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Plastic Surgery Home Page
Health Information
Division of
Plastic Surgery
Breast Reduction and Augmentation
John Fischer
J. Fischer
Joshua Fosnot
J. Fosnot
Steve Kovach
S. Kovach
David Low
D. Low
Ivona Percec
I. Percec
Joseph Serletti
Dr. Serletti

Women with large breasts experience more physical pain and psychological distress than medical professionals have acknowledged in the past. New studies show that the degree of physical pain may exceed that of cancer or arthritis, and that women who opt for reduction mammaplasty report great improvement in their quality of life. 

patientAmong the symptoms of women presenting for this surgery are neck, back, shoulder and breast pain, grooving from bra straps, poor posture, and skin irritation. These women are less likely to exercise because of the discomfort and often have difficulty finding appropriately fitting clothing. The social embarrassment they experience as a result of unwanted attention and teasing contributes to dissatisfaction with their body image.

While determining the surgical procedure best suited for the patient, the plastic surgeon takes several factors into consideration. Among them are the patient's anatomy, the size and volume of the breast, the degree of sagging and the placement of the areola. The desired result is a breast size in proportion to the patient's body, and a shape that is aesthetically pleasing.

The surgical technique used most often requires three incisions, one that completely surrounds the areola, the next that extends from the edge of the areola to the crease under the breast, and the last, underneath the breast following the natural curve of the woman's breast. The surgeon places the incisions to minimize visibility after the surgery. For virtually all patients, the scars from the incisions are a reasonable trade off for relief of their symptoms.

During the procedure, the nipple and the areola remain attached to the underlying tissue and then reattached at a higher position, whenever possible. If the tissue remains attached, the woman may be more likely to maintain sensation after surgery.  In some cases, the nipple/areola is transferred as a graft. Your surgeon will discuss these details with you.

During the immediate post-surgical period, patients are instructed to wear a supportive bra and rest at home. The surgical drains and dressings are usually removed the day following surgery, and the patient can begin to move about, but instructed to avoid any strenuous activity. After three to four weeks, patients can resume exercise. It will be several months before the reduced breasts will take on their revised shape and contour. During this period patients usually experience a diminishing of pain and other symptoms associated with large breasts.

Inpatient Facilities:
Hospital University of Pennsylvania (HUP)
Pennsylvania Hospital (PAH)
Office Visit Locations:
Perelman Center for Advanced Medicine
Center for Human Appearance, Suite 1-150E (HUP)
230 W. Washington Square (PAH)
Making an Office Visit Appointment:


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