Dr. Brandon Elnekaveh Answers FAQs on Breast Reductions

Our very own Garden Plastic Surgeon specialist, Dr. Brandon Elnekaveh, took time to chat about frequently asked questions regarding breast reduction surgery. Read this blog to understand more about breast reduction surgery and if it might be right for you. 

Breast reduction surgery is a cosmetic procedure that aims to reduce the size of the breasts. It can often be paired with lifting the breasts to correct breast drooping, as well as fat grafting or liposuction to provide an overall slimmer, more youthful appearance.

What is the main purpose of breast reduction surgery?

There’s a few common reasons why women elect to have breast reduction surgery. Dr. Elnekaveh explains breast reduction surgery can help:

  1. Alleviate back pain
  2. Shoulder grooving, bra strap pain, or reduce indentations from the bra straps
  3. Reduce rashes that are underneath the breasts
  4. Help women who feel their breast size impacts their ability to perform daily activities of living i.e. exercising, lifting objects, physical work requiring arms in certain positions, etc.
  5. Cosmetic reasons i.e. help clothes fit better, improve body proportions, reduce unwanted attention from breast size, and/or add a youthful appearance
  6. Confidence boost and enhance self body image

“Back pain is probably the most common reason women have a breast reduction.” If you are suffering from chronic pain and discomfort in your back, neck and shoulders, and suspect it’s due to the weight of your chest, it could be helpful to consult a plastic surgeon to determine if a breast reduction is an appropriate treatment for you. 

Before opting for a breast reduction it is also important to consult an orthopedist or other specialists to rule out any other causes for the back pain. 

However, “if you have large breasts and back pain, and it is determined that there is no lumbar pain, nor pain that radiates to the legs (like radiculopathy), then it's possible that the back pain is caused by the heavy weight of your breasts.” Dr. Elnekaveh shares. 

It is likely putting added stress on the back, resulting in pain. In this case, a breast reduction could be an effective surgery to alleviate discomfort. 

Who is a candidate for breast reduction?

“Anyone with the symptoms or reasons mentioned above is a candidate.” 

Dr. Elnekaveh commonly sees patients who suffer chronic back pain, are bothered by issues with their bra fitting (like shoulder grooving), struggle to perform daily activities, or generally have body image issues, and really can relate that to their breasts being large. 

“Many of my patients are also seeking cosmetic improvement for breast size or they yearn for a more youthful appearance. This is because a breast reduction is not only removing breast tissue, but it's also lifting up the breasts for a more perky appearance.”

For any of these reasons, it's a good idea to seek out a plastic surgeon to get a sense of how a breast reduction could accommodate your aesthetic goals.

What are the benefits of having a breast reduction? 

Dr. Elnekaveh joyfully reports that breast reduction patients tend to be the happiest patients in plastic surgery. “It's probably the most common thing that patients seek.” 

Especially for patients undergoing a breast reduction for back pain, these patients say,  ‘Oh my god, I can't believe I haven't done that or I didn't do that earlier. I just wish I had done it years ago.’ “They didn't realize their back pain, for so many years, was attributed to the breast weight.” 

Dr. Elnekaveh also shares that many women who were previously insecure or uncomfortable feel so much better and much more confident post breast reduction surgery. “Some patients, if [the breasts are] not too large, they're able to not even wear a bra [after surgery]...for likely the first time in their adult life… and sometimes that's their motivation.” 

Is there a specific time in a person's life that might be best for a breast reduction?

Any age is okay to have a breast reduction, Dr. Elnekaveh reports. “I've done breast reductions on patients who are younger than 18 years of age, with their parents' consent… because in adolescence, patients who have larger breasts want to be comfortable in their own bodies.” 

Dr. Elnekaveh has also performed breast reductions in patients who are over 70 who have been living with an unwanted breast size for a long time and it's just the right time for them. 

Dr. Elnekaveh points out that if patients are young, become pregnant, or decide to breastfeed, it’s important to consider that “as we age and go through the stages of our lives, breast shapes and sizes change.” Breast reductions can provide stable results, but because of these natural  physiological changes with the aging process, breast size both naturally and with surgery are not necessarily permanent.

Do breast reductions impact a woman’s ability to breastfeed?   

“The short answer is it's totally safe for pregnancy.” 

Regarding breastfeeding, many patients will be able to breastfeed after surgery, but there are a percentage of women who will be unable to do so. 

“One way to think about the issue is that some women, even without a breast reduction, aren't able to breastfeed exclusively and they need to supplement with formula, or they can't breastfeed at all. So just bearing that in mind, patients who undergo a breast reduction have similar results to women who have not had this surgery. The numbers differ in research papers, but simplify them and get a general sense, about a third of women will have no issues breastfeeding, a third may have to supplement with formula, and then third may not be able to breastfeed.” 

This is helpful to keep in mind for what to expect after breast reduction if you are thinking about breastfeeding in the future.

If you do become pregnant or decide to breastfeed, it's recommended to wait about six months after pregnancy and breastfeeding to have a breast reduction for to have stable results. This is so that the breasts won’t change shape or size, since pregnancy and breastfeeding stimulate many changes in the breasts.

What does recovery from breast reduction surgery look like? 

“It really isn't too bad. Everyone's a little bit different, but it typically just takes a couple of weeks to recover. Patients go home on the same day from surgery with a special recovery bra. It is a supportive bra – kind of like a sports bra – that you wear for about six weeks straight (only taking it off to shower).” 

Some pain medication is prescribed by the surgeon, and Tylenol and Advil can also effectively relieve pain. Sometimes, for the first couple of nights, patients need something stronger like a narcotic. A narcotic may be prescribed, along with an antibiotic to prevent any post-surgery infections, which are uncommon. 

It can be expected to have some pain for the first week, but after a couple of days, patients don't generally need narcotic pain medications. Depending on what the patient does for work will dictate when they can go back to working because there's no lifting for about six weeks. If, for instance, the patient has a desk job, she can go back to work within about two weeks.

What activities do women need to avoid when recovering from breast reduction surgery?

When can women post-breast reduction surgery start exercising, doing more vigorous daily activities, intercourse, etc.? Dr. Elnekaveh explains, “for about six weeks the patient should not engage in any strenuous activity i.e. exercising, lifting anything over 10 pounds, etc. because you don't want to stress the incisions.”

Will the breast reduction surgery incisions be visible? Will there be scarring? 

Dr. Elnekaveh explains scarring and incisions really depends on “the size of the breast and what we're trying to accomplish. But generally speaking, there's always going to be an incision around the areola. Areola size is generally going to be reduced to be proportional to the new size of the breast. And there is also an incision straight down from the areola to the bottom of the breast. A lot of times for larger reductions, there's going to be a scar at the bottom of the breasts. This is called the inframammary fold underneath the breast where the bra line is. 

“The length of that really depends on the size of the breast that we need to reduce and how we're going to shape it. We're also able to do some liposuction through those incisions for patients who want to get rid of extra tissue and fat in the armpit area.” This procedure helps reduce the bulging that appears over a bra strap near the armpit. These types of things are able to be done at the same time.

Does having a breast reduction impact your chances of having breast cancer? 

A breast reduction can actually decrease the risk of breast cancer in women. 

“It's very difficult to define exactly how much that risk is reduced, but generally speaking, taking out breast tissue, statistically will reduce the chance that any breast tissue can convert into a cancer. So a breast reduction can reduce the risk somewhat.” Dr. Elnekaveh shares.

Before breast reduction surgery takes place, the patient must receive a mammogram if they are 40 years old or have risk factors, to deem it is safe to undergo the surgery. 

The breast tissue that is then removed during the surgery is typically sent for pathologic analysis. This is to be extra cautious because “even though patients will have a normal mammogram, there is still a chance that we find something, so the tissue is sent to pathology to review.”  

A breast reduction therefore can actually be something that's helpful for monitoring breast cancer, because we're able to take the tissue out and get it biopsied to see if it’s healthy. 

Can you do other procedures at the same time as a breast reduction?

“This is something I am asked frequently…Generally, there are two main considerations: the length of time of the procedures, and if the procedures are opposing or would be difficult to recover from if done simultaneously. A six hour procedure time or less is desirable. We are usually able to do another procedure at the same time such as a tummy tuck, or liposuction.”

If you are interested in receiving a few procedures at the same time, we recommend scheduling a consultation with Dr. Elnekaveh because, “that's something that we can talk about. We can discuss the procedures and your cosmetic goals together in the office to determine what is best.”

What our plastic surgeon personally enjoys about helping clients with breast reductions

Dr. Elnekaveh shares, “Most patients usually are suffering for a long time and they're genuinely so happy afterwards that it's such a reward to be able to help these patients to just have a normal quality of life.”

Why do patients choose breast reduction surgery with Dr. Elnekaveh and Garden Plastic Surgery?

“I really try to tailor the surgery for each individual person. There's so many different techniques, and so many different places we can place the incisions…for example, we can decide to add in liposuction or not for the area above the bra near the shoulder” 

Dr. Elnekaveh is very considerate and precise when considering the techniques that help meet each woman’s lifestyle. Before the surgery, he always talks through the most important considerations for each patient. 

For instance, “if a woman would like the best chance of being able to breastfeed there’s a specific technique for that...or if a woman is postmenopausal and that’s not a concern anymore, we could focus on what's important for them—maybe it's extra tissue in one area that can receive liposuction.” 

In other instances, a woman may be most concerned with the shape of her breasts. “Maybe it's making sure that there's cleavage…maybe the shape is more important or we can even do fat grafting to improve the shape.”

Whatever the case, he will consider what's the best technique for each individual patient. 

“Just having an individualized approach and figuring out what is most important to that particular patient is really important to me and Garden.”

If you are considering a breast reduction or other plastic surgery procedures, we invite you to schedule a complimentary consultation with Dr. Elnekaveh at our plastic surgery center in Lake Success, New York so that he can provide you with comprehensive information that fits your aesthetic needs and goals. 


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