Heavy, large breasts can affect a woman's physical and mental health. While breast reduction surgery can often help relieve back pain, shoulder pain, and some breathing difficulties, the procedure can also have positive effects on a woman's confidence, self-esteem, and ability to find well-fitting clothes.

If you're considering breast reduction surgery, what do you need to know? WVU Medicine Plastic and Reconstructive Surgery Chair Gregory Borah, MD, and surgeon Vidas Dumasius, MD, answered some questions about breast reduction surgery.

Is a breast reduction considered major surgery?

Dr. Borah: Yes. While the procedure is a safe operation that does not involve internal organs, breast reduction surgery can take three or four hours under general anesthesia.

Dr. Dumasius: Every surgery that is done on you is a major surgery. However, the majority of my patients are able to go home the same day as their breast reduction. Occasionally, patients spend one night in an observation unit.

Who is a good candidate for this surgery?

GB: The best breast reduction surgery candidates are women in good general health, with their medical issues (such as high blood pressure, diabetes, and lung problems) well-controlled by lifestyle and medications as needed. Surgery of any kind is a stressor, so women need to be in good physical condition.

Women who are smokers are poor candidates because nicotine causes severe complications with wound healing. If you smoke, you will not be a suitable breast reduction patient until you’ve stopped for a minimum of two months prior to surgery. Severe obesity is also a relative contraindication because of poor nutritional health which delays or prevents safe wound healing.

VD: Any woman whose breasts have contributed to neck and back pain, rashes below the breasts, difficulty breathing due to the weight of their heavy breasts, numbness radiating to the arms, or deep grooves over the shoulders.

Would a breast reduction help reduce my back pain?

GB: Maybe yes, maybe no. Many patients without heavy breasts (men) have back pain. However, a majority of women will have fewer symptoms once the excess load on their shoulders and neck is relieved.

VD: The majority of the women that I have treated stated that they should have had a breast reduction years ago to stop the cycle of pain. Granted, there are other causes of neck pain and back pain. Women should have an evaluation by a neck surgeon, but symptoms can be reduced with breast reduction surgery.

Does insurance cover breast reduction surgery?

GB: When we feel a patient’s health will benefit from breast reduction surgery, many insurers will cover a portion of the surgery’s costs. However, some do not, and patients opt to pay for the procedure themselves. Certain criteria must be met to obtain insurance approval. Having an evaluation by a plastic and reconstructive surgeon is a great starting point.

How much recovery time is involved?

GB: Breast reduction surgery is a same day surgery procedure in most cases. You are home and walking around the same day. Afterward, you need to take it easy for a couple of weeks and then are encouraged to gradually increase your activity.

VD Women who do not need to lift items greater than 20 pounds return to work in three to five days. Regular, unrestricted activity resumes ends six weeks after surgery.

I’m interested in having a breast reduction. What’s my first step?

GB: If you are considering breast reduction, please call to make an appointment with the surgeons of the WVU Plastic and Reconstructive Surgery division. We have appointments available in our new outpatient offices at the Cheat Lake Physicians office, conveniently located just off Interstate 68.

VD: A discussion with your primary care provider can help document symptoms that you’re experiencing due to heavy breasts. Your doctor can also refer you to a plastic and reconstructive surgeon.

Is there anything else I should consider before having this surgery?

GB: Our greatest concerns are the safety of surgery and a quick and complete recovery, as well as your overall health. If you are not an immediate candidate because of another health issue, we will help arrange for medical care to optimize your suitability for breast reduction.

VD: It is important to have open conversation with all of your care providers, especially your primary care provider.