How a Breast Lift Differs from a Reduction

There are a lot of similarities between breast lifts and breast reductions and, sometimes, it can be a very grey area between the two.  Particularly when it comes to insurance coverage for a breast reduction. 

Breast Lift (Mastopexy)

A typical breast lift involves removing excess skin on the breast, elevating the nipple and areola and reducing the size of the areola if it is too large.  Most breast lifts do not include removing breast tissue unless the patient wants to be a little smaller or reducing one side int he case of breast asymmetry. 

Breast Reduction (Reduction Mammaplasty)

A breast reduction is exactly the same procedure as a breast lift except that a considerable amount of breast tissue is removed at the same time in order to reduce the size of the breast.  A breast lift where a good amount of breast tissue is removed is essentially exactly the same procedure as a small breast reduction except for who is paying the bill.  A breast lift is a cosmetic procedure that is entirely paid for by the patient whereas a breast reduction is usually an insurance covered surgery. 

Loss of Nipple Sensation 

Because a breast lift is typically less invasive than a breast reduction, it is generally less painful and has a shorter recovery.  Loss of sensation to the nipple area is a risk with either procedure but is pretty rare with a lift.  Permanent numbness to the nipple and areola occurs in an average 35% of breast reductions and is more likely in larger procedures where more tissue is removed.  Like most surgical procedures, the bigger the surgery, the bigger the risk.  

Symptoms Relieved with a Reduction

A breast reduction can be performed on women whose breasts have stopped developing and is often performed on teenagers and young adults with excessive breast size causing back pain, neck pain and shoulder strap pain as well as limiting their ability to perform physical activities.  There are many psychological benefits from a reduction including improved self-esteem and a more positive body image.  There is also the advantage of not having to special order bras and tops as patients are finally able to fit into normal size clothes so they can now 'buy off the rack'. 

Timing of Surgery

It is advisable to wait until one has stopped having children with no future plans on breastfeeding to have a breast lift.  That is not, however, an ultimatum.  Many patients who have lost considerable amounts of weight have severe (grade 3) sagging (ptosis) and do not want to wait for many years to improve their condition.  Although they may grow some excess skin back with subsequent pregnancies and breastfeeding, most of them will still be happy with their shape and not require a second breast lift procedure.  

Likewise, most breast reduction patients will wait until after having their children to finally have surgery.  It is very common after surgery for these patients to report that they do not know why they waited so long and wish they had undergone the procedure decades earlier

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