Breast Reduction Surgery: The Ultimate Guide

Pros

• Reduction mammaplasty makes the breasts smaller, higher, and more proportionate to your body size. 
• It resolves painful and irritating physical symptoms, including rashes, headaches, deep bra strap grooves, and neck, back, and shoulder pain caused by very large breasts. 
• Breast reduction surgery has high patient satisfaction, earning a 97% Worth It Rating from reviewers on RealSelf. Many report how excited they are to finally dress in a way that matches their personal style and no longer feel self-conscious. They’re also able to participate in physical activities like running with more enjoyment and ease. 
• The procedure positively impacts self-esteem, self-confidence, and quality of life. (This also goes for male breast reduction surgery, known as gynecomastia surgery.)  
• Areola reduction, usually performed as part of the procedure, can help make the breasts look perkier and more proportional. 
• Breast reduction surgery may even reduce the risk of breast cancer. One study published in Breast Care in 2022 showed a “reduction in breast cancer incidence of about 82%.”

Cons

• Most patients need about a week of recovery time.
• There’s now way around visible scars with this procedure. “Rarely, though, do patients regret having breast reduction surgery purely on the basis of the resulting scars,” says Dr. Ram Kalus, a board-certified plastic surgeon with practices in Charleston, South Carolina.
• Breast reduction surgery can interfere with breastfeeding, in some situations. However, Dr. Kalus says, “most surgeons use a technique that preserves the ability to breastfeed.” 
• Asymmetry is another potential complication. Your surgeon will try to achieve visual balance, but the way the skin settles and stretches may create some variation in breast size and shape.
• Some women experience a temporary decrease or even loss of sensation in their nipples. Most regain feeling within 12 months, once the nerves have repaired themselves.

Related: How to Avoid Breast Reduction Regret

• Average Cost:
• $9,886

• Range:
• $2,600 - $21,000

Your cost will depend on several factors, including:

• your surgeon's credentials and level of experience
• their practice location
• whether insurance covers a portion of your procedure

Most insurance providers cover breast reduction surgery if it's considered medically necessary, a determination that must be backed up with documentation of chronic health issues stemming from breast size.

Keep in mind that not all plastic surgeons' practices accept insurance coverage, so you may have to work directly with your insurer to be reimbursed. Be sure to ask about this during your initial consultation.

If your procedure isn’t covered, ask your surgeon if they offer payment plans or accept third-party financing options, such as CareCredit.

See our complete guide to breast reduction costs

As you're picking a plastic surgeon, look for breast reduction pictures with a rounded, elevated breast shape, symmetrical results, and thin scars.

The nipple-areolar complex should be in a higher position, with the dimensions of the areola in line with the new breast size. The new shape and size of the breasts should also look well-proportioned to the rest of the body. 

The breast reduction before and after pictures in our gallery have been shared by the surgeon who performed the procedure, with the patient's consent.

Ideal candidates for a breast reduction fit these criteria:

• Healthy (no medical conditions that can impair healing)
• Nonsmoking, or willing to abstain from nicotine for ~6 weeks pre- and post-op
• History of breast-related back, shoulder, and neck pain; postural changes; bra-strap grooving; skin irritation and rashes under the breasts; and/or difficulty exercising
• Old enough: Some patients qualify as young as age 15, although insurance providers may require patients to be at least 16 to be eligible for coverage. Breast reduction is also common in women over age 50, due to hormonal changes from menopause.

Your surgeon will thoroughly evaluate your medical history, overall health, skin condition, emotional maturity, and goals.

If you’re over 40 or have a family history of breast cancer, your surgeon will probably ask that you get a mammogram and address any suspicious findings before your reduction mammaplasty procedure.

Related: The Real Reasons Women Get Breast Reductions

Reduction mammaplasty typically takes 3 to 4 hours. It’s performed under general anesthesia, in a private surgical center or hospital.

These are the two most common surgical techniques.

Vertical or “lollipop” breast reduction works best for a moderate size reduction.

• One incision is made around the areola
• It connects to a second incision running vertically, from the bottom of the areola to the crease beneath the breast

Inverted-T or anchor breast reduction works better for patients who need a significant size reduction and lift.

• An incision is made around the areola
• It connects with a vertical incision made from the bottom of the areola to the breast crease
• This connects to an incision within the crease, creating an upside-down “T”

Once the incisions are made, a breast reduction procedure typically looks something like this:

• Your surgeon removes excess breast tissue, skin, and fat from each breast 
• Liposuction may be performed, to contour fatty tissue
• Your surgeon reshapes the remaining tissue, often sitting you up mid-operation (while you’re asleep) to make sure your results will look symmetrical
• Typically, they then reposition the areola and nipples, which remain attached to the underlying tissue to ensure a healthy blood supply and maintain sensitivity
• Many surgeons inject a slow-release numbing agent like Exparel, to ease post-op pain
• They close the incisions with dissolvable sutures and may place thin surgical drains, to remove excess fluid that accumulates in your breast for up to 48 hours post-op

Immediately after surgery, you will be placed in a sterile gauze dressing or bandage, often covered by a surgical bra. You’ll be taken to a recovery room, where your vitals will be monitored as you emerge from the anesthesia.

You’ll probably be given pain medication, to keep you comfortable as you head home. Have a trusted relative or friend available to take you home and stay with you for the first night.

RealSelf Tip: If you’re concerned about belly fat, combining a breast reduction procedure with abdominal liposuction can also help create a well-proportioned result. Some patients also combine it with a tummy tuck (abdominoplasty), for a full mommy makeover.

Insurance wouldn't cover the cost of lipo or a tummy tuck, but there are financial advantages to combining them, since at least a portion of the anesthesia and facility fee may be covered. Just be aware that longer operations can come with elevated risks, which your provider should discuss with you.

A breast reduction procedure isn’t painful at all, thanks to the anesthesia. However, the first few days of recovery can be uncomfortable.

You’ll be bruised and tender, and you may feel as if there’s pulling, stretching, or tightness in the area for the first 2 to 3 weeks. “If liposuction is done along with a breast reduction, those sites tend to be the most sore,” notes Dr. Janetzke.

“Most patients do fine with over-the-counter analgesics, such as acetaminophen,” says Dr. Kalus. Others require a few days worth of prescription pain medication, like Norco, a combination of hydrocodone and acetaminophen.

During your consultation, ask your provider how they help mitigate pain during recovery.

Most patients take 1 week off work for their initial breast reduction surgery recovery, but 2 weeks is ideal—and sometimes even necessary, if your job involves heavy lifting or you have extensive liposuction.

Your surgeon should give you detailed instructions to help smooth your recovery, but here’s what to expect.

• Most plastic surgeons use dissolvable sutures that don’t need removal.
• You will have a follow-up appointment at 1 week, and possibly others to ensure you’re healing normally.
• Surgeons typically recommend wearing a surgical bra for 4 to 6 weeks post-surgery, followed by a sports bra for an additional 2 to 4 weeks.
• Sleep on your back with your upper body elevated until you’re fully healed. This minimizes fluid buildup, enhances circulation, and avoids putting pressure on your breasts.
• You’ll likely be able to resume workouts and other normal activities within 4 to 6 weeks.  
• By 6 to 8 weeks, swelling will have reduced by about 50%. Breasts should feel soft, natural, and comfortable. 
• Some patients lose sensation around the nipple post-op. It usually returns once the swelling goes down, but for some patients it can take up to 2 years for the nerves to fully recover.
• Scars from breast reduction surgery can take a full year or more to fade. Scar treatments can speed up this process. 

During your initial recovery, your doctor will want you in a surgical bra or sports bra day and night. Avoid underwire bras, which can put undue pressure on the breast crease and any incisions there.

It will be difficult to lift your arms over your head until the soreness and swelling resolves, so plan to wear loose tops or pajamas that button in front for up to a week. 

The size of your breasts will be different (obviously!), so you’ll need to get fitted for new bras and tops once you’ve healed and the swelling has gone down. It can take 6 months to a year before all the swelling subsides and you know your final size, so until then, you may want to opt for options that will adapt reasonably well with your body.

Related: Plastic Surgeons Say the Best Breast Reduction Outcomes Have These 5 Things in Common

The amount of weight you lose from this procedure will depend on how much tissue is removed. Most patients lose at least 2 pounds, while some lose 8 pounds or more. Your plastic surgeon may be able to provide an estimate during your initial consultation.

Even if weight loss is minimal, women who undergo this type of surgery frequently hear that they look like they’ve lost weight, according to Dr. Kalus. “That’s because the visual impression of a disproportionately large-breasted woman is that she appears overweight, even if she is not.”  

This surgery helps patients exercise more easily and live a more active lifestyle, so you may find yourself losing much more weight after you get through the recovery period. Just keep in mind that major post-procedure weight loss can change the proportions of your breasts or leave excess skin.

If you’re planning to lose weight after the procedure, your provider may advise you to delay breast surgery until you’re closer to your goal weight, so you don’t end up with sagging skin once that fat is gone.

Breast reduction is permanent, but your boobs will continue to age and evolve due to hormonal fluctuations, weight changes, gravity, and aging. 

“It is uncommon, but breasts can grow back,” says Dr. Leo Kim, a board-certified plastic surgeon in Sydney. “This can be due to normal changes throughout different stages of life—but in rare cases, mostly in younger women, it can lead to rapid growth.”

Since your breasts are partly made up of fat, you may have an increase in bra size if you gain weight. Maintaining a healthy lifestyle is essential to keeping your ideal cup size after surgery.

Breast reduction is widely considered to be a safe procedure when it’s performed by an experienced, board-certified plastic surgeon. One study published in 2017 found that only 6% of reduction mammaplasty complications were serious enough to require revision surgery. 

During your consultation, your surgeon should talk you through these potential side effects and risks. They should note how they mitigate them in their practice and how they’ve handled  

• The most common breast reduction side effects are bruising, swelling, and scarring. 
• Like all surgical procedures, this one also carries the risks of reaction to the anesthesia, infections, or hematoma.
• There’s also some risk of asymmetry between the two breasts. 
• Nipple sensation may decrease, and it can take up to 2 years to regain full feeling.
• Smoking is known to reduce blood flow through blood vessels and impair healing, so avoiding tobacco for at least one month before and after surgery is strongly encouraged.
• It’s extremely rare, but possible, to lose part of the nipple or areola tissue “if there is not enough blood supply to the area, or if it becomes ‘congested’ and the blood cannot flow out properly, or if the graft does not ‘take,’ in extremely rare instances,” says Dr. Janetzke.

Breast reduction surgery has the potential to interfere with breastfeeding, but studies show that breastfeeding is possible 75–100% of the time, when the nipple and areola are partially or fully preserved.

This complication is more common in procedures where a significant amount of breast tissue is removed beneath the nipple and areola.

If you plan to nurse in the future, tell your provider during your consultation, so they can take that into account in your treatment plan.