Breast Reduction

Women who have large breasts may have problems with neck pain, back pain shoulder pain with bra strap grooving, irritation underneath the breasts, pain and tension headaches radiating up their back and neck and even migraines. If conservative management such as supportive, properly fitting bras and a program of physical therapy to strengthen the back along with weight reduction are unsuccessful in eliminating these symptoms, then breast reduction might be an alternative. The procedure is usually performed under general anesthesia and takes anywhere from 1 ½ to 2 ½ hours depending upon the breast size. The procedure helps to eliminate the neck, back and shoulder pain based upon two mechanisms. 1) The breast tissue is physically removed so that the breasts are lighter and 2) the nipple is repositioned at a higher level to take the stress and weight out of the bra which is then transferred to the bra straps. This procedure usually requires an incision around the areola, an incision from the bottom of the areola towards the chest and sometimes an incision underneath the breasts. This depends upon the size of the breasts and is determined during the consultation with the operating surgeon. The main risks with this procedure are unfavorable scarring, infection, change in nipple sensation, bleeding, hematoma, and possible nipple necrosis due to poor blood supply. This is more often seen in patients who smoke or who are Diabetic. While most patients do experience a significant improvement in their back, neck and shoulder pain from the procedure, it is a procedure that does result in significant scarring and one must weigh the risks, benefits and alternatives of the procedure.