Breast Reduction in Tampa, FL

Surgical Technique

A breast reduction is usually performed under general anesthesia on an outpatient basis, meaning the patient goes home the same day. Rarely, if a patient has other procedures performed in addition to a breast reduction, an overnight stay may be required. The surgery usually takes three to four hours to perform but varies depending on the individual technique the patient and Dr. Perez decides upon.

Liposuction or Scarless Breast Reduction – Liposuction or scarless breast reduction is ideal for younger patients with tight, elastic skin, good breast shape, no familial history of breast cancer, and those who desire a small reduction (i.e. less than 500-cc per breast). Additionally, older patients with heavy breasts who wish to avoid an invasive surgery and have less concern over an ideal, cosmetic result may also consider liposuction or scarless breast reduction. While not actually scarless, tiny incisions are made on the medial and lateral aspect of the base of the breast to allow for the introduction of a liposuction cannula. Traditional or ultrasound-assisted liposuction (click here to learn about Liposuction) is then performed to reduce the breast to the desired size. The obvious advantages to this surgery are that larger scars are avoided and the blood supply to the nipple-areolar complex is not compromised by a more invasive surgery. The disadvantage to liposuction or scarless breast reduction is that the overall shape and nipple position of the breast is not altered. Thus, patients with drooping, or ptosis, of the breast are not a good candidate for this operation. Another disadvantage is that the breast tissue removed via liposuction cannot be adequately examined by a pathologist.

Short Scar or Minimally Invasive Breast Reduction – A short scar or minimally invasive breast reduction uses a combination of incisions and liposuction to reduce breast volume and alter breast shape to a moderate degree. Ideal patients for this procedure have relatively good quality skin, a small degree of breast sagging, and desire a moderate reduction (i.e. greater than 500-cc) in breast volume. Incisions are placed either around the nipple-areola complex alone or may also include a vertical incision extending from the bottom of the nipple to the inframammary fold (i.e. where the bottom of the breast crease touches the chest wall). These incisions allow the surgeon access to the breast tissue in order to perform a breast lift (click here to learn about Breast Lift) along with a breast reduction when appropriate. Liposuction is then utilized to further reduce the breast to the desired size. The benefit to this procedure is a lessened scar burden when compared to traditional breast reduction surgery. Similar to liposuction or scarless breast reduction, the breast tissue removed via liposuction cannot be adequately examined by a pathologist. Therefore, patients with a family or personal history of breast cancer are not candidates for this surgery.

Traditional Breast Reduction – Traditional breast reduction uses a combination of internal breast tissue incisions and external skin incisions to reduce breast volume and restore breast shape. Ideal patients for this surgery require a large reduction (i.e. greater than 750-cc to 1000-cc per breast) and dramatic reshaping of the breast mound. These patients often have sagging, pendulous breasts with inferiorly displaced nipples. Incisions are placed around the nipple-areolar complex, down from the bottom of the nipple extending to the inframammary fold (i.e. lollipop or vertical breast reduction), and may incorporate a horizontal incision hidden within the inframammary fold (i.e. anchor or inverted-T breast reduction). The advantage of this technique is that large amounts of breast tissue can be removed and dramatic reshaping and elevation of the nipple can be performed through the more aggressive incisions. The obvious disadvantages, however, is the greater number of scars on the breast and possibility for wound healing problems, scar widening, or postoperative elevation of the nipple or flattening of the breast (particularly with the anchor or inverted-T technique).

Free Nipple Grafting Breast Reduction – A free nipple grafting breast reduction involves the actual removal of the nipple from the underlying breast tissue and reattachment at the end of the surgery in the correct position as a skin graft. Candidates for this surgery have extremely large breasts and long distances between their breastbone and nipple (i.e. greater than 30 to 40-cm) and between the nipple and inframammary fold (i.e. greater than 18-cm). Additionally, patients with medical conditions requiring short anesthesia times or systemic diseases that impair blood flow may require this procedure rather than a traditional breast reduction. Incisions are like those of the anchor or inverted-T breast reduction and allow for large volumes of breast tissue to be removed and reshaped. The advantage to this operation is the limited anesthesia time and decreased chance of total nipple-areolar complex loss or necrosis. Because the nipple is detached from the body and replaced as a skin graft, the disadvantages are pronounced and include permanent loss of nipple sensation, loss of ability to breast-feed, and possible changes in nipple color in patients with dark skin.