swelling of your breasts is to be expected. Following breast reduction or breast lift, the breasts may initially appear quite high and perky, and will settle into a natural appearance over several weeks. Please be patient.
  • If you elected to have simultaneous liposuction, swelling and bruising is to be expected. Please be patient, the swelling and feeling of tightness will gradually subside over the following months. Bruising may last for a few weeks and will move down your body due to gravity.
  • It is not uncommon for wounds to develop along the incision under the breast. These typically appear 2 to 3 weeks after the operation at the junction of the vertical incision and inframammary fold. The wounds are often red with patches of yellow and white – this is not an infection, which is usually associated with fever and spreading redness. These wounds can be treated with soap and water wash and a gauze dressing; and they will heal on their own in a few days to weeks.
  • The incisions often appear lumpy and bumpy. This is normal and the incisions will flatten over a few weeks.
  • Following breast reduction or breast lift, the nipples can be inverted rather than projecting outward. This is normal and the nipples will usually project again within a few days to weeks.
  • The areola can appear asymmetric or irregularly shaped. This is normal and is due to the dissolving suture - similar to the way a draw string works on a garbage bag. Please be patient, the irregular shape and asymmetry will resolve over a few weeks.
  • Sensations like numbness, shooting pain, and burning are common during the healing process, may last several weeks, and gradually disappear. If the nipples are sensitive, it is best to desensitize them with gentle touch.
  • Scars take one full year to mature. You may notice that they become red, raised and firm for several weeks to months before becoming soft, flat and pale. Avoid Vitamin E as it can irritate the scar. Mederma has no proven benefit and is likely not worth the expense. All incisions will be sensitive to sunlight during the healing phase. Direct sun contact or tanning booths are to be avoided. Silicone cream or skin moisturizer with sunscreen and gentle massage may be helpful.
  • Please call our office (617-492-0620) if you have:
    o Continuous bleeding (a small amount bleeding from the incision is expected) o Significantly more swelling on one side when compared to the other
  • Worsening pain
  • Fever, spreading redness or irritation of the skin
  • Shortness of breath

It is important to be seen by Dr. Taylor or Dr. Sullivan after your operation. They will see you in follow-up appointments at regular intervals, typically 1 week, 2-4 weeks, 3 months, 6 months, and 1 year or as often as needed post-op. Call to schedule your appointments at Taylor & Sullivan Plastic Surgery office at (617) 492- 0620 between the hours of 8:30 – 5:00 or visit our webpage at www.massplasticsurgeons.com. We are always available for postoperative concerns or emergencies and can be reached through our paging service 24 hours per day at (617) 492-0620.

Download our Breast Lift and Breast Reduction Postoperative Instructions Here.

Consultation for Breast Reduction in Boston

If you are interested in a breast reduction procedure, contact us to set up your consultation with Dr. Taylor and Dr. Sullivan, named among the best Board Certified Plastic Surgeons in Boston. While one doctor will be your primary surgeon, they usually operate together as a team to optimize your care and safety.

When it comes to the best breast reduction Boston has to offer, you can trust the experienced and caring team of Dr. Taylor and Dr. Sullivan, named among the best Board-certified Plastic Surgeons in Boston by Boston Magazine each year since they began practicing in the area.

Dr. Taylor and Dr. Sullivan trained at some of the finest medical institutions in the world, including Harvard Medical School, where they now teach medical students and residents. They strive to provide honest and informative consultations and perform surgery with precision and care with an emphasis on safety.

During your consultation, Dr. Taylor and Dr. Sullivan will listen to your concerns and discuss the details of your breast reduction. Excellence with compassion is the motto of Mount Auburn Hospital, which we aspire to exemplify.

Call Today 617.492.0620

To schedule a private consultation with Dr. Taylor or Dr. Sullivan, please call the office or request an appointment using our form. We welcome your visit and your questions.

300 Mount Auburn St. Ste 304, Cambridge, MA 02138

Taylor & Sullivan Plastic Surgery Boston
American Society of Plastic Surgeons American Board of Plastic Surgery Fellow American College of Surgeons America Association of Plastic Surgeons Sigill Massachusetts

617.492.0620

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300 Mount Auburn St. Ste 304, Cambridge