Adjunct procedures for breast reductions

From alleviating back pain by removing heavy breast tissue to just simply helping clothes fit better off the rack, it's no surprise women love breast reductions. In fact, breast reductions on their own have one of the highest patient satisfaction rates in plastic surgery, but there are several adjunct procedures that can give you superior results.

You may be wondering what an adjunct procedure is, so let's jump in. An adjunct procedure is an additional surgery that is performed in connection with the primary procedure and is often used to better the overall results or improve the recovery process.

For breast reductions, there are several commonly requested procedures used to improve the appearance of the breast as well as the body around the breast area. These can include liposuction to tone the area surrounding the breast and internal scaffolding to support the breast structure, among many others.

To gather more insight into breast reductions and adjunct procedures that are often performed with them, we spoke with ASPS Member Surgeons Kelly Killeen, MD, and Peter Krasniak, MD.

The concept of adjunct procedures for breast reduction

Adding additional treatments to complement a plastic surgery procedure is not a new concept, especially within aesthetic breast procedures. In fact, these adjunct procedures are often performed in combination with breast reduction to help patients achieve their cosmetic goals.

"There are several adjunctive procedures that can be done with breast reduction to improve the overall aesthetics," said Dr. Killeen. "Most common would be liposuction of the bra roll, axilla (armpit) or abdomen and use of mesh support. These can be awesome additions, but are often not needed."

While there are several options, one adjunct procedure is most frequently paired with a breast reduction.

"As true adjuncts, the most commonly employed tool is definitely liposuction," said Dr. Krasniak. "This is generally offered to patients on a case-by-case basis depending on if there are any areas of the chest that would benefit from liposuction, especially when considering the goal of a more harmonious aesthetic once the breasts have been reduced in size. Areas where liposuction could be considered and are often beneficial from an aesthetic perspective are the sides of the chest under the armpit, even extending onto the back, as well as the upper abdomen just below the breasts. These areas, sometimes referred to as the 'bra roll,' can sometimes be addressed by the liposuction alone, but in some cases, especially after weight loss, your surgeon may feel that skin excision would also be needed."

Plastic surgeons note that adjunct procedures with breast reductions have been growing in popularity.

"I've definitely seen an uptick in people requesting these procedures," said Dr. Killeen. "I think women have better information available online and often come into consults having done significant research in the procedure. Women are going to live with their outcome for decades after surgery, they want to feel good about their outcome from a cosmetic standpoint in addition to having the benefits of improvement in neck and back pain."

One such source for increased awareness and popularity of adjunct procedures is social media.

"There are tons of patients who have shared their experiences and what they liked and did not like," said Dr. Killeen. "It's been helpful for patients to see what various outcomes look like."

Ultimately, better-educated patients who have a clear understanding of what outcome they want are having more in-depth conversations with plastic surgeons during consultations.

"This leads to patients often coming in having read or heard about specific procedures or products prior to their consult," said Dr. Krasniak. "Because of this perceived increase in knowledge prior to their consult, there does seem to be an increase in patients requesting specific procedures or even specific techniques for their surgeries. This can often lead to a productive conversation with your surgeon regarding the options for both technique and adjunct procedures and, in turn, hopefully lead to a surgical plan that best suits your overall goals."

What you should know if you're interested in an adjunct procedure

There are a few key best practices and crucial information for patients considering an adjunct procedure to their breast reduction.

First, it's of the utmost importance to find the right surgeon to do the job. This process involves ensuring that the surgeon is not only well-versed in this area but is also properly board certified.

"Because of the nuances in breast surgery as well as these adjunct procedures that are increasingly being used, it is important to find a plastic surgeon who understands your goals," said Dr. Krasniak. "Many plastic surgeons specialize in breast surgeries and are particularly suited to these surgeries. Using the ASPS Find a Surgeon tool can help with this decision."

As with any surgery, there are additional concerns that need to be considered when adding an adjunct procedure to breast reduction.

"It is important to know that any time additional procedures are added, generally, there are new considerations and potential risks that your surgeon should be discussing with you," said Dr. Krasniak.

The aesthetic results of adjunct procedures are certainly promising within breast reduction, but it's crucial to keep your overall budget top of mind when considering adding a secondary procedure to breast reduction. Breast reductions are sometimes covered by insurance, but adjunct procedures may not be.

"I think it's important to remember that these adjunctive procedures are not covered by health insurance," said Dr. Killeen. "These are out-of-pocket costs."

While breast reduction may have a standardized recovery process and timeline, adding in an adjunct procedure, such as bra line liposuction, can affect your recovery.

"In general, these things do not affect your healing much, and the postop care is usually similar," said Dr. Killeen. "You will need more compression at the liposuction areas for several weeks."

Although this may be a new concept to some, it's actually quite common for patients to elect for an adjunct procedure or procedures to better their breast reduction results. There are plenty of options available to patients to help them reach their aesthetic goals. While these procedures may not be a necessary part of breast reduction, they are certainly a promising and rewarding addition for many patients.

To find a qualified plastic surgeon for any cosmetic or reconstructive procedure, consult a member of the American Society of Plastic Surgeons. All ASPS members are board certified by the American Board of Plastic Surgery, have completed an accredited plastic surgery training program, practice in accredited facilities and follow strict standards of safety and ethics. Find an ASPS member in your area.