Dr. Cohen has extensive experience with this procedure with extremely happy patients. Because of his training in state-of-the-art breast reduction techniques, this has become one of his signature procedures. He has developed a reputation in the community for having highly aesthetically balanced breast reduction results, and in his hands, this is a highly satisfying procedure in the right surgical candidate.
The biggest concern for some women is the anchor-shaped scar (a scar around the areola, a vertical scar from the areola down, and a horizontal scar in the crease under the breast). Each of these three scars is a result of a surgical maneuver aimed to alter the breast in an effort to restore its original anatomy. A breast is a 3-dimensional surface; a large, pendulous breast has excess skin in both the vertical and horizontal dimensions. The vertical scar from the areola down is a result of excising the excess skin in one dimension; the horizontal scar hidden in the crease under the breast results from excising the excess skin in the other dimension; the scar around the areola results from the surgical raising of the nipple-areola to a new, higher location on the breast, which means that a new skin opening for the nipple-areola has to be created in order to accomplish this. In a patient who accepts this scar, the results are a dramatic improvement in the shape of the breasts and often a decrease in tension and tightness in the neck and shoulder regions.
While our practice currently does not participate with any health insurance plans, if the volume of the reduction meets certain criteria, Dr. Cohen will provide all the necessary documentation required to get reimbursed by health insurance. Due to the increasing lack of reliability of health insurance coverage of breast reductions, no guarantees of such reimbursement are ever made by our practice.
Because of tremendous variation in patient anatomy, every patient is assessed on an individual basis, with extensive anatomic measurements, and a customized surgical plan. As a rule, the smaller the breasts that are being reduced, the less complicated the operation, and the lower the complication rates. However, even this rule is subject to variations based on individual anatomy.
One of the questions that comes up with this operation involves the population of teenage girls, ages 14 to 17, who occasionally seek this operation because of limitations in activity (such as playing sports), social stigmatization during formative years in high school, or restrictions with choices of garments. As long as the patient and her mother (or female legal guardian) are on the same page about wanting this operation, and as long as they both think that the breasts have not increased in size over the preceding 6 months, it is a perfectly reasonable procedure in this age group. The caveats include potential future inability to breastfeed, as well as the potential for the breasts to grow back with future pregnancies. No “before and after” photos of any breast patient under the age of 18 will be displayed on our website.