Breast Reduction New York City
Choosing Breast Reduction
Breast reduction (technically known as “reduction mammoplasty” is a surgical procedure that removes excess fat, skin and glandular tissue from your breasts. A reduction mammoplasty can relieve the neck and back pain caused by large breasts. It can also enhance your self-esteem and make your breasts more proportional to your body.
Am I a Good Candidate for Breast Reduction?
You are a good candidate for breast reduction if you are unhappy with the large size of your breasts. You must also be in good health, live in New York City (or be willing to travel), and be motivated to follow Dr. Cangello’s pre-operative and post-operative instructions. This includes wearing a support bra while you are healing from surgery.
You may wish to consider reduction mammoplasty if your breasts are causing physical or psychological pain. This includes neck and back pain due to the weight of your breasts. You may also have permanent indentations on your shoulders from your bra straps or irritated skin caused by your breasts rubbing against your upper abdomen. Many women also experience psychological discomfort from having breasts that they feel are too large for their body.
Reduction mammoplasty is available to women who are at least 16-years-old. Good candidates range from high school students whose breasts are hindering their sports careers to older women whose large breasts have caused a lifetime of back pain. For the best results, you should also be close to your ideal weight and your weight should be stable.
Good candidates must also have realistic expectations for the surgery. One can expect a likely reduction in all of the symptoms that prompted the person to seek breast reduction in the first place. The surgery will also elevate the nipple position on the chest wall and improve the shape of the breasts. Dr. Cangello will explain the results that you can expect from the reduction mammoplasty and may suggest additional procedures to achieve your desired look.
The Consultation: Creating Your Plastic Surgery Plan
Your breast reduction journey begins with a consultation with Dr. David Cangello in our New York City office. Dr. Cangello will discuss your medical history and the results that you hope to achieve from your breast reduction. For your surgery to proceed safely, you need to be honest about your allergies, medications, personal habits, and previous surgical procedures. You will also need to tell him if you are planning on getting pregnant and breastfeeding.
The ability to breastfeed varies greatly after reduction mammoplasty. The outcome depends on the incision placement, the reduction technique the surgeon choses to use, and the amount of tissue that was removed. Dr. Cangello will discuss breastfeeding with you and may recommend that you postpone breast reduction until after you’ve had children if you have a strong desire to breast feed.
Dr. Cangello will ask about your goals for the breast reduction and the look you hope to achieve – including the size, shape and volume of your breasts. His goal is to create breasts that are physically comfortable but still look natural on your body.
Dr. Cangello will conduct a physical examination. He will be looking at the size and shape of your breasts, the weight of your breasts (some breasts have more dense breast tissue and are heavier and this can affect the final result) the position of the nipples relative to the inframammary fold (crease below your breast), and the quality of your skin. After the exam, Dr. Cangello will recommend a surgical plan based on your height, weight, build, anatomy and current breast size.
This plan will help create the body contour that you desire.
Dr. Cangello will answer your questions and explain how to prepare for your breast reduction, as well as what you can expect in your post-operative care.
Preparing For Breast Reduction
Dr. Cangello is committed to achieving the best results possible. During your initial consultation, he and his surgical team will create a pre-operative plan for you to follow. This plan is designed for your unique needs, to make sure that you have the best outcome possible. Your pre-op plan may include changes in diet and other habits that impact your health. You will be advised to avoid ANY nicotine-containing products for at least two to four weeks before and after surgery.
Dr. Cangello’s staff will also give you instructions for the days before your surgery. These include stopping certain medications and supplements. You will also be told not to eat beginning at midnight on the day of your surgery.
Finally, Dr. Cangello and his staff will explain your post-operative plan. He will give you prescriptions to fill prior to surgery and ask you to find someone to drive you home following surgery.
Where Will the Surgery Be Performed?
Your breast reduction surgery will be performed at Dr. Cangello’s New York City office. He has a fully accredited (AAASF) state-of-the-art operating room on-site. Our operating room facility is truly second to none in New York City. You are encouraged to ask for a tour of the operating facility when you come in for your consultation.
Types of Anesthesia
Breast reduction surgery generally 2-4 hours depending on the size of your breasts. Patients with extreme macromastia (enlargement of the breasts) will have a longer surgical time. The procedure will be performed using general anesthesia and a local tumescent anesthesia to reduce the risk of bleeding during surgery. You will not feel any pain or remember the surgery. Dr. Cangello only uses exceptionally experienced board certified anesthesiologists, not certified nurse anesthetists (CRNAs) for care of his patients during surgery.
Inferior pedicle technique (also known as Wise pattern, inverted T-scar, or Anchor scar patterns)
The inferior pedicle produces a reduced size which usually maintain lactational ability. The volume and size reduction of enlarged breasts is performed with an incision around the areola , which then extends downwards, in a vertical line at the along the lower half of the breast to the fold below the breast. After excising the proper amount of tissue (glandular, adipose, skin), the nipple-areola complex is transposed to the proper position on the chest wall where its height is above the inframammary fold.
Vertical scar technique (lollipop incision)
The breast reduction performed with the vertical-scar technique usually produces a well-projected breast as two vertical pillars of breast tissue are brought together to from a cone shape after the appropriate amount of tissue has been excised. The breasts have less scarring as there is no incision made along the breast fold, as is the case with the inferior pedicle technique described above. The nipple-areola complex (NAC)is elevated by means of a pedicle (superior or medial) that maintains the viability of the NAC. The vertical-scar reduction mammoplasty is best suited for less severe cases of macromastia as smaller amounts of excess skin and breast tissue are removed with this technique.
Free nipple-graft technique
The breast reduction performed with the free nipple-graft technique moves the nipple-areola complex (NAC) as a tissue graft without an attached blood supply that comes from a skin and glandular pedicle as in the techniques described above. The advantage of this technique is that a greater volume of breast tissue can be removed without concern for the viability of the nipple. This technique is reserved for cases of severe macromastia only where the breasts are extremely pendulous and the nipple hangs well below the breast crease on the chest wall. The disadvantage of this technique is that the patient cannot lactate and the nipple becomes insensate. In addition, there may be loss of pigmentation of the areolar skin over time. The medically indicated candidates for free nipple graft are: the woman whose health presents a high risk of ischemia (localized insufficiency of blood flow to tissue) of the nipple-areola complex, which might cause death of the NAC. Women who are diabetic, are smokers or who have an approximate NAC-to-IMF measure of 20 cm are sometimes offered this technique.
The breast reduction performed with the liposuction-only technique usually applies to the woman whose oversized breasts require the removal of a small to moderate volume of internal tissue. The ideal breast liposuction candidate is the woman whose breasts are not dense and mostly composed of fatty (as opposed to glandular) tissue. These women should also have very good breasts skin elasticity and minimal or mild ptosis (sagging of the breast and nipple-areolar complex). The therapeutic advantages of the liposuction-only technique are the very small incision-scars required to perform the procedure and the resultant shorter post-operative healing and recovery period.
The Recovery Process
You will wake up with a surgical dressing over your incisions and possibly drains under each arm. You will also be wearing a post-surgical bra or compression garment. Although your breasts may feel tender, swollen or bruised following the surgery, they should also feel smaller and lighter. Dr. Cangello will prescribe pain medication to keep you comfortable.
Your sutures sutures will all be dissolvable except for one that is usually removed two weeks postoperative. If you have drains, they are often removed the day after surgery. You should be able to return to work within a few days to one week, as long as your job does not require heavy lifting. You will have to continue wearing a highly supportive bra with no underwire for the first month following surgery and will need to limit your activity during that time. It may take a few months for swelling to completely disappear. In the first month, the breasts usually look very firm, often flat (as opposed to rounded) along the bottom half and the shape is not a very natural breast shape. This invariably improves with time such that by three months the breasts have attained a natural tear drop appearance.
Breast reduction surgery is extremely satisfying because patients tend to be extremely happy with the results.
Please call our New York City office at 212-644-4416 to set up a consultation and learn how you can benefit from breast reduction.
How long does recovery take?Recovery for Breast Reduction surgery, like all surgeries, happens in phases. For the first couple of days after surgery patients may feel some soreness around the breasts. They are provided with pain medication to keep themselves comfortable. Patients who have jobs that do not require physical labor can usually be back to work within a few days. By one to two weeks after surgery patients are usually feeling very well, almost as if they never had anything done. At 4-6 weeks post surgery patients can return to full activity including exercise.
Will my insurance cover the procedure?Insurance often does cover the procedure if certain clinical criteria can be demonstrated to the insurance company and if your plan allows for coverage. Not all insurance plans have breast reduction as a covered benefit. Dr. Cangello is out of network with all insurances. So you must have out of network benefits to obtain reimbursement for your surgery. Our office will help in providing you with the proper information to submit to your insurance company to obtain coverage.
Will there be scaring?As with any surgical procedure, there is always scarring. With breast reduction surgery there is always one of two types of scar pattern on the breasts. They are: “lollipop” or circumvertical scars (around the areola and a vertical scar from the bottom of the areola down to the fold below the breast) and the “anchor” or Wise pattern scars (same as the lollipop scar with an additional horizontal scar along the length of the fold below the breast). Dr. Cangello is meticulous in the way he closes incisions so that your scars will be as invisible as possible. Of course, the way you heal also effects the final result of the scar. You are encouraged to look at our before and after gallery to see examples of Dr. Cangello’s work. Notice how inconspicuous his scars are.
Can I breastfeed after a breast reduction?The ability to breast feed after breast reduction surgery may be reduced. This depends in part on the amount of tissue removed and the technique employed by the surgeon.
Can men have breast reduction surgery?Men can and do have breast reduction surgery. When men have very slight feminization of their breasts the reduction usually involves liposuction alone or a combination of liposuction and excision of some of the glandular tissue of the breast. This is accomplished through a very small incision at the bottom of the areola. For men with greater breast development excision of excess skin and repositioning of the nipple may be necessary.
Can my nipples be moved or resized during a breast surgery?Your areolas will be resized (made smaller) and moved during breast reduction surgery. They will be relocated so that they lie at a level just above the skin fold below the breast. Nipple size can also be reduced if requested.
How long will my results last?The results of your breast reduction are essentially permanent. However, it is possible that pregnancy and associated hormonal changes or significant weight gain can cause reaccumulation of breast tissue necessitating further reduction in the future.
Why does choosing a Board Certified Plastic Surgeon matter?It is extremely important that you chose a plastic surgeon who is a Diplomate of the American Board of Plastic Surgery (only) for your breast reduction surgery. A surgeon who is certified by the American Board of Plastic surgery has to undergo rigorous training in the field of both cosmetic and reconstructive plastic surgery. In addition they have to pass very difficult oral and written examinations to verify their proficiency in the field. Unlike surgeons who undergo cosmetic training alone, plastic surgeons also have extensive experience with reconstruction of the entire body. So they are the most qualified to deal with any untoward event that may occur as a result of having breast reduction surgery. They are also the most qualified to have in depth understanding of the anatomy involved when performing the procedure.