Craig Mezrow MS, MD, FACS

What is breast reduction?

Breast reduction surgery is also referred to reduction mammaplasty. This procedure reduces the size of your breasts, improves asymmetries and shape of the breasts as well as lifts droopy, pendulous breasts. It is typically performed for women who have inherited out of proportion very large breasts, large heavy pendulous -hanging breasts. The patients may have back, neck and or shoulder pain, as well as grooving of the shoulders and or skin irritation in the creases of the breasts. In addition, very large breasts may limit ones physical activity and cause difficulty fitting into various clothing. Patients are often very self-conscious about the size of their breasts.


How is the procedure done/Where will I have scars?

There are different incision options depending on the size of the breast reduction. The incisions classically are described as an anchor design (around the areola extending vertically from the bottom of the areola to the breast fold then horizontally along the curve of the breast fold. Other options may include the previously described incisions with no scar or limited scar along the breast fold. The method you choose will depend on the size of the breast reduction. Dr. Mezrow will discuss which technique you are a candidate for. After making the incisions, the excess skin and breast tissue are removed and the nipple–areola are raised to a higher position. Typically, the areola that are enlarged are reduced in size. Liposuction may also be used to further shape the outer quadrants of the breast and reduce axillary fullness.

Usually, the nipple and areola remain attached to underlying tissue thereby preserving sensation and the possibility to breast-feed. Rarely, if your breasts are extremely large and pendulous, the nipples and areolas may need to be completely detached before they are raised to a higher level (free nipple graft). In such a case, you will loose sensation and the possibility of breast-feeding.

The procedure is performed as an outpatient. The procedure typically takes approximately 2-3 hours to perform depending on the size of the reduction. Most patients recover within 1 to 2 hours after surgery and are discharged home. It is important to arrange for someone to drive you home after surgery and to stay with you for at least the next day or two.

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Consulting with Dr. Mezrow

During the consultation, Dr. Mezrow will ask you about your particular concerns regarding your breasts and desired breast size. This will help determine your expectations and determine whether they can be realistically achieved. 

After obtaining a comprehensive medical and surgical history, Dr. Mezrow will examine your breasts and chest wall and shoulders. The breast volume, asymmetries, breast skin tone, presence of masses, nipple position and sensation will be assessed. Dr. Mezrow will also take measurements that will guide him in surgical planning.


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Who is a candidate?

Breast reduction can be performed at any age, but plastic surgeons usually recommend waiting until breast development has stopped. Childbirth and breast-feeding may have significant and unpredictable effects on the size and shape of your breasts. Nevertheless, many women decide to undergo breast reduction before having children and feel that they can address any subsequent changes later. If you plan to breast-feed in the future, you should discuss this with Dr. Mezrow.

You should discuss with Dr. Mezrow, if you plan to lose a significant amount of weight, particularly if you have noticed that your breasts become smaller with weight loss. Dr. Mezrow may recommend that you stabilize your weight before having surgery. Insurance coverage is sometimes available for breast reduction surgery. Many factors determine your eligibility, including the specific terms of your insurance policy and the amount of breast tissue to be removed. A letter of predetermination may be required by your insurance company prior to surgery.

What are the potential complications?

Fortunately, significant complications from breast reduction surgery are infrequent, however, all surgery has risks. Dr. Mezrow will discuss with you, the risks, benefits and alternatives and answer all your questions.

Some potential complications include infection, bleeding, delayed healing, loss of skin, altered nipple sensation, nipple loss, areola and breast asymmetries, inability to breast feed and poor scarring. A complication, which delays healing and prolongs recovery, is more common in diabetic patients and those who smoke. Preoperative and postoperative instructions will be given to you by Dr. Mezrow in attempt to reduce the likelihood of complications and make you as comfortable as possible with the whole process.


Smokers will be instructed to stop smoking 4-6 weeks prior to surgery and not resume smoking to reduce the risk of delayed healing, wounds, infections and compromised outcome. Aspirin, anti-inflammatory medications as well as agents that cause bleeding should be discontinued two weeks prior to surgery (or as otherwise instructed by Dr. Mezrow and your primary physician) to reduce the likelihood of bleeding.

What kind of medications will be given to me?

Medications are administered for your comfort during the surgical procedure. Typically, a general anesthetic is administered, so that you will be asleep throughout the procedure. When surgery is completed, you will be taken into a recovery area where you will continue to be closely monitored. You will be placed is a surgical bra and have gauze dressings over your incisions.

You may be permitted to go home after recovery, unless you and Dr. Mezrow have determined that you will require a short stay in the hospital or post surgical facility.


What happens after surgery?

You will be instructed to get out of bed for short walks to promote blood circulation and decrease the risk of blood clots. Strenuous activities should be avoided for the first several days, since these activities might cause compromised results including but not limited to increase swelling or even bleeding.

Sutures will not be removed, as they are resorbable. You will be instructed on taping of incisions to optimize healing of the scars.

You will have swelling and bruising, which will resolve with time. It is not uncommon to have some altered sensation of the breast skin and nipples. The incisions will be initially be reddish and then slowly fade over months resulting in permanent scars.

When can I return to work?

Depending on your physical condition, you may be able to return to non-strenuous work in approximately one to two weeks after surgery. During healing you may experience some mild, periodic discomfort and swelling, such feelings are normal. Severe pain should be reported to Dr. Mezrow.

How long is the healing process?

Breast reduction will reduce the size of your breasts, enhance their shape and lift droopy – saggy breasts. In addition, back pain and limited physical activity due to large heavy breasts will be likely improved. It is not uncommon to feel more comfortable in your clothing, bathing suits and be more confident about your appearance.

Healing from your surgery is a process that takes up to a year for final result. You will be instructed to return to Dr. Mezrow’s office for follow-up care at prescribed intervals to monitor your progress and optimize your outcome.

If you have any questions or concerns prior to surgery or during your recovery, you should contact Dr. Mezrow.

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