What You Need to Know About Breast Reduction Surgery

Reviewed by Richard J. Greco, MD, FACS

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Breast reduction surgery (reduction mammoplasty) is a plastic surgery procedure in which your surgeon removes excess breast fat, tissue and skin to bring your breasts into better proportion with the rest of your frame. Overly large breasts can cause physical symptoms such as back and neck pain, make exercise difficult and make a woman feel self-conscious.

Oversized breasts (breast hypertrophy) typically develop during puberty or soon after. Sometimes pregnancy-related breast enlargement persists. Although rare, sudden onset of breast enlargement may also occur. Specially designed bras can help relieve some of the discomfort, but they may also cause irritation to the shoulder area.

While weight loss may help some women, breast reduction surgery (or in some cases liposuction of the breast fat) is the only way to treat this condition. Breast reduction surgery is typically performed to create a more proportional chest and to alleviate problems with activities, health and clothing. The procedure can also help achieve breast symmetry.

The Initial Consultation

The first step is to schedule a consultation with a board-certified plastic surgeon who has experience with all types of breast surgery. To get started on your search for the right surgeon, visit our plastic surgeon directory, which exclusively lists surgeons who are board certified by the American Board of Plastic Surgery (ABPS). Surgeons who are certified by the ABPS have achieved the highest levels of education, training and experience and are held in high esteem by their medical colleagues. By exclusively listing ABPS-certified surgeons, the Consumer Guide to Plastic Surgery Directory can help ensure you find the best doctor to assess your candidacy and perform your surgery.

During your initial consultation, your plastic surgeon will measure your breasts in relation to your frame and take "before" photos of your breasts. He or she may also request a breast X-ray (mammogram) before surgery to rule out breast cancer or any other anomalies. You will also discuss your potential candidacy, expectations, risks, breast reduction costs and benefits with your surgeon. The procedure should be explained in detail, and all your questions should be answered. Also ask to see before and after breast reduction photos to get an idea of what type of results you can expect.

How Breast Reduction Surgery Is Performed

Breast reduction plastic surgery is usually performed under general anesthesia. Before entering the operating room, your surgeon will ask you to sit upright or stand so he or she can mark your breasts. These markings outline the natural position of your breast while erect and serve as guides for incision placement. The drawings will typically take the form of an anchor — encircling and extending above the areola (darkly colored skin around the nipple) to the new location of the nipple. The markings also extend vertically below the nipple and horizontally along the natural curve of your breast crease.

Your surgeon then trims, lifts and/or shapes the excess skin, fat and glandular tissues. In most cases the nipples are moved to a higher position but remain attached to the nerves and blood vessels. In very large breasts, the nipples may need to be detached from the underlying connective tissues and moved to their new location.

Please click here to view an animation about breast reduction surgery.

Your surgeon then trims, lifts and/or shapes the excess skin, fat and glandular tissues. In most cases the nipples are moved to a higher position but remain attached to the nerves and blood vessels. In very large breasts, the nipples may need to be detached from the underlying connective tissues and moved to their new location.

Nipple surgery may be performed as well, to reduce the size of your areolas. Breast reduction can also be paired with a breast lift to raise and firm your breasts.

Your surgeon then closes the incisions to reshape your breasts. The sutures help support your breasts. There will be scars from breast reduction incisions, but these tend to fade with time.

In some cases, breast reduction may be accomplished with liposuction if only fat needs to be removed. Your skin must be highly elastic for this approach to work.

After Breast Reduction Surgery

Your breasts will be sore, swollen and bruised after breast reduction. Your surgeon can prescribe pain medications to help relieve any discomfort. You can expect to wear bandages for about the first two days of your breast reduction recovery. You should do no heavy lifting or pushing for three or four weeks after your surgery. Caring for young children immediately after surgery is not recommended. For extra support, your doctor may recommend a special soft surgical bra or athletic bra. Stitches are removed in two to three weeks.

Complications and Risks

As with any surgery, there are risks associated with breast reduction, including infection and/or reaction to anesthesia. Read more about breast reduction side effects and how to minimize them in our comprehensive article on the topic.

Male Breast Reduction Surgery

Breast reduction surgery is also performed on men for the treatment of gynecomastia (enlarged male breasts). Please visit our comprehensive pages on various aspects of the procedure, including male breast reduction surgery risks and recovery from male breast reduction.