Breast surgery · New York and New Jersey
Breast Reduction
Breast reduction makes the breasts smaller and lighter and lifts them at the same time. It is done to relieve the neck, back, and shoulder pain that large breasts can cause. Dr. Steven Ovadia is a board certified plastic surgeon with offices in New York City and New Jersey.
Overview
What breast reduction is
Breast reduction, also called reduction mammaplasty, removes breast tissue, fat, and skin. The remaining breast is reshaped, and the nipple and areola are moved up to a higher position. The areola can be made smaller at the same time. Every breast reduction includes a lift.
Most patients come in because of physical symptoms. Large breasts can cause:
- Neck, upper back, and shoulder pain
- Grooves in the shoulders from bra straps
- Rashes or skin irritation under the breasts
- Difficulty exercising or staying active
- Trouble finding bras and clothes that fit
- Breasts that feel out of proportion to your frame
At your consultation, Dr. Ovadia examines you, asks about your symptoms, and goes over the size you would like to be and what your frame allows.
Who it is for
What makes someone a candidate
Symptoms from breast size
Pain, shoulder grooving, rashes, or limits on activity that have not improved enough with supportive bras and other measures.
Breasts that have finished developing
Surgery is usually done once the breasts have stopped growing. For teenagers with significant symptoms, the timing is decided together with the patient and family.
A stable weight
Weight changes after surgery can change the size and shape of the breasts. It helps to be at a weight you expect to maintain.
A break from nicotine
Nicotine affects how well incisions heal. If you smoke or vape, Dr. Ovadia goes over taking a break from nicotine before and after surgery.
Good overall health
Breast reduction is done under general anesthesia. Dr. Ovadia reviews your health history and medications with you as part of planning your surgery.
Breast screening up to date
Depending on your age and history, a mammogram may be requested before surgery.
How it is done
Incisions and scars
There are two main incision patterns. Which one is used depends on the size of the breasts, how much tissue is removed, and how much lift is needed. Dr. Ovadia goes over which pattern fits you at your consultation.
Anchor pattern
Also called an inverted T
The incision goes around the areola, straight down to the fold under the breast, and along the fold. It allows the most tissue and skin to be removed.
- Used for larger reductions
- The most control over shape and skin
- The scar in the fold sits under the breast
Vertical pattern
Also called a lollipop
The incision goes around the areola and straight down to the fold, without the incision along the fold. It is an option when less skin has to be removed.
- Used for smaller reductions
- No scar along the fold
- Less skin can be removed
The nipple and areola are not removed. They stay attached to the breast tissue beneath them, which carries their blood supply and nerves, and are moved up to their new position.
Scars are permanent, but they fade. They are usually pink or red for the first several months and keep lightening for a year or more. They are placed where a bra or swimsuit top covers them.
Real results
Breast reduction before and after
These are Dr. Ovadia's own patients. Each case notes how far out from surgery the "after" photo was taken, because swelling takes months to settle and scars keep fading for a year or more.
Before-and-after photographs
This section contains before and after photographs of real surgical procedures, including the unclothed chest.
You must be 18 years or older to view this content.
Recovery
What to expect after surgery
Relief often comes early
Many patients notice less weight on the neck, back, and shoulders soon after surgery, while they are still healing.
Swelling is normal and expected
The breasts are swollen at first, and they sit high and feel firm. Wearing your surgical bra is important: the compression helps prevent and minimize swelling. Over the following weeks and months the swelling goes down and the breasts settle into a softer, more natural shape.
Drains are commonly used after breast reduction
Drains are commonly used after breast reduction surgery, and Dr. Ovadia often places them. They are thin tubes that remove fluid from under the skin while you heal. While you are in the hospital, the nurses care for the drains and teach you how to empty them, so you are comfortable doing it at home. They are removed in the office.
Getting back to exercise
At about 2 weeks, you can generally walk on a treadmill or ride an exercise bike at an easy pace. Running and faster-paced exercise usually come back at 3 to 4 weeks.
Changes in feeling are usually temporary
Early after surgery there may be changes in sensation in the nipples or the skin of the breast. These typically return to baseline over time. Permanent changes or loss of sensation are uncommon.
How the incisions heal
The incisions generally heal well. Occasionally, healing is slower at the point under the breast where the incisions meet. This usually heals with simple wound care.
Call the office if one breast suddenly becomes more swollen, firm, or painful than the other, or if you notice spreading redness, warmth, drainage from an incision, or a fever. These can be signs of bleeding or infection, and they are best taken care of early.
A general timeline
This is a general guide. Everyone heals differently. During your recovery, Dr. Ovadia will review your timeline with you.
Insurance
Breast reduction is often covered by insurance
Because breast reduction treats physical symptoms, it is considered a reconstructive procedure. It is frequently covered by insurance when medical criteria are met and it is a covered benefit of your policy.
Common criteria for insurance coverage
- Documented symptoms, such as neck, back, or shoulder pain, shoulder grooving, or rashes under the breasts
- Treatments already tried, such as supportive bras, physical therapy, or medication
- A minimum amount of tissue to be removed, often based on your height and weight
- Photographs and a letter from your surgeon
Every plan sets its own criteria. Our office assists with documentation and pre-authorization. If your plan does not cover breast reduction, we go over the cost with you before you decide.
If you have questions about possible insurance coverage for surgery, call or email us and we will go over it with you.
Your surgeon
Board certified and double fellowship-trained
Dr. Ovadia is board certified by the American Board of Plastic Surgery. After his plastic surgery training he completed two fellowships: gender-affirming surgery at Johns Hopkins, and craniofacial and pediatric plastic surgery at UT Austin / Dell Children's Hospital.
He performs breast reduction for symptom relief, and he uses the same and similar techniques in breast reconstruction and in cosmetic breast lifts and reductions. He sees patients in New York City and in Jersey City and Millburn, New Jersey.
Questions
Common questions about breast reduction
Am I a candidate for breast reduction?
You may be a candidate if the size of your breasts causes symptoms such as neck, back, or shoulder pain, grooves from bra straps, rashes under the breasts, or limits on activity. It helps to be at a stable weight and in good overall health. Dr. Ovadia examines you and reviews your health history at your consultation.
How small can I go?
You and Dr. Ovadia decide on a goal together. It depends on your frame, how much tissue can be removed safely while keeping a good blood supply to the nipple, and, when insurance is involved, how much your plan requires to be removed. Bra cup sizes vary between brands, so a specific cup size cannot be guaranteed.
Does a breast reduction include a lift?
Yes. In every breast reduction the breast is reshaped and the nipple and areola are moved up to a higher position. The areola can be made smaller at the same time.
Where are the scars?
With the anchor pattern, the scars go around the areola, straight down to the fold under the breast, and along the fold. With the vertical pattern there is no scar along the fold. Scars are permanent, but they fade over a year or more, and they are placed where a bra or swimsuit top covers them.
Is breast reduction covered by insurance?
Often, yes. Because breast reduction treats physical symptoms, it is frequently covered by insurance when medical criteria are met and it is a covered benefit of your policy. Each plan sets its own criteria. Our office assists with documentation and pre-authorization.
How long is the recovery?
Patients often stay in the hospital overnight, though some go home the same day. Many are back to desk work in about two weeks. At about two weeks you can generally walk on a treadmill or ride an exercise bike at an easy pace, and running and faster-paced exercise usually come back at three to four weeks. Swelling goes down over the following months, and the breasts settle into their shape by about three to six months. Everyone heals differently, and this is only a general guide.
Will I lose feeling in my nipples?
This is uncommon. Early after surgery there may be changes in sensation, but these typically return to baseline over time. Permanent changes or loss of sensation are uncommon.
Can I breastfeed after a breast reduction?
Usually, yes. In Dr. Ovadia's breast reductions the nipple stays attached to the breast tissue beneath it, and studies of this approach have found that women breastfeed at rates similar to women who have not had surgery. Not everyone is able to breastfeed, with or without surgery.
Will my breasts grow back?
The results of breast reduction are long lasting. The breasts can still change somewhat with weight, pregnancy, hormones, and age, but a significant increase in breast size after a breast reduction is uncommon.
Does breast reduction affect mammograms?
You continue screening for breast cancer on your regular schedule, or as your primary care doctor recommends. Let the imaging center know that you have had a breast reduction. The tissue removed during surgery is routinely sent to a pathologist to be examined.
Can I have a consultation without coming to the office?
Yes. Phone and video consultations are available, in addition to in-person visits in New York City, Jersey City, and Millburn, New Jersey.
Next step
Start with a consultation
Dr. Ovadia will examine you, go over your symptoms and the size you would like to be, and explain which approach fits you and what recovery involves.
225 Broadway, Suite 3100, New York, NY
377 Jersey Ave, Suite 440, Jersey City, NJ
90 Millburn Ave, Suite 206, Millburn, NJ
Phone and video consultations available · info@ovadiaps.com