Reduce back and neck pain from enlarged breasts with Cleveland Ohio breast surgery

Who is a candidate for breast reduction surgery?

Breast reduction, as the name implies, involves reducing the weight and size of the breasts. This Cleveland breast surgery is generally covered by insurance as medically necessary to treat back pain, neck pain, rashes, and functional impairment (interference with movement and exercise). Patients who are candidates for breast reduction in Ohio typically have these symptoms.

Most insurance companies require 500 grams (1.1 pounds) or more of breast tissue to be removed per breast to consider this a covered procedure. Insurance approval involves a “pre-determination” letter from the plastic surgeon to the insurance company documenting pre-existing symptoms, prior medical treatment, and an estimate of the weight of the tissue to be removed. Clinical photographs must also accompany the pre-determination letter.

What are the different types of breast reduction?

There are multiple techniques available to accomplish breast reduction.  Dr. Goldman uses a spectrum of techniques depending on the size of the breasts and goals of the patient. Most patients are best suited to the inferior pedicle technique.

Inferior Pedicle Breast Reduction – By far, the most popular technique in the United States is the inferior pedicle breast reduction (also known as the Wise pattern or inverted-T reduction).

For the inferior pedicle breast surgery reduction, the Dr. Goldman will draw a pattern on the patient’s skin prior to breast surgery, with the patient standing up. This pattern marks out the incisions and the amount of skin to be removed.

In the operating room, after anesthesia is induced, the Dr. Goldman sculpts a central mound of breast tissue that is attached, at its base, to the underlying chest wall (the rib cage). Excess breast tissue is removed from the sides and top of the breast.

The breast mound is then lifted, bringing the nipple and areola (the pigmented circle of skin around the nipple) to a higher, more youthful position. The areola is often made smaller.

The breast skin, which was tightened according to the pattern drawn preoperatively is then, in essence, wrapped around the reshaped breast mound. This leaves a circular incision around the areola, a vertical incision down to the fold underneath the breast (the inframammary fold), and a horizontal curved incision in the inframammary fold. The latter two incisions are shaped like an upside-down, or inverted, “T,” so this technique is often referred to as an inverted-T breast reduction.

Vertical Breast Reduction – Smaller volume reductions may be candidates for a vertical breast reduction in Ohio, which minimizes the size of the incisions used.

There are several breast surgery reduction techniques that are referred to as vertical breast reductions. In the United States, these tend to be used mainly for small volume breast reductions (reductions that do not remove much weight from the breast).

Vertical breast reduction techniques in Ohio remove tissue from the central lower breast. The sides of the breast are then brought together to reshape the breast mound.

Skin patterns are similar to those for inverted-T reductions and are also drawn prior to surgery with the patient standing. Vertical reductions generally allow for a shorter horizontal scar at the inframammary fold.
**Some techniques actually eliminate the horizontal scar, but this can cause an unusually long lower breast and consequently an unusual breast shape.

Free Nipple Grafting – extensive reductions are best suited with a technique referred to as free nipple grafting, in which the nipples are moved up as skin grafts.

In patients with extremely large breasts, the nipple-areola complex has to be removed from the breast and replaced as skin graft, after the breast size is reduced.

In such cases, the blood flow in and out of the nipple is altered significantly by removal of a large amount of breast tissue. So, it is actually safer to move the nipple as a skin graft. Generally, an inverted-T skin pattern is still used.

What are the risks of breast reduction surgery?

Any surgery carries the risk of bleeding, infection, and medical or anesthetic complications.  But risks specific to breast surgery reduction include:

  • nipple numbness, which can be permanent
  • transient changes in nipple sensation
  • wound healing problems like keloids (thick scars), skin necrosis (an area of skin can die, scab over, and then scar), or fat necrosis (fat within the breast becomes hardened)
  • size issues (being too big or too small or asymmetric after surgery)
  • pain
  • decreased ability to breast feed

In rare instances patients may require a transfusion or must return to the operating room due to bleeding.  This statistic is less than 1% of breast reduction patients in Ohio and for Dr. Goldman’s practice.

Similarly, requiring treatment for infection or anesthetic complications after breast reduction is rare. Performing this procedure in an accredited surgical facility with certified anesthesiologists or anesthetists is standard.

Dr. Goldman performs a thorough history and physical examination on every patient and obtains medical clearance preoperatively whenever necessary. Our surgery centers also follow standardized guidelines in obtaining screening laboratory studies preoperatively.

Will my cup size be guaranteed after breast reduction Surgery?

Bra cup size cannot be guaranteed for any breast surgery because it is not standardized as cup size is different between manufacturers. One company’s B-cup will not be the same size as other companies.

Furthermore, cup size is also subjective: one woman may wear a D-cup bra, but a woman of equivalent size may like the fit of a C-cup better. It is also important to note that the volume of a given cup size increases as chest size increases, so a 34-C cup is actually a much smaller cup than a 40-C. Thus, a woman may fit into a 34-C or a 36-B, for example.

Can I Have breast reduction Surgery if I smoke?

Dr. Goldman requires that all patients quit smoking 2-3 months prior to breast surgery. Smoking clearly increases complication rates from surgery, including skin necrosis, fat necrosis, and medical complications, like pneumonia and blood clots.

We have immense success with smoking cessation for our patients. In appropriate patients, Dr. Goldman will prescribe Chantix or Wellbutrin, two medications shown to help patients quit smoking.

Why choose Dr. Goldman?

Choosing the right plastic surgeon for you is like choosing any physician.

First, make sure the doctor is well-trained and board certified in plastic surgery. Membership in major plastic surgery societies also lends credibility to the doctor’s qualifications.

Second, evaluate the physician’s results. The internet is ideally suited for this purpose because plastic surgeons can show before and after pictures.

Third, does the physician communicate well and have good bedside manners? This is critical because the surgeon has to understand your goals, and you have to understand the risks, benefits, recovery, alternatives, and techniques for the Ohio breast surgery you are contemplating.

We invite you to examine Dr. Goldman’s credentials, before and after pictures, and the rest of our website.  Then we hope to see you in consultation to find out if breast reduction in Ohio is a viable choice for you.

How do I schedule a consultation?

Feel free to email at info@drgoldman.com or call (216) 514-8899. Our friendly and well-informed staff would be happy to answer questions and expedite a consultation.