Breast Reduction Vs. Breast Lift
Patients often ask us as plastic surgeons upon consultation, “Do we need a breast reduction or should we have a breast lift performed?” This of course is associated with the amount of breast tissue which is both glandular and fatty tissue versus the amount of breast skin and skin laxity that the patient has. An experienced Board Certified Plastic and Reconstructive Surgeon will be able to indicate on clinical examination and by palpation of the patient’s breast, the amount of skin versus the amount of glandular fatty tissue that is creating the breast enlargement or hypertrophy.
On examination, patients may often look much larger than they actually are because the breasts are so loose, the skin is so lax, that they have enormous draping breast. Actually, when the skin is removed and the breast is elevated, the breast volume is really greatly reduced and the size of the breast is truly not as large as the woman thought she was.
For example, many patients come to us who have had massive weight loss and now have very wide inferiorly displaced grade III ptotic breasts that are sagging and they look enormous in pictures, but actually they are very flat, have minimal upper pole fullness. These patients should only undergo a formal mastopexy or breast lift. Tissue should be conserved and minimal or no breast or glandular tissue should be removed, with only a formal breast lift performed in order to maintain as much volume as possible.
On the other hand, some women present with enormous breasts that have an enormous amount of glandular and fatty tissue throughout the breast, especially the lateral aspect extending to the anterior axillary line. These patients should undergo a significant reduction of breast tissue of skin, fatty and glandular tissue in order to reduce the overall size of the breast to reduce the symptoms that the patient has which usually include back pain, neck strain, grooving around the shoulder blades and rashes underneath the breast creases.
So, when considering a breast lift versus a breast reduction, it is absolutely essential that the doctor make the correct judgment call and patients who have skin problems perform breast lifts and patients who have massive tissue problems perform reduction mammoplasties in order to reduce the symptoms of the enormous heavy breasts.