Teenage Breast Reduction à la Ariel Winter

As a plastic surgeon specializing in breast surgery, patients come to me to discuss issues they have with their breasts. One thing is loud and clear: breast reduction isn’t just for adults. Teenage breast reduction is becoming more popular: more and more teen girls are having the procedure done—as teens, doctors, and parents are realizing that too-large breasts can trigger long-term pain and discomfort, and lower self-esteem, now…and for years to come.

Breast Reduction Surgery Benefits Teenagers

Stephanie’s Story At 18, Stephanie* hated doing the things most teen girls love: shopping for clothes and hanging out at the beach with her friends.

With a breast size of 34F, Stephanie had a difficult time finding clothes that fit and was extremely self-conscious about her large breasts (also called macromastia, the medical term for excessively large breasts), frequently wearing baggy shirts to camouflage her figure and help her feel less self-conscious. More than anything, she was annoyed; she wanted to wear the latest trends and just fit in with—not stand out from—her friends.

Stephanie had been thinking of breast reduction for at least two years before she finally got up the nerve to discuss it with her parents—and come to see me. She wasn’t even sure that teens could have breast reduction surgery but she figured if adults could have it done, maybe she could, too. She began to research the surgery online and talked about it with her closest friends, but it wasn’t until she read the recent breast reduction story of Modern Family actress Ariel Winter, age 17, in Glamour that she finally decided to make an appointment. (Ariel went from a 32F to a 34D after breast reduction surgery and unveiled her newfound confidence, and curves, at the Emmy Awards in September of this year.)

Why Breast Reduction Can be Appropriate for Teens

Breast reduction can improve self-esteem Teens who have large breasts feel awkward or flawed—a feeling that can stick with them into adulthood. Stephanie was no different. “I’ve been so self-conscious and embarrassed about my body for so long,” Stephanie told me at our first appointment. “I’ve always asked ‘Why me?’ when I look at the rest of my friends who can wear tank tops with their jeans. They look great and I just look…huge.”

Patients and their parents are often not sure if it’s appropriate for a teenager to have breast reduction surgery.

“Despite what many people believe, teenage breast reduction is not just cosmetic.”

Large breasts can trigger physical problems like neck, back, and shoulder pain. Breast size is also critical to a teen’s self-esteem: studies have shown that teenagers with large breasts are more prone to disordered eating and low self-esteem. Having breast reduction surgery has been found to boost self-confidence post-surgery.

Breast reduction can improve a patient’s ability to engage in sports Breast reduction surgery can make it possible for teens to get back into sports and exercising—something large-breasted teens often steer clear of because of the embarrassment of their bouncing, and extremely painful, breasts (no matter how many layers of sports bras they wear).

Breast reduction can improve physical symptoms of pain and discomfort Breast reduction surgery (also called a reduction mammoplasty) fixes, too, the physical problems that so many teens with large breasts face: neck pains; aching shoulders and back; irritated grooves on shoulders from the heaviness of their bras; and chafed skin from heavy, bouncing breasts. These are the medical reasons many insurance companies will often reimburse for the surgery.

These reasons may be why breast reductions are on the rise, particularly among teens, increasing 157 percent between 1997 and 2013, according to the American Society for Aesthetic Plastic Surgery. (In fact, breast reduction surgery was one of the 10 most common surgeries in the U.S. as of 2013.)

Teenage Breast Reduction Facts

• The best candidates The best age for the surgery is when teens have reached what’s called skeletal maturity—when the bones and breasts stop developing, typically around the age of 17 or 18—are at or near their ideal weight, are non-smokers, are emotionally mature, and are in good physical health.

• About the surgery The surgery is performed under general anesthesia—and takes about 4 hours. The patient goes home the same day, no overnight stay at the hospital required.

• What’s involved Breast reduction surgery involves removing the excess breast tissue (also called glandular tissue), fat, and breast skin—and re-shaping the breasts, lifting them (and the nipple) to a higher, more balanced position. During the consultation, I explain to each patient exactly how the surgery will be performed. Knowledge is power, and patients are excited to know how their breast will be reduced, shaped, and lifted. Reviewing breast reduction before-and-after photographs also helps to visualize the change that might occur.

I perform what’s called Superior Pedicle Breast Reduction Surgery, which preserves the fullness in the upper breast—and helps to limit the length of the scar created. I very rarely need to use what’s called an Anchor Incision Pattern Scar—and can almost always create a very limited scar pattern with a Vertical Incision Pattern Scar (also called the Lollipop or LeJour Method) around—and vertically below—the areola.

• Breast reduction recovery Postoperatively, all my patients wear a support bra 24/7 for several weeks. No strenuous activities are allowed for 2 to 3 weeks after the surgery. All of the sutures are dissolvable and do not need to be removed. My patients come to see me one week after the surgery and then again, the second week post-op. Less frequent visits are necessary over the next several months.

• Risks These include scarring, loss of nipple sensitivity, and a potential inability to breastfeed later in life. There’s also a chance with teens that breasts may get larger again after the surgery. But for teens like Stephanie, the benefits far outweigh the risks.

• Satisfaction rates Adults who had breast reduction as teenagers report high satisfaction levels throughout adulthood, according to studies.

“Breast reduction surgery has one of the highest patient satisfaction rates among all plastic surgery procedures.”

Stephanie just completed her breast reduction procedure—and is thrilled with the results. She sent me a thank-you note, saying: “I love my new breasts! I can finally wear fitted t-shirts and find clothes that fit. I even lifted up my shirt to show my friends my breasts and the scars. I’ve never showed my breasts to anyone before! I would recommend this surgery to any teenager who suffers from large breasts.”

Breast Reduction Cost

Breast reduction can cost anywhere from $10,000 to $20,000 and even higher. For patients who have insurance, my insurance coordinator, Judy, works with each patient to determine coverage and how much the insurance company will pay for the procedure. Each patient can then know, before surgery, exactly how much the procedure will cost.

Some patients will have most of the costs covered by insurance while others will end up paying a greater share. In some cases, insurance won’t cover the procedure at all because they don’t deem it medically necessary or a patient’s plan doesn’t include the surgery as a benefit.

Navigating the insurance gauntlet can be a challenge and Judy is a patient’s best advocate to assist and facilitate in this process.

To find out more about teenage breast reduction surgery, call 212-860-0670 to book an appointment with board-certified New York City plastic surgeon, Tracy Pfeifer, MD, FACS, who specializes in breast surgery.

* Name has been changed to protect the privacy of patient

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