We answer all your questions on the similarities and differences between these two procedures.
What is a breast reduction?
Breast reduction surgery involves the removal of excess breast tissue and skin. During this process, the nipple and areola are also lifted into a more appropriate position. In virtually all cases, liposuction is performed at the same time to better contour the breast and sides of the chest.
Who is a good candidate for a breast reduction?
Good patients for breast reduction are those that are generally unhappy with the size (volume) of their breasts. In many cases, symptoms such as back, neck and shoulder pain are significant issues. Difficulty finding appropriate bras and fitting into certain clothes can be an issue as well. Finally, there are often psychological impacts of having large breasts that are difficult for patients to deal with.
What is the difference between a breast reduction and a breast lift (mastopexy)?
The goal of a breast reduction is to make the breast significantly smaller by removing extra breast tissue, thereby making the breast smaller and less heavy. Of course, once removed, the incisions are closed such that the overall breast shape is improved and the nipple is repositioned higher on the chest.
The goal of a mastopexy is to improve the overall shape of the breast and to lift the breast and nipple into a more youthful position higher on the chest. During a mastopexy, some breast tissue can be removed as well to make the breast smaller.
In essence, the difference is in both the primary goal (reduction in volume versus improvement in shape and lift) and in the amount of breast tissue removed.
Does OHIP cover breast reduction surgery?
In order for a breast reduction to be covered by OHIP, an application must be submitted by the surgeon. OHIP will evaluate the patient’s symptoms, their current body habitus and breast size and the expected amount of breast tissue to be removed. When symptoms are significant and removal of a large amount of breast tissue is expected to improve these symptoms, the application is approved.
What if I have symptoms from the droopiness of my breasts but I don’t want them smaller?
It is very possible that back, neck and shoulder pain are caused by increased droopiness of the breast. Additionally, when a bra is worn constantly to raise the position of the breasts, patients will often complain of bra discomfort and shoulder grooving. In addition to improving the shape of the breast, a breast lift may help significantly with these symptoms. Despite this improvement in symptoms, a breast lift alone or with removal of a small amount of tissue is not an OHIP-covered procedure.
What are the other options I should consider when thinking about Breast Reduction?
Liposuction – This is a recommended adjunct to virtually all breast reduction procedures. Liposuction is used to improve the shape of the lateral, or outside, part of the breast as well as to help contour the lateral chest wall or “bra roll”. This is a standard part of a breast reduction in most of the world and is performed at the same time as the breast reduction through the same incisions. In Canada, OHIP does not cover the liposuction component of the surgery.
Auto-augmentation – In some patients, the upper part of the breast is flat and even after a breast reduction, or breast lift, the upper chest remains quite flat. In these cases, some of the tissue that would otherwise be removed can be repositioned into the upper part of the breast, almost like a small implant augmentation but with your own breast tissue.
How do I decide which surgery is best for me?
We often ask patients if they are happy with the size and shape of their breast while wearing their best fitting bra. If this is the case, a mastopexy with or without a small reduction is the best option for you. If you still feel that your breasts are several cup sizes too large, a breast reduction may be the right option.
Ultimately, your best bet is to visit us for a comprehensive consultation. Our surgeons will discuss your symptoms and your goals. With detailed measurements, consideration of lifestyle and after discussing potential future changes in your body and breast, we will guide you to the right procedure for you.