Gary R. Donath, MD

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Pismo Beach, California

Breast Reduction


Breast Reduction is a surgical procedure that is offered to women who have large, heavy, pendulous breasts. The surgical procedure is, in essence, a blend of cosmetic and functional surgery. In other words, the patient may in fact have symptoms such as mid-thoracic back pain, shoulder discomfort and poor posture as well as difficulty enjoying certain athletic activities such as running and bicycling. Reducing the breast size should, in most patients, offer relief from these symptoms and enhance comfort. Patients, however, are also aware that the aesthetic appearance of their breasts is important as well. Breast reduction is not simply an amputation-type procedure, and requires careful planning and surgical contouring to provide adequate shape as well as smaller size and weight. These features account for the opinion by many that the procedure is also in some ways elective and cosmetic in nature.

There are several methods for surgically reducing the breast and techniques have evolved over many years which aim to preserve nipple viability and sensation and yield a natural shape to the breast while concealing scars. Certain patients are better candidates for one method or another depending on many factors such as breast size, age and medical history. Most procedures maintain a connection between the nipple/areolar complex and the underlying breast tissue (parenchyma). Some procedures also maintain a connection between the nipple/areolar complex and the surrounding deep layer of skin (dermis). These methods are known as pedicled operation.

Breast reduction and breast lift are actually quite similar and differ in the relative amounts of breast tissue vs. skin that is removed during surgery. A board-certified plastic surgeon is best qualified regarding which procedure is recommended. There is a certainly a continuum regarding this principle as women do not always fit neatly into categories. Under certain circumstances, health plans and insurance companies may feel that breast reduction is a covered benefit. They may request information and or photographs in an effort to determine whether the surgical procedure is medically necessary. Again, it is best to allow your plastic surgeon to guide you through this sometimes vexing process.

Some valuable information regarding breast reduction may be obtained by visiting the American Society for Plastic Surgery website at

A thorough consultation is essential for a patient considering breast reduction surgery. The following topics are important components during the office consultation:

  • Medical and Surgical History
  • Personal History of Breast Surgery, Breast Disease and Mammography
  • Family History of Breast Cancer
  • Occupation and Job Requirements
  • Participation and Limitations in Sports and Hobbies
  • Patient Motivation and Expectations
  • Examination of the Breasts Including Standard Measurements for Planning Breast Reduction
  • Recommendations regarding the technique
  • Discussion of alternatives (if applicable), and/or adjunctive procedures
  • Discussion regarding anticipated recovery and limitation of post-operative activities
  • Recommendations regarding anesthesia care
  • Follow-up Care in the Office
  • Financial Requirements/Considerations
  • Scheduling Surgery and Pre-Operative visits

Thank you for visiting our website and for taking the time to review this information. To help facilitate your education and make a consultation more rewarding you may print this page and bring it with you to the office. Use the reverse side of the page to write down any questions you have so they can be answered in the office. Please download and fill out our Patient Information Form and bring it with you when you have your appointment.

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Pismo Beach Medical Center
2 James Way, Suite 109
Pismo Beach, CA 93449
Phone: (805) 544-6000

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