Dieting
& exercise unless they are performed in excess to affect hormone levels
will have little or no effect on breast gland volume. Though they may
lead to a decrease in overall body fat they cannot spot reduce breast
size and cannot lead to a consistent decrease in breast size in all cases.
Different surgical procedures can be used to reduce breast size depending
on a specific patient's needs and the surgeon's experience. Since the
very large breast can give rise to multiple medical problems surgical
breast reduction may be covered by health insurance. It is not a cosmetic
procedure per se.
In breast reduction
or reduction mammoplasty the surgical procedures used employ an incision
around the nipple possibly with an incision along the skin crease under
the breast. Circumareolar or donut breast lifts and circumareolar breast
reductions can only be performed to lift the nipple about 3cm. If you try to do more the outer
donut circumference becomes too much greater than the inner donut circumference.
This leads to a corrugated skin surface around the nipple-areola complex
that can be quite disfiguring. It will also flatten the breast peak in
the front to back direction. For elevation in the 3 to 6cm range a vertical
incision/scar under the nipple areola complex is required to take up this
excess skin (lollipop approach or vertical scar excision). For even greater
elevation of the nipple another incision must be made along the infrabreast
crease (anchor or inverted T approach) to avoid leaving corrugated skin
at the midpoint of this crease which is also unsightly. Severe corrugation
can also create healing problems.
Liposuction has been
used for breast reduction but is only of use if the excess breast tissue
is composed mostly-entirely of fat (which is not always the case) and
the skin is sufficiently elastic to shrink after liposuction. This skin
only exists in younger patients who incidentally have more breast gland
tissue than breast fat tissue. Liposuction also damages the tissue so
that it may not be possible for a pathologist to examine the removed tissue
in the search for possible cancer cells.

Both cases were performed using the anchor or inverted T approach. This approach
can give a good result in an African American as well as a blonde haired
blue eyed individual.
Breast reduction
surgery can enhance your appearance and your self confidence. Realistic
expectations are important to be happy with any surgery. As each patient
is an individual, different results can be expected in each patient.