What is a breast reduction?

A breast reduction is the surgical reshaping of the breast to make it smaller. Breast reduction, also called reduction mammoplasty, involves removing excess fat, glandular tissue, and skin to reduce breast size. Some people seek breast reduction for cosmetic or aesthetic reasons. Your doctor may also recommend it if large breasts are causing discomfort, back problems, or other health problems.

Breast reduction surgery is a common but major surgery with significant risks and potential complications. You may have less invasive treatment. Consider getting a second opinion about all your choices before having breast reduction surgery.

Types of breast reduction surgery

The types of breast reduction procedures include:

  • Free nipple graft (FNG) involves removing your nipple and grafting it in a new location on your breast. Your surgeon removes breast tissue while your nipple is off, and then grafts your nipple back into place.
  • Liposuction involves injection and suction of fatty tissue and usually leaves little or no scarring.
  • Pedicle method involves making a circular incision around your areola (the dark area that surrounds your nipple) to remove breast tissue.
  • Anchor incision is an extension of the pedicle method with an incision that runs vertically down from the areola to the bottom of your breast and into a semi-circle around the bottom of your breast. This makes an anchor-like incision.
  • LeJour incision is an extension of the pedicle method with an incision that runs vertically down from the areola to the bottom of your breast and stops at your chest wall.
  • Stevens laser bra uses a laser and the extra skin that would normally be discarded to create a permanent internal support structure for your breasts.

Other procedures that may be performed 

Your surgeon may perform other procedures in addition to breast reduction surgery. The most common combination is a breast reduction with a breast lift (mastopexy). A breast lift is a procedure to boost sagging or loose breasts.

Why is a breast reduction performed?

Your doctor may recommend breast reduction surgery if you want smaller breasts for cosmetic reasons. Your doctor may also recommend it if large breasts are causing discomfort or medical problems.

Not everyone is a good candidate for breast reduction surgery. A good surgical candidate is physically healthy, does not smoke, has fully developed breasts, and has realistic expectations of improvement, not perfection. Ask your doctor about all of your treatment options and consider getting a second opinion before deciding on breast reduction surgery.  

Your doctor may recommend breast reduction surgery if you are a good surgical candidate and:

  • One breast varies in size or shape from the other one.
  • One or both breasts did not develop normally.
  • You are self-conscious about your breasts or feel that your breasts are too large or are disproportionate to your body size.
  • Your breasts interfere with your ability to participate in sports or other physical activities.
  • Your breasts cause sleep difficulties.
  • You have poor posture or numbness and tingling in your arms due to the weight of your breasts.
  • You have headaches or back, neck or shoulder pain due to weight of your breasts.
  • You have permanent grooves in your shoulders from your bra strap holding the weight of your breasts.
  • You have skin irritation, rashes, sores, or infections under the crease of your breast.
  • Your breasts have stretched skin, stretched areolas, or nipples that hang below your breast crease.
  • You are a male with gynecomastia (breast enlargement in males).

Who performs a breast reduction?

A plastic surgeon performs breast reduction surgery. A plastic surgeon specializes in aesthetic and reconstructive surgery.

How is a breast reduction performed?

Your breast reduction will be performed in a hospital or outpatient surgery setting. Your surgeon will use one of the following approaches:

  • Minimally invasive surgery involves inserting special instruments and an endoscope through small incisions in your underarm or around the base of your breasts. An endoscope is a thin, lighted instrument with a small camera. The camera sends pictures of the inside of your body to a video screen viewed by your surgeon while performing surgery. Minimally invasive surgery generally involves a faster recovery and less pain than open surgery. This is because it causes less trauma to tissues and organs. Your surgeon will make a small incision(s) instead of a larger one used in open surgery. Surgical tools are threaded around muscles and tissues instead of cutting through or displacing them as in open surgery.
  • Open surgery involves making a large incision around your areola and under your breast. Open surgery incision allows your surgeon to directly view and access the surgical area. Open surgery generally involves a longer recovery and more pain than minimally invasive surgery. Open surgery requires a larger incision and more cutting and displacement of muscle and other tissues than minimally invasive surgery. Despite this, open surgery may be a safer or more effective method for certain patients.