Reduction mammoplasty is a surgical procedure that reduces large breasts by removing adipose, glandular, and skin tissue. It requires general anesthesia and an incision with varying scars. The surgeon then reshapes the area occupied by the nipples and areola. Breast reduction surgery is typically reserved for women, but can be performed on men too. Breast size is influenced by genetic factors, circulating sex hormones, body weight, and build. When is breast reduction needed? Breast reduction surgery is primarily for aesthetic purposes. Still, it can also be used to address the negative effects of large breasts, such as chronic pain in the back, neck, and shoulders, skin irritations, deep dips on the shoulders due to bra straps, low self-esteem, difficulty in finding suitable clothes, difficulty sleeping, and inability to perform physical activities due to the bulk of the breasts. The best time for breast reduction surgery is between the end of development and the desired pregnancies, as pregnant women may experience an increase in breast size, making the surgery partially useless. Breast reduction surgery can also be performed on men with gynecomastia, an abnormal development of the male breast, which can be related to genetic, hormonal, or pharmacological reasons and often has serious consequences. Some health insurance plans may cover breast reduction surgery if it is deemed medically necessary. Coverage works under insurance by requiring medical necessity, insurance requirements, pre-authorization process, in-network providers, out-of-pocket costs, and an appeals process. Common medical reasons for breast reduction covered by insurance (https://normanrowemd.com/procedures/breast/breast-reduction/) include chronic neck, back, and shoulder pain, skin irritation, shoulder grooves, postural problems, and difficulty engaging in physical activities due to breast size. How to prepare for breast reduction? Before breast reduction surgery, the physician conducts a thorough assessment of the patient's health and clinical history. They analyze the breast, prescribe laboratory tests, and observe the patient's last mammogram. If the patient's profile is positive, the surgeon can proceed with more specific aspects. The patient is asked about their expectations and desired breast size, with the surgeon deciding how to intervene. The surgeon explains the risks, benefits, hospitalization procedures, and implications of the surgery, including anesthesia requirements, pre-and post-operative limitations, and medications to avoid. The patient is also informed of the obligation to be accompanied home by a relative or friend after the surgery for safety reasons. The surgeon's decision to intervene depends on the patient's expectations and the surgeon's discretion. How is breast reduction performed? Breast reduction surgery begins after general anesthesia has taken effect, involving the removal of excess fat, glandular, and skin tissue by making an incision in the breast starting from the areola. Various methods of intervention depend on the size and characteristics of the breast and can last from 90 minutes to 4 hours and may require a hospital stay of more than a day. General anesthesia involves the use of anesthetics and painkillers, which render the patient unconscious and insensitive to pain. The intervention ends when the breast volume is reduced, incisions are closed, and a small tube is inserted to drain any blood that may accumulate inside. The anesthetist stops administering anesthetics, the patient wakes up, and begins the hospitalization phase. Post-operative care Breast surgery can cause tenderness, swelling, and bruises, which usually subside after painkillers are taken. Discharge typically occurs 1-2 days after the operation, with hospitalization monitored for health conditions. The patient's physician will inform them of check-ups. Recovery periods include the first week, when the breasts feel tender and sore, followed by a gradual fade. Wearing a sports bra for at least 3 weeks is recommended, and lifting heavy objects should be avoided until the 4th week. Pain may occur during movement. Normal bras can be worn between the 4th and 6th week, and the scars will gradually improve, becoming less red. The scars should fade between the 6th and 9th month. Resuming activities should be done within 2-4 weeks, using normal bras for one month, and avoiding driving until the seat belt doesn't cause discomfort.