Breast Confidential

By: Marie Kuechel and Dr. Robert Singer

Breast lift and reduction improve more than appearance
Breast lifts and breast reductions are often overshadowed by the popularity and number of surgeries performed to enlarge breast size with implants. But breast reduction and breast lift procedures are equally as gratifying, bringing balance to your body and restoring self-confidence.

Breast reduction
Excessively large breasts can limit your fashion options and make you self-conscious, as well as result in back aches, neck problems and rashes under the breast. The weight of heavy breasts can also cause bra straps to dig into the shoulder area, leading to thoracic outlet syndrome, which causes tingling, numbness and weakness from the shoulder down to the fingertips. In this procedure, breast fat and tissue are removed through one or more of the following incisions. Sometimes a combination of these incisions is needed to properly sculpt the breast into a smaller shape.
1. Around the areola
2. Vertically down from the areola to the breast crease
3. Horizontal at the breast crease
The nipple, which usually remains attached to the nerve and the blood supply, is repositioned, the overall breast skin is reduced, and the size of the areola is reduced to match the proportion of the new breast. Liposuction can also be used as part of the reduction.

Women who consider breast reduction need to accept there are trade-offs. You will have visible scarring on the breasts, which improves with time, and you may have a decreased chance of breast-feeding. But these downsides are a fair exchange for increased comfort, better proportion and restored confidence. Fashion freedom and better mobility and comfort during physical activity are added pluses that result in high patient satisfaction among those who undergo breast reduction.

Alternatives to surgery
Minimizing bras can help to enhance appearance, but nothing can alleviate the physical symptoms of the excess stress caused by breast weight. For some women, losing weight can help to reduce breast size, but only if a woman is carrying a few extra pounds. The theory that only large women have overly large breasts is simply not true. Breast size isn’t primarily determined by weight, it is first determined by heredity. Weight loss can only achieve a proportionate reduction to the reduction of body mass as a whole.

Breast lift
Gravity, time and pregnancy can all contribute to sagging breasts. For some women, the shape or position of the breast—a sagging appearance—can be purely hereditary. Pregnancy also brings weight gain and hormone changes that can alter the shape of your breasts. All of these factors can lead to changes that take a toll on self-esteem.

A breast lift requires incisions that are similar to those used in breast reduction, however breast volume is not reduced and only the breast is reshaped. In some cases a breast implant may also be recommended to support the new breast shape and enhance firmness.

Alternatives to surgery
Lasers have been touted to tighten breast skin and lift the breast. Threadlifts—using barbed sutures inserted through limited incisions to suspend the breast higher—are also thought of as an innovative alternative. But the breasts are composed of fat, glands and tissue, and skin is the outer shell that offers little support. Therefore just tightening or lifting the skin through these methods has no long-term effect, if any, on reshaping the breast. Botox has been promoted to help achieve a perkier profile. But Botox acts by relaxing muscle action—there is no muscle action that pulls the breasts downward to produce sagging.

Do push-up bras help? They do when you’re wearing them. And the array of push-up bras available today can provide some remarkable results. But many fashions, for either day- or bedtime, can’t be worn with a push-up bra.