Breast Reduction

Most patients find the treatment process with breast reduction to be fairly painless and stress-free. Surgery is performed under general anesthesia, allowing you to sleep deeply throughout the process and wake up with no memory of the procedure. After breast reduction, you can take oral painkillers prescribed by the doctor to alleviate any discomfort.

Patients can expect a series of 4-5 visits with Dr. Bitar, including the consultation, surgery, and several follow-up sessions. The doctor will ensure that your healing process is progressing optimally by continuing to monitor your progress after your surgery. The follow-up appointments allow Dr. Bitar to remove your sutures and drains, assess your incisions, and address any questions or concerns related to the recovery process.

You may experience a moderate amount of swelling and bruising after breast reduction that can make your breasts look bigger than you would like. Rest assured, with each passing week, your chest will appear more balanced, sculpted, and proportionate. It can take several months for all residual swelling to dissipate and for your final results to become evident.

The breast reduction scar undoubtedly causes a lot of women who seek this operation some anxiety, and that is understandable. The exact scar will depend on the degree of breast sagging and the amount of reduction planned. A vertical breast reduction with a lollipop incision can be used in mild to moderate reductions, and a Wise pattern reduction with an anchor incision is utilized for more significant reductions. In both procedures, breast tissue, fat, and skin are removed. In a reduction, a large amount of breast tissue is removed, with an average of about 1-2 lbs removed from each breast. The breast reduction scar can cause women who seek this operation some anxiety, but having smaller breasts with the weight literally lifted off of their shoulders offsets any dissatisfaction from the anchor incision scars.

We are often asked many questions about scars. Usually, scars will heal well. Scars can be revised in the future according to the patient’s wishes; however, our revision rate is approximately 2%. The rest of the patients, over time, are generally satisfied. We also offer women a unique scar tape and cream system proven in a study on 800 patients to optimize scar healing. The vast majority of patients are very happy with their breast reductions.

There are different ways of performing a breast reduction. The two main techniques are either a vertical breast reduction with a scar around the areola and a lower vertical scar (“lollipop” incision) or a “Wise” pattern technique with an “anchor” incision. The rationale for performing a breast reduction with a “lollipop” incision is to spare a patient the horizontal scar at the bottom of the breast. The horizontal scar can heal unfavorably in some patients; therefore, if it is unnecessary, it can be eliminated.

The advantage of a vertical breast reduction is less scarring and a more rounded, projected breast shape. The disadvantage of doing the “lollipop” incision (vertical breast reduction) is that it takes slightly longer for the breast to look natural. Additionally, a small amount of excess skin below the breast may need to be removed at a later time.

The advantage of the “Wise” pattern technique is that it is a simpler technique with few complications and consistent results. It also allows for more skin removal in cases of severe breast enlargement. The main disadvantage is the lower horizontal scar, as well as some risk of bottoming out in the long term.

It is recommended that you wait at least 4-6 weeks before returning to your normal exercise regimen and workout schedule. However, Dr. Bitar encourages you to take gentle walks immediately after surgery, as this can support healthy circulation and improve your overall mood.

Yes. Dr. Bitar commonly pairs breast reduction with a breast lift, liposuction, or mommy makeover to enhance results and take your appearance to the next level. He can discuss your options for a combined treatment plan during your private consultation.

At the Bitar Cosmetic Surgery Institute, we take pride in ensuring that we provide the best possible surgical experience. This process encompasses preoperative preparation, the actual surgery, and postoperative care.

• General Complications
  General complications can occur with any surgery. Cosmetic surgery is typically a safe procedure performed on healthy patients and, like all surgeries, comes with a low risk. To further lower the risk of complications, we operate at a first-class surgery center with board-certified anesthesiologists and nurses. To avoid postoperative complications, we advocate for early mobilization – patients seen in our office one or two days after surgery – and active participation in their own postoperative care. When we create a partnership, the results invariably improve.

• Bleeding
  Bleeding after a breast reduction is rare. Before surgery, our patients are tested to make sure they don’t have any common bleeding disorders by their own physicians and by lab tests. In our practice, the rate of significant bleeding is less than 1%. Very rarely, we will put drainage tubes in the breasts during a procedure if we feel there will be some bleeding after the surgery, so the blood will be drained into a plastic bulb that the patient can empty. Those drains are removed in the days after surgery.

• Infection
  The most important step in avoiding infections is to perform the surgery at a first-rate surgical facility with board-certified anesthesiologists and nurses. Patients are given the appropriate intravenous antibiotic coverage throughout the surgery. During the surgery, the patient’s skin surface is cleaned thoroughly. After the procedure, our patients are given antibiotics to minimize infection. As a result of these extra precautions, our rate of infection after a breast reduction is extremely rare.

• Open Wounds
  In a breast reduction, a relatively large amount of breast tissue is manipulated, with the resection of 1-2 pounds of skin, fat, and breast tissue, and the closure of the skin under some mild tension. Because the incisions are under tension, as well as the weight of the breast causing pressure, there can be either loss of some skin or a small opening of the wound at the base of the breast. This is treated with dressing changes and wound cleaning in the office as needed. This occurs in approximately 2-4% of patients. Usually, the wounds heal very well, and no further action is needed.

• Ability to Breastfeed
  Women are sometimes concerned that if they get a breast reduction, they will not be able to breastfeed afterward. The likelihood of losing the ability to breastfeed after a breast reduction is about 4% in the literature. With the techniques that are described above, the inability to breastfeed after breast reductions that we have performed has not occurred with any of our patients to our knowledge.

• Loss of Nipple Sensation or Nipple/Areolar Skin
  Similar to what has been said about the ability to breastfeed, loss of nipple sensation is a potential complication after breast reduction. Due to the technique used in this procedure, complications are rare, with an occurrence rate of less than 1%. Temporary loss of sensation from a “stunned” nerve or a bruised nerve may occur in the time period after surgery, but sensation in the vast majority of cases returns within a few weeks. Cuts in the breast tissue will divide blood vessels and may cause loss of the nipple or areolar skin. Fortunately, there are multiple blood vessels to the nipple, so the risk of nipple or areolar skin loss is extremely rare. If it does occur, it is treated with dressing changes and wound cleaning in the office.

• Smoking
  Smoking is an absolute contraindication in breast reduction. The carbon monoxide and nicotine in cigarette smoke cause a severe reduction in blood supply to the skin and breast tissue during healing. This results in delayed wound healing, wound separation, death of the skin, loss of nipple tissue, and a higher risk of infection. Cotinine testing is performed in patients with a smoking history to ensure that they are safe when having this procedure.

To start your search for the right provider, you should begin by checking your potential surgeon’s training background, credentials, awards, board certifications, specialized techniques, reviews, and before-and-after photos. The next step is to meet your provider in person to determine if you feel comfortable working together. Dr. Bitar, a board-certified body sculpting expert in Fairfax, VA, invites you to schedule a private consultation with him and his team. He will answer all your questions and explain his approach to surgery, empowering you to make informed decisions that are best for your overall health and well-being. Call today to get started.