shutterstock 1341907685

*Deciding to go under the knife or needle for any reason is, needless to say, a big decision. What’s the best way to make a big decision? Arm yourself with as much information as possible. In this series, [Ask AEDIT](https://aedit.com/aedition/category/ask-aedit), we break down the best questions to ask before choosing to undergo aesthetic treatments and procedures with expert insight from the providers that perform them.*

[Breast reduction](https://aedit.com/procedure/breast-reduction) is one of a handful of procedures that can have both a medically necessary and cosmetic component to it. Whether you’re interested in undergoing the surgery to alleviate pain and improve quality of life or are aesthetically unhappy with the shape and size of the chest, there are certain things you need to know about the procedure. From the impact it can have on breastfeeding to insurance coverage, these are some frequently asked (and important) breast reduction questions answered by two top plastic surgeons.

### **1. What should I consider when choosing a breast reduction surgeon?**
Choosing the right surgeon for a breast reduction (or any procedure for that matter) isn’t about any one thing. Instead, it’s important to [find a provider](https://aedit.com/aedition/category/how-i-found-my-plastic-surgeon) that is well qualified and also someone you feel comfortable with. In addition to researching [board certification](https://aedit.com/aedition/medical-board-certification-in-plastic-surgery-cosmetic-dermatology) and speciality, “it is imperative that you can speak to the surgeon openly and freely,” says [Payman Danielpour, MD](https://aedit.com/provider/payman-danielpour-md-797), a board certified plastic and reconstructive surgeon in Beverly Hills. That includes being able to “express your desires openly without feeling that you are uncomfortable or that the surgeon is dominating the experience,” he adds.

But it’s not just about bedside manner. Understanding a prospective surgeon’s technique and aesthetic is also key. Ask to see before and after photos of patients who have a similar breast size and skin color as you, explains [Umbareen Mahmood, MD](https://aedit.com/provider/umbareen-mahmood-md-23), a board certified plastic and reconstructive surgeon in NYC, “as poor scarring is a potential concern” (more on that later). 

### **2. Does insurance cover breast reduction?**
In short: It depends. “This is highly variable and depends on a number of factors,” Dr. Mahmood shares. As it turns out, [insurance companies](https://aedit.com/aedition/insurance-coverage-for-plastic-surgery-cosmetic-procedures) can be quite prescriptive and even seek to dictate the specifics of the surgery. “Even if the insurance company gives a precertification for the procedure, they then determine how many grams of tissue the surgeon must remove for the surgery to be covered, which often may leave patients with breasts that are far smaller than they desire,” she continues. 

There is no doubt overly large breasts can cause medical concerns (think: neck and back pain, rashes in the breast folds, interference with daily activities, etc.), but a breast reduction procedure is also aesthetic and needs to be treated as such. “I often tell patients, while breast reductions are certainly a medical issue, they are *also* an aesthetic procedure and should result in breasts that look beautiful to the patient,” Dr. Mahmood says.

### **3. What are the risks associated with breast reduction surgery?**
The primary risks associated with breast reductions are hematoma (blood clot), decreased nipple sensation, and wound healing issues. In rare cases, “the blood supply to the nipple can get damaged, causing loss of the nipple,” Dr. Mahmood explains. There is also the possibility of asymmetrical results, although “asymmetry between the breasts is not considered a risk since it is an inherent element when operating on two of the same body part — but it is still an important point to discuss with patients,” she adds. 

### **4. If I plan to have children, should I wait to have a breast reduction until after?**
Ideally, yes. But in both doctors’ experience, patients as young as 18 often decide to proceed with breast reductions to eliminate neck, back, and shoulder pain. “I see many patients in their late teens and twenties who may be years away from thinking about a family but are in agonizing physical pain as well as emotional and psychological distress due to their overly large breasts,” Dr. Mahmood explains. “While I certainly counsel all patients on the inherent risk of decreased ability to breastfeed, in instances like these, a patients quality of life and well-being must be considered.”

If you can wait, Dr. Mahmood advises waiting until after you have breastfed (if that is something you want to do, of course!). “Breastfeeding potential after a breast reduction is based on the amount of milk ducts and milk producing glands that remain after the surgery,” Dr. Mahmood says. “Reduction techniques that keep the nipple attached have a much higher chance of maintaining breastfeeding potential, as well as those that preserve more of the glandular tissue from the nipple to the chest wall.”

The [ability to breastfeed](https://aedit.com/aedition/how-pregnancy-and-breastfeeding-impact-breast-implants) after a breast reduction is not something doctors can determine for sure one way or another — every body is different. “The longer the period from the operation, the higher the likelihood that lactation will be successful,” Dr. Danielpour says. 

### **5. What is the breast reduction recovery process like?** 
The good news is that a breast reduction is not the hardest [postoperative process](https://aedit.com/aedition/how-long-does-it-takes-to-recover-from-cosmetic-surgery-procedures). For six weeks afterwards, patients are advised to wear a surgical or sports bra and cannot exercise (no heavy lifting, swimming, or vigorous physical activity). “Most of my breast reduction patients do well with Tylenol alone and no narcotic pain meds,” Dr. Danielpour says.

### **6. What kind of scarring is expected after a breast reduction?** 
“In the immediate postoperative period, the scars are very visible, red, and raised,” Dr. Danielpour says. They do, however, flatten and lighten over the course of several months. It can take up to a year to see how scars have fully healed, and, most of the time, he says it’s quite minimal. “Most patients, even those with known tendencies to form hypertrophic scars, heal well after a breast reduction, likely because there is no tension on the tissue — unlike with a [medial thigh lift](https://aedit.com/procedure/thigh-lift) or [brachioplasty](https://aedit.com/procedure/arm-lift),” Dr. Mahmood says. “The post-surgical bra takes pressure off the incisions, and I advise patients to use scar cream at three to four weeks post-op and use sunblock when outdoors or on the beach.” If, ultimately, the scarring bothers you, it can be reduced with lasers and other treatments. 

### **7. If I am overweight, do I need to lose weight before a breast reduction?**
“As with all elective plastic surgery procedures, patients are advised to be at an appropriate weight before surgery,” Dr. Mahmood says, noting that “studies have shown that the risk of infection and wound breakdown is elevated for those at a higher BMI.” Needless to say, surgeons want to mitigate risk for patients. 

It’s also important to maintain a [good diet and exercise regimen](https://aedit.com/aedition/why-you-should-lose-weight-before-plastic-surgery) after surgery, she adds, adding that “most are excited about finally being able to do, as they are finally unencumbered by large breasts.” An active lifestyle is important to avoid having breast volume increase again in the future, she explains.

### **8. If my weight fluctuates after a breast reduction, will it impact the results?** 
Though this isn’t common, it can happen. “It is generally unlikely that breast growth will occur after a breast reduction, particularly because skin, fat, and breast tissue are removed,” Dr. Mahmood explains. When it does occur, it is usually the result of hormonal changes (think: [pregnancy](https://aedit.com/aedition/how-pregnancy-affects-cosmetic-surgery-results), [menopause](https://aedit.com/aedition/cosmetic-procedures-skincare-for-women-in-menopause)), weight gain, or medication. 

### **9. How is the size of my post-reduction breasts determined?**
Determining the right size requires an open and honest dialogue between patient and provider. Dr. Danielpour says it is important to balance the patient’s goals with what will work best for their body. “The size should match the individual’s frame and also be small enough that it will help, if it is meant to reduce neck, shoulder, and back pain,” he says. 

A pro tip? Don’t fixate on a particular size. “It is well known that there is wide variability in bra sizing — different companies and brands have their own sizing rules — so there is no consistency in determining what a patient's size is pre-op,” Dr. Mahmood says. “Furthermore, most patients are wearing incorrect or poor fitting bras, and they often state themselves that their bra size is an inaccurate representation of their current breast volume”

As she explains, there is no correlation between the amount of breast tissue removed and the resulting bra size because patients have different baselines, different overall breast measurements, and varying tissue composition. To combat this, Dr. Mahmood asks patients to generally tell her what their “ideal size” is, as women tend to have a rough idea of what cup sizes look like. “Based on that, I perform the surgery and tailor the amount of tissue I remove to what will help them achieve that size,” she says.

### **10. Can I speak to former patients and/or see before and after photos?**
Absolutely! “It can be challenging to speak directly to former patients based on HIPAA regulations, as well as patients not wanting their personal information shared,” Dr. Mahmood shares. “But patient testimonials and before and after photographs are certainly invaluable to helping patients determine which surgeon is the right fit for them and what their results might look like.” So, don’t be afraid to ask for the assets you need to make the best decision for yourself.

Expert Opinion

From the impact it can have on breastfeeding to insurance coverage, these are some frequently asked breast reduction questions answered by two top plastic surgeons.

Breast Reduction Questions: Insurance, Recovery, Breastfeeding, Breast Size

10 Questions To Ask Before Getting A Breast Reduction

implant removal

It is recommended that [breast implants be replaced](https://aedit.com/aedition/guide-to-replacing-breast-implants) every 10 years or so, but what if you no longer want your implants? That’s where [breast implant removal](https://aedit.com/procedure/breast-implant-removal) comes in. 

Generally speaking, there are a few reasons women who undergo [breast augmentation](https://aedit.com/procedure/breast-augmentation-with-implants) or [breast reconstruction](https://aedit.com/aedition/comprehensive-guide-to-breast-reconstruction-nipple-reconstruction-after-breast-cancer) with implants later wish to have them removed, says [Melissa Doft, MD](https://aedit.com/provider/melissa-doft-md-63), a double board certified plastic and reconstructive surgeon and founder of Doft Plastic Surgery in New York City: 

- **Capsular Contracture**: The most common reason for removal, according to Dr. Doft, the condition occurs when the capsule that forms around the implant hardens, distorting the implant and potentially causing pain.
- **Patient Preference**: Some women decide they simply no longer want to have implants. “They may have had them placed 20 years ago and find that the size no longer fits their body,” Dr. Doft says.
- **Breast Implant Illness (BII) Symptoms**: Breast implant patients sometimes describe symptoms like fatigue, chronic pain, hair loss, headaches, photosensitivity, sleep disturbance, and depression (to name a few) that may be attributed to the implants. “It is unclear if BII is a real disease, as removing the implant often does not improve symptoms,” Dr. Doft explains.

Just this week, Chrissy Teigen shared on social media that she is planning to have her implants removed “soon” because they no longer serve her. “I’m getting my boobs out! They’ve been great to me for many years but I’m just over it,” [she wrote, in part, on Instagram](https://www.instagram.com/p/CAqylh4pjZ-/). “I’d like to be able to zip a dress in my size, lay on my belly with pure comfort! No biggie! So don’t worry about me!”

Whether your preferences have changed like Teigen or you are experiencing complications from breast augmentation, anyone considering breast implant removal likely has a lot of questions: *What does the breast implant removal surgery entail?* *What will my breasts look like afterwards?* *Are additional procedures required?* Here, we break down everything you need to know about the process. 

## **The Breast Implant Removal Process**
Women considering breast implant removal should first consult with a [board certified](https://aedit.com/aedition/medical-board-certification-in-plastic-surgery-cosmetic-dermatology) plastic surgeon to assess the state of their implants and discuss their aesthetic goals and/or concerns. In many cases, the explant is a fairly straightforward cosmetic procedure during which the surgeon will remove the implant from the breast capsule (i.e. the pocket the body forms around the foreign substance). In some cases, conditions like capsular contraction, deflation, or rupture  may make the removal surgery more complex, but desired results can still be achieved. 

Similar to how breast implants are placed, breast implant removal surgery requires an incision to be made along the lower fold of the breast (i.e. the inframammary fold) or around the areola. From there, surgeons will remove the implant and, in most cases, the breast capsule as well.

## **How Breasts Look After Implant Removal**
As Dr. Doft explains, the shape and condition of the breasts after implants are removed depends on three factors:

1. The size of your breasts before implants
2. The size of the implants placed
3. Body changes while having implants (think: weight loss or gain, pregnancy, menopause) 

It should come as no surprise that larger implants will have a larger effect on the natural breast than smaller ones. “Larger implants will lead to more distortion of the breasts — saggy skin and deflation,” Dr. Doft says. “A smaller implant will have less effect on the skin.” As such, removing small implants often results in what she describes as a “very natural,” “slightly ptotic” (read: saggy) breast.  

Similarly, women who naturally had smaller breasts pre-implants will see less of an effect post-implants. “If you had very small breasts before the implants, there is less of a change than if you had larger breasts as there is less skin and breast tissue to sag,” she explains. “Hormonal and weight changes will often make your breasts saggier, and, without the extra volume of the implant, your breasts will look more deflated and ptotic.”

Age also plays a role in how the breasts recover from implant removal. “Small breasts in young women may contract back to close to where they were,” Dr. Doft notes. “Older patients have less elastin and collagen in their skin and are less likely to revert back.” 

## **Achieving the Best Breast Implant Removal Results**
If someone truly wishes to have their breast implants removed, Dr. Doft always recommends a “complete removal.” But, to ensure patients are happy with their breasts post-op, she may suggest coupling it with additional procedures. “If the implant is large, they have loose skin, or they wish to have the best possible breast shape with their natural tissue, I often recommend a [breast lift](https://aedit.com/procedure/breast-lift) at the same time as the implant removal,” she says.  

And it’s not just additional breast surgeries that patients may add onto a breast implant removal. “Often, women who are removing breast implants are at the ‘next stage’ of life — meaning that they had implants placed in their twenties or early thirties and now it is 20 years later,” Dr. Doft shares. “They may want to have their eyes done, a [facelift](https://aedit.com/aedition/popularity-of-facelift-cosmetic-surgery-for-aging-sagging-neck), or a body contouring procedure, like a [tummy tuck](https://aedit.com/procedure/abdominoplasty) or [liposuction](https://aedit.com/procedure/tumescent-liposuction).” 

Assuming the patient is a candidate for such procedures, [doubling (or tripling) up](https://aedit.com/aedition/when-is-it-safe-to-combine-plastic-surgery-procedures) can be more economical for two reasons: “The cost of surgery is often less when multiple procedures are added together and the cost of downtime — time off from work, increased babysitting, vacation days — are less,” she says. 

## **The Takeaway**
Whether a patient is dealing with complications from breast implants or simply no longer wishes to have them, breast implant removal is often the best solution. Depending on factors like the size of the implants, the size of natural breasts, and the age of patient, breast sagging and deflation can occur post-op. In those cases, procedures like mastopexy (a.k.a. breast lift) can be performed in conjunction with the removal procedure to improve results. It should also be noted that, if a patient is simply interested in downsizing their current implants, a breast implant replacement — using a smaller size — is an option. Consulting with a board certified plastic surgeon will ensure patients get the best treatment for their needs.

Aesthetics

If you, like Chrissy Teigen, are considering removing your breast implants, you likely have a lot of questions. Here, The AEDITION breaks down everything you need to know about the process.

What Happens When You Have Breast Implants Removed

PG46053-E76D28CC-E7D5-4C79-BAB1-6E03488CCB5A

Reasons for seeking a surgical remedy for larger breasts vary from person to person. Some choose to undergo a breast reduction because they are dissatisfied with the size and shape, while others tend to experience health problems, such as back pain and headaches. We spoke to three female patients who decided to undergo [breast reduction surgery](https://aedit.com/procedure/breast-reduction) for different reasons and learned what each of their surgical journeys was really like.

## **Genni, Palm Springs, CA**

Genni was 16 when she first started to feel self-conscious about the size of her breasts; she would compare herself to her friends and classmates and started to feel unhappy about how she looked. “Initially I loved having bigger boobs than my friends, they were all jealous of how quickly mine came in and of how grown up they made me look,” she shares. “But as they grew bigger, they started to be the first thing anyone would notice about me, and they made clothes shopping a nightmare and just generally made me feel down about how I looked. I considered surgery in my late teens, but I backed out at the time. I wanted to be sure I was making the right decision and ended up going ahead when I was 26.”

**The AEDITION**: *What were your main concerns before having the procedure?*

**Genni**: Aside from the usual anesthesia-related concerns, I was anxious that I’d pick the wrong final size for my breasts. I had always thought I wanted to be a C cup, but after discussing my options with my surgeon, I decided to go for a D cup. I then spent weeks going back and forth in my mind about whether or not that would still be too big for me, but I also didn’t want to go too small! I ended up following my surgeon’s advice. He told me about the importance of them being proportionate to my body and I think I made the right decision.

**The AEDITION**: *How was the procedure itself for you?*

**Genni**: I went to the clinic early on the day of my surgery. The nurses ran a few tests, and I saw my surgeon, who came to discuss the procedure again and to check about the size I wanted, then he drew markings on me to be used during the surgery. When it was time for the procedure an anesthetist fixed me up to an IV and after about three minutes or so I was out. When I woke up, I was quite out of it! But I wasn’t in any pain and came around pretty quickly. I went home about three hours after the surgery.

**The AEDITION**: *How did your recovery compare to what you expected?*

**Genni**: For me, it was far more emotional than I’d thought it would be. I had been pretty focused on preparing myself physically, but I hadn’t really addressed how I would cope with the procedure emotionally. There was a period when I didn’t feel like my new boobs were mine, they felt very foreign on my body. It turned out I just needed to give myself time to heal and to process the changes, and it all came together after a couple of months.

## **Louise, Phoenix, AZ**

Having spent most of her adult life suffering from chronic back pain and headaches, Louise underwent breast reduction surgery last year in the hope of reducing her pain. “I was so tired of being in pain from my large chest,” she says. “People always talk about being unhappy about the size of their boobs, but I was more bothered by the weight. I knew I needed to do something about it and I wanted to improve how they looked too, so surgery made the most sense for my circumstances.”

**The AEDITION**: *Could you talk us through your initial consultation?*

**Louise**: When I first met my surgeon I wanted to discuss less invasive options, I’d read about [liposuction](https://aedit.com/procedure/power-assisted-liposuction) being used to remove fat from breast tissue as I was concerned about the scarring and recovery time associated with having a breast reduction. After discussing the results I wanted (less weight and a nicer shape) my surgeon recommended I go ahead with a more traditional breast reduction. He reassured me that the scarring would be tidy and that she would make sure it wouldn’t be visible when I wear a bra or bikini top. We discussed my ideal size and I decided on a D cup, which would already be a good reduction from the G cup I was starting out with.

**The AEDITION**: *What did you do to prepare for the procedure?*

**Louise**: I arranged my procedure so that my kids would be on summer break, I booked their two weeks at camp to coincide for when I would be recovering so I wouldn’t have to take care of them myself while I was feeling fragile. I bought myself some button-down tops so that I wouldn’t hurt myself when getting changed. Possibly an unusual one, but I also took the opportunity to upgrade my air conditioning system, I really didn’t want to be feeling hot if I was in pain, so I made sure all of that was sorted before the surgery! In terms of cleaning, I asked my housekeeper to drop by for some extra hours so that I wouldn’t have to worry about doing any chores or laundry. It turned out that the pain was manageable and I could probably have done more than I did, but I was pleased that I’d taken care of it all just in case.

**The AEDITION**: *How was your recovery from surgery?*

**Louise**: It went much smoother than I’d expected. I looked at photos of scarring and recovery progress photos online before the procedure and expected the swelling to be very painful. The first two days were very uncomfortable, but I kept up with the medication given to me by the clinic and was able to sleep most of the time, so it wasn’t so bad. After that, the area mainly felt quite tight, and I got tired more easily than usual. I just made the most of my self-imposed break and caught up on movies! After a week I had my bandages taken off, the swelling looked pretty gross to be honest, but I had expected that from what I’d researched. I did have a flash of doubt at that point, but the nurse reassured me and told me things would settle down in time. After about two months the results started to show properly and ever since I’ve been happy with what my surgeon achieved. The procedure has completely changed my life.

## **Zoe, Rochester, NY**

As a keen runner, Zoe started to look into having breast reduction surgery when her natural breast size was preventing her from achieving her fitness goals and made running uncomfortable. The former high school athlete wanted to have her surgery as soon as possible so that she could pursue her activities competitively while at college. “If I hadn’t been so involved in sports, I might have waited a bit longer before having the surgery,” she says. “I knew that I needed to get it done to be able to continue enjoying sports like I did before my boobs reached the size they were before surgery.”

**The AEDITION**: *How was your consultation with your surgeon?*

**Zoe**: It went really well. I was nervous, but I had done my research about which physician to consult near me. I took my mom with me because I wanted someone there in case I forgot to ask an important question or didn’t pick up on every detail. It was a bit overwhelming but all in all a good experience. I had a lot of questions about recovery and how long it would take me to get back to sports, it wasn’t as long as I’d expected either so I was pleased about that! I asked about how much pain I could expect to be in, if there were any steps I could take to speed up my recovery, and my mom had some questions about the effects of surgery if I wanted to breastfeed when I’m older. I felt really comfortable with my surgeon, and in the clinic itself, that was super important to me.

**The AEDITION**: *Do you have any advice for future breast reduction patients?*

**Zoe**: I wish someone had told me just how much easier life would be after the surgery. It may sound dumb to other people, but everything from choosing clothes to running up stairs is just easy now, I never have to think ‘will I be able to do that?' – it’s refreshing!

**The AEDITION**: *If you could go back in time, would you still go ahead with the procedure?*

**Zoe**: I can’t say this strongly enough, but absolutely! It has changed my life in so many ways I hadn’t thought it would. My biggest post-surgery victory is that I can work out wearing only one sports bra now, which any big boobed girl will tell you is amazing. I went from an F to a C cup. I’m petite and my natural boobs were completely out of proportion. I feel more confident, I am able to do any of the activities I want to, I don’t feel self-conscious when I’m on the beach or wearing sundresses. It’s been awesome.

Patient Perspective

What It's Really Like to Have a Breast Reduction