Scarless Breast Reduction
When Should I Consider a Breast Reduction?
- Large, heavy breasts causing back, shoulder & neck pain, poor posture, bra-strap indentations, and rashes under breast creases
- Excessive breast size, which may decrease a sense of attractiveness and self-confidence
- Excessive breast size, which may interfere with normal daily activities or with the ability to exercise
- Smaller breasts with an lifted, more attractive contour
- Improvement in back, shoulder & neck pain, postural changes, shoulder grooving, and rashes under the breast creases
Dr. Kimberly Short, a board certified plastic surgeon, has been selected as a speaker at the national plastic surgery meeting highlighting her breast reduction technique, the SPAIR technique as compared to previous, older breast reduction techniques. Dr. Kimberly Short is a premier breast surgeon and her most recent presentation was a presentation on “Incorporating the SPAIR Mammoplasty into Your Practice”. Dr. Kimberly Short’s technique for the breast reduction technique is a SPAIR technique. This surgery technique is an updated, improved approach to breast reduction surgery compared to the older “Anchor” incision approach. The SPAIR technique delivers less scarring and an improved breast shape; regardless of the amount of breast tissue removed. Dr. Short was able to personally train with the inventor & founder of the SPAIR technique in Grand Rapids, Michigan.
The SPAIR technique is a revolutionary technique to reshape and reduce the breast by providing a prettier breast shape (less boxy in appearance compared with the older “Anchor” technique), limiting the incisions on the breast (avoiding extending the incisions in the breast crease referred to as the “Anchor” incision), and decreasing the lateral breast fullness. As a female plastic surgeon, Dr. Short understands the importance of achieving the optimal, desired breast size and shape, and the ability to guide patients with an appropriate balance of proportions. Dr. Short performs two breast reduction techniques, the most common approach is the above description of the SPAIR technique or more traditional approach as well as liposuction of the breasts or referred to as the scarless breast reduction.
Scarless Breast Reduction: Liposuction of the Breasts
Dr. Short can perform a liposuction only breast reduction, often called the scarless breast reduction, through two small 1.0 cm incision on each side of the breast crease. Because the breast tissue is composed primarily of fatty tissue, liposuction can be used to remove this fatty tissue component and promote skin contraction after surgery. This is an ideal option in younger patients with a mild degree of low nipple position and a good skin envelope without significant skin stretch or stretch marks. Liposuction only for reduction of the breasts is ideal for patients seeking a reduction to one to two cup sizes as well. On average, Dr. Short is able to remove 500-1000 cc from each breast and due to a more conservative removal; skin contraction and mild elevation of the nipple are anticipated without the more traditional incisions required for skin tightening and lifting of the nipple. The results are permanent. Liposuction typically does not interfere with nipple sensation or the ability to breastfeed. The patients have a more limited recovery pain but are required to wear compression with an ace wrap following surgery for 2-4 weeks. The patient are also recommended to perform external ultrasound massage to the breasts following surgery to decrease the areas of firmness and to reduce the swelling.
For most breast reductions Dr. Short uses the SPAIR technique. This technique is a recent advancement in breast reduction procedures that can allow for a prettier breast by decreasing lateral (outer) fullness and creating a more natural looking breast shape, while at the same time decreasing the incisions on the breasts. The incision with the SPAIR technique is around the nipple-areolar complexes (pigmented region around the nipples) with a vertical incision down (like a lollipop). Sometimes the incision is also placed in the fold of the breast crease. The nipple-areolar complex is decreased in size and is repositioned in a central location. Dr. Short’s technique uses a permanent pursestring suture around the areola to maintain the diameter long term; this suture is the only permanent suture placed for a breast reduction surgery. The nipple-areolar complex is not removed but the skin is tightened around the breast mound. The nipple is not removed and nipple sensation is preserved. Excess breast tissue, fat, and skin are then removed to the desired cup size and the skin envelope is tightened creating a “perkier” breast shape with significantly less breast volume. The breast reduction surgery is able to preserve nipple sensation and the ability to breastfeed following surgery.
Patient who smoke are required to stop smoking a minimum of 6 months prior to surgery to ensure adequate healing and decrease the risk of complications related to decreased blood flow to the incisions after surgery. Smoking has been shown in the literature to reduce the blood flow to the incisions by at least 30%, significantly contributing to complications.
Planning the Surgery:
Time off Work:
10-14 days with lifting restrictions for the first 4-6 weeks depending on the approach and amount of tissue removed.
You will need someone to take care of you for the first 24-48 hours following surgery. You are required to return to the office the day after surgery for a post operative appointment.
The Day of Surgery:
The procedure is performed as an outpatient basis under general anesthesia. The breast reduction procedure takes approximately 3-5 hours.
You will go home with light dressings over the incision sites and a surgical support bra is worn for 2 weeks. You may shower after 72 hours if no drains are placed. If drains are placed, then you are not able to shower until the drains are removed in the office. Typically, drains are removed after 5-7 days. Skin glue adhesive or steri-strips are applied to the incisions. Scar treatment options are available at your two week appointment. Extensive taping to the breast incisions is recommended for the first 6-8 weeks to improve scarring. The scars will fade over time. Light activities can be resumed after 14 days and aerobic activity may be resumed at 6 weeks after surgery.
This is a procedure that may be covered by your insurance company. Each insurance company has certain standards or criteria that must be documented in order to receive approval. The insurance company will require documentation from your primary care physician for treatment of conservative therapy for back pain, neck pain, rashes under the breast, etc. Following the consult, Dr. Short can supply you with preoperative pictures, a letter stating it is medically necessary, measurements of the breast, and support from the examination that a breast reduction will improve symptoms. You can then submit this information to your insurance company. Dr. Short is out of network with all insurance companies so we do recommend checking into your out of network benefits prior to surgery. With out of network benefits, the Gillian Institute does require full payment prior to surgery. After you submit the appropriate documentation to your insurance company, you will receive reimbursement from the insurance company at a later date if they agree the procedure is medically necessary . Also, please keep in mind, our office and surgery center are not able to bill the insurance company for these services since we do not have the appropriate insurance billing computer software or forms; but we are happy to provide you with the documentation for you to submit for reimbursement on your own.
Note: It is important to address any concerns with Dr. Short at the time of your consultation. There is some risk, as with any surgical procedure. Minor complications that do not affect the final outcome occur occasionally. Major complications are unusual. Dr. Short can explain the procedure and potential complications to you in detail, and she can assist you in determining if a breast reduction is right for you.