There are a number of variations of reduction techniques that surgeons can use. A good surgeon will choose the most appropriate to fit your situation. However, in general, the greater the difference bewtween pre-op size and post-op goal, the more tissue has to be removed and the greater the risk of complications from nerve or blood supply issues. Also, the same as it relates to the distance the surgeon has to move the nipple. FInally, the more shaping required, the more scars you will need.