Awake Breast Reduction
in Long Island, NY

Our clinic on Long Island offers awake breast reduction to address the physical burdens that overly large breasts can impose on daily life. Many women struggle with persistent discomfort, challenges in finding clothing that fits properly, or limitations in physical activity. Issues like skin irritation and neck or shoulder strain often prompt consideration of this surgical option. Emotional factors, such as feeling self-conscious or frustrated by unwanted attention, also weigh heavily for some patients. Fortunately, our advanced procedure provides the opportunity to restore balance and enhance the overall quality of life through professional, personalized care.

What is Awake Breast
Reduction?

Awake breast reduction is a type of reduction mammoplasty performed while the patient remains conscious, typically using local anesthesia and sedation rather than general anesthesia. This approach allows for a less invasive experience compared to traditional methods. The procedure usually takes about two to three hours to complete. It primarily addresses issues caused by excessively large breasts, such as chronic shoulder pain. By targeting the underlying problem, awake breast reduction helps improve comfort and physical function.

Visit our gallery

Breast Reduction Options

Inverted-T (Anchor) Reduction

Anchor reduction is a surgical technique commonly used in patients who require a significant volume reduction. It involves three incisions: one around the nipple-areola complex, a vertical line extending down to the breast fold, and a horizontal line along the inframammary crease, which together form an inverted-T shape. This approach provides Dr. Gargiulo with maximum control over tissue removal and breast reshaping. The nipple-areola complex is typically repositioned to a higher, more natural location during the procedure. This method is well-suited for addressing severe sagging and substantial excess tissue.

Vertical (Lollipop) Reduction

Lollipop reduction involves a more limited incision pattern than the anchor technique, making it suitable for moderate breast reductions. The procedure includes a circular incision around the areola and a vertical incision running from the areola to the breast crease. This vertical incision allows for effective removal of excess tissue while minimizing scarring compared to more extensive techniques. The method preserves a natural breast shape and often results in quicker recovery. It is ideal for patients with mild to moderate sagging and less dramatic size reduction needs.

Periareolar (Donut) Reduction

Donut reduction is an option designed for individuals needing minor tissue removal and reshaping. The technique involves a single circular incision around the areola, through which excess glandular tissue and skin are removed. This approach limits visible scarring to the edge of the areola, making it a cosmetically appealing choice for some patients. Because it does not include vertical or horizontal incisions, it is not typically recommended for those with significant drooping. It offers a subtle enhancement with minimal disruption to the breast’s natural contour.

Breast Reduction Consultation

Preparation for awake breast reduction begins with an initial consultation, during which Dr. Gargiulo reviews the patient’s medical history and assesses their physical symptoms, such as back, neck, or shoulder discomfort caused by excess breast tissue. This meeting enables us to determine whether awake breast reduction is the most suitable procedure for the individual, taking into account their anatomy and goals. A detailed physical examination is often conducted to evaluate skin elasticity, breast size, and the position of the nipple-areola complex. From there, Dr. Gargiulo develops a personalized treatment plan that outlines the surgical approach and expectations. Preoperative instructions are also provided to ensure a smooth and safe experience.

Awake Breast Reduction Procedure

Anesthesia

Awake breast reduction is performed under local anesthesia, sometimes combined with mild sedation, allowing the patient to remain conscious and comfortable throughout the entire procedure. This approach minimizes the risks associated with general anesthesia while still effectively controlling pain and anxiety during surgery.

Incisions and Excess Tissue Removal

Small, strategically placed incisions are made, depending on the chosen reduction technique, often around the areola and extending vertically or along the breast fold. Through these incisions, excess glandular tissue, fat, and skin are removed to achieve the desired breast size and shape. Care is taken to preserve critical structures, including nerves and blood vessels, to support healing and reduce the risk of complications.

Nipple and Areola Preservation

The nipple-areola complex is carefully repositioned, if necessary, with a focus on preserving nipple sensation and circulation. Since the procedure is done while the patient is awake, real-time feedback may help guide symmetry and placement.

Fluid Management and Closure

After reshaping the breast, the surgical area is examined for excess fluid, which is either drained or absorbed using internal techniques. The incisions are then closed with sutures, and sterile dressings are applied to the area. Throughout the procedure, steps are taken to minimize trauma and support optimal healing.

Add-On Procedures

Liposuction

Liposuction is a surgical procedure often added to breast reduction to further contour the chest, back, or underarm area. It targets localized pockets of excess fat that may remain after glandular tissue is removed. Using a thin tube called a cannula, fat is suctioned out through small incisions, enhancing the overall proportions and definition of the upper body. Liposuction can be performed under local anesthesia in many cases, making it a compatible addition to awake breast reduction. It is especially beneficial for patients seeking smoother, more sculpted results.

Tummy Tuck

A tummy tuck is a form of plastic surgery that can be performed alongside breast reduction to improve abdominal contour. The procedure involves removing excess skin and tightening the underlying muscles of the abdominal wall. It is commonly chosen by women who have experienced significant weight loss or pregnancy, which can leave loose skin and weakened tissue. A tummy tuck complements the reshaping of the breasts by creating a firmer, more balanced midsection. The combined approach enhances both upper and lower body aesthetics.

Recovery After Awake Breast Reduction

First 24 Hours

During the first 24 hours of the recovery process, rest is essential to support proper healing and minimize discomfort. Prescribed pain medications are typically used to manage any soreness, and a surgical bra is worn continuously to provide compression and reduce swelling. Post-operative instructions often include sleeping in an elevated position and avoiding any physical activity. Most patients return home the same day under supervision and begin gentle movement within hours to encourage circulation. It’s also important to monitor for any signs of unusual bleeding or complications during this early phase.

Week 1

By the end of the first week, swelling and bruising remain but begin to gradually decrease. The surgical bra should be worn around the clock, and physical activity should be kept to a minimum to prevent strain on the incisions. Follow-up appointments during this period enable Dr. Gargiulo to assess progress and remove any dressings or drains that may have been used. Post-operative instructions continue to emphasize hydration, avoiding weight gain, and protecting the incisions from pressure or friction. Most patients can resume light daily tasks, though rest remains a priority.

Weeks 2–4

During weeks two to four, healing progresses further, and discomfort typically becomes mild or resolves. The surgical bra may still be required, especially during the day, to ensure continued support and proper healing of breast tissue. Physical activity is generally limited to walking or very light movements, with strenuous exercise still restricted. Any residual swelling begins to diminish, and follow-up appointments help monitor scar formation and breast symmetry. Adherence to all post-operative instructions is essential for optimal results during this stage of the recovery process.

Week 5 and Beyond

After five weeks, most patients experience a significant return to their regular routines, including work and light exercise, as guided by Dr. Gargiulo. The surgical bra may be gradually phased out, and physical activity is reintroduced cautiously to avoid complications. Weight gain should be avoided during this period to maintain surgical results and reduce tension on healing tissues. Continued follow-up appointments ensure the breasts are settling properly and that scar maturation is progressing as expected. Long-term care may include scar treatments and ongoing monitoring of breast sensation and shape.

Candidates for Awake Breast Reduction

Some individuals experience a combination of physical and emotional challenges related to breast size that may lead them to consider awake breast reduction. The procedure is often recommended for those who meet specific clinical or lifestyle criteria associated with breast-related concerns. Typical candidates include:

Women experiencing chronic neck pain due to overly large breasts
Those dealing with physical discomfort from daily activities
Patients who suffer from skin irritation beneath the breasts
People who feel self-conscious due to breast size
Women whose bra straps leave deep shoulder grooves
Candidates who maintain a generally healthy weight
People facing emotional discomfort related to body image

Enhance your confidence with curves that feel like you.

Schedule your consultation to discuss your goals and explore personalized options for beautiful, natural-looking results.

Benefits of Breast Reduction Under Local Anesthesia

Awake breast reduction offers a modern surgical approach that aligns with the needs of individuals seeking greater comfort and control during their procedure. The benefits of breast reduction extend beyond cosmetic improvements, addressing both physical and emotional well-being. Patients can expect:

Reduced physical symptoms caused by oversized breasts
Improved posture and daily mobility
Increased body confidence and self-esteem
Reduced risk of future back strain
Decreased unwanted attention in public settings
Ability to wear a wider variety of clothing styles
Fewer skin issues under and around the breasts
Enhanced ability to exercise and stay active
Long-term support to prevent health issues

Cost of Awake Breast Reduction in Long Island

The cost of awake breast reduction in Long Island ranges from $8,000 to $15,000. The total price depends on factors like the surgical technique, facility fees, and the qualifications of the plastic surgeon performing the procedure. Most quotes include anesthesia, follow-up care, and post-surgical garments.Dr. Gargiulo provides accurate price quotes during the initial consultation.
To obtain an accurate estimate and determine the best course of action for your case, it’s essential to schedule a consultation. Working with experienced plastic surgeons, such as Gargiulo, helps ensure safe and high-quality care.

What Makes Our Awake Breast Reduction Different From Others?

Dr. Gargiulo’s approach to awake breast reduction stands out due to a combination of expertise, patient-centered care, and attention to detail. As a board-certified doctor, he ensures that every procedure is tailored to the unique needs of each individual, beginning with a thorough personal consultation. This careful planning allows patients to experience the transformative benefits of breast reduction while remaining comfortable and informed throughout the process. The emphasis on minimally invasive techniques and personalized care results in outcomes that prioritize both physical relief and aesthetic goals. This approach creates a distinct experience compared to other providers.

Frequently Asked Questions (FAQs)

Is breast reduction painful?

Some discomfort is common after surgery, but prescribed pain medications help manage pain effectively during recovery. The surgical procedure itself is painless because it is performed under local anesthesia and sedation, providing maximum patient comfort while Dr. Gargiulo works with heavy breasts.

To what extent can I decrease my breast size through a reduction surgery?

The amount of reduction depends on individual goals and anatomy, with the surgeon helping to determine a safe and balanced size.

Can I combine breast reduction surgery with other cosmetic procedures?

Yes, breast reduction can often be performed alongside other procedures, such as a tummy tuck or liposuction, to enhance overall body contouring.

Is a breast lift included in breast reduction surgery?

A breast lift is included as part of the reduction surgery to reposition and reshape the breasts.

Is breast reduction covered by insurance?

Health insurance coverage may be available for those with extremely large breasts, but insurance companies often require documentation and approval. Our friendly team can assist you with all insurance-related matters.

What are the potential risks of breast reduction surgery?

Possible risks include visible scarring and changes in nipple sensitivity, which may improve over time but can sometimes be permanent. Other potential risks include asymmetry, infection, bleeding, seroma (fluid accumulation), delayed wound healing, and other issues. Dr. Gargiulo utilizes the latest techniques to prevent these problems and supports patients in the event of any complications.

Awake Breast Reduction in Long Island, NY

What is Awake Breast Reduction?