Breast Reduction Surgery: What You Need to Know

Medically reviewed by Ellen A. Janetzke, MDBoard Certified Plastic SurgeonReviewed on May 23, 2023
Written byJolene EdgarUpdated on May 15, 2023
RealSelf ensures that an experienced doctor who is trained and certified to safely perform this procedure has reviewed this information for medical accuracy.You can trust RealSelf content to be unbiased and medically accurate. Learn more about our content standards.
Medically reviewed by Ellen A. Janetzke, MDBoard Certified Plastic SurgeonReviewed on May 23, 2023
Written byJolene EdgarUpdated on May 15, 2023
RealSelf ensures that an experienced doctor who is trained and certified to safely perform this procedure has reviewed this information for medical accuracy.You can trust RealSelf content to be unbiased and medically accurate. Learn more about our content standards.

Bilateral breast reduction (reduction mammoplasty) is one of the most popular plastic surgery procedures world-wide. According to the most recent statistics from the International Society of Aesthetic Plastic Surgery, their member surgeons performed over half a million breast reduction surgery procedures in 2021, for aesthetic or reconstructive reasons.

It’s so common “because so many women suffer from symptoms caused by breasts that are disproportionately large for their bodies,” says Dr. Ram Kalus, a board-certified plastic surgeon with practices in Charleston, South Carolina, and Tel Aviv, Israel. (Male breast reduction surgery is known as gynecomastia surgery.)

During this outpatient procedure, a surgeon removes excess fat, skin, and glandular tissue from the breasts to reduce their size. They also reshape the remaining tissue and may raise the nipples to a perkier position.

Reducing excess tissue and elevating the breasts on the chest wall improves or completely alleviates back pain and other physical symptoms associated with disproportionately large breasts, according to Dr. Ellen Janetzke, a board-certified plastic surgeon in Bloomfield Hills, Michigan.

Interested in a breast reduction?

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Pros

  • Reduction mammaplasty makes breasts more proportionate to your body size. 
  • It also 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 reviewers 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. 
  • Studies show the procedure positively impacts patients’ self-esteem, confidence, and quality of life.  
  • Areola reduction is usually performed during the same procedure, which helps make breasts look perkier, younger, 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

  • You’ll need a week of recovery time.
  • This procedure leaves visible scars. Incision lines usually fade and improve, but faint lines may be visible forever. “Rarely do patients regret having breast reduction surgery purely on the basis of the resulting scars,” says Dr. Kalus. 
  • Depending on your surgeon’s technique, breast reduction surgery may interfere with your ability to breastfeed. However, Dr. Kalus says that “most plastic surgeons perform the surgery with a technique that preserves the ability to breastfeed.”  
  • It’s possible to end up with asymmetry. 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, though most regain normal feeling within 12 months, once the nerves have repaired themselves.

Related: How to Avoid Breast Reduction Regret

  • Average Cost:
  • $8,200
  • Range:
  • $2,800 - $20,000

Your cost will depend on your surgeon's level of experience, their practice location, whether insurance covers a portion of your procedures, and a few other key factors. 

Most health insurance providers cover breast reduction surgery that’s considered medically necessary, backed up with documentation of chronic health issues stemming from breast size. 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

Interested in a breast reduction?

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As you're picking your plastic surgeon, look for breast reduction pictures with a rounded, elevated breast shape, symmetrical results, and thin, well-hidden scars. The nipple-areolar complex should be in a higher, more youthful position, with the dimensions of the areola proportional to the new breast size. Finally, the new shape and size of the breasts should 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 breast reduction are healthy people who don’t smoke or have medical conditions that can impair healing.

“Patients who benefit most from breast reduction surgery are women who have disproportionately large breasts, causing problems such as back, shoulder, and neck pain, postural changes, bra-strap grooving, skin irritation and rashes under the breasts, and difficulty with activities of daily living and exercise,” says plastic surgeon Dr. Tom Pousti, who practices in San Diego. 

There are no official age restrictions for breast reduction surgery. Depending on a variety of factors, some females may qualify as candidates when they’re as young as 15, although insurance providers may require patients to be at least 16 to be eligible for coverage.

At the opposite end of the age spectrum, breast reduction is common among women 50-70 years old due to hormonal changes and possible weight gain from menopause.

At any age, your provider 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

A breast reduction procedure typically takes 3 to 4 hours and is performed under general anesthesia, in a private surgical center or hospital. Dr. Janetzke says that it’s typically an outpatient procedure, though your surgeon may keep you overnight to monitor your vitals if they have any concerns.

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 with a second incision, which runs vertically from the bottom of the areola to the crease beneath the breast

Inverted-T or anchor breast reduction works better for patients who have considerable sagging or need a significant size reduction.

  • 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 inverted “T”

Once the incisions are made, your surgeon will remove excess breast tissue, skin, and fat to reduce the size of each breast. 

Liposuction may also be performed, to remove fatty tissue and improve the shape of the breast. Dr. Kalus tells us that “liposuction alone is generally only indicated for women with minimal sagging or drooping, since it will rarely allow for any significant ‘lift’ or tightening of a droopy breast.” Removing fat alone can also leave excess skin, if you don’t have good elasticity. 

Once the excess tissue and fat are removed, your surgeon will reshape the remaining tissue. They may adjust the surgical table so you’re upright, Dr. Janetzke says, to make sure your breasts are visually symmetrical. 

They will also reposition your areola and nipples, which usually remain attached to their underlying tissue to ensure a healthy blood supply.

Finally, your surgeon will close the incisions with dissolvable sutures. They may place small surgical drains at the end of the incisions under each arm, connected to a small collection reservoir. Drains can help remove excess blood and fluids that may accumulate within your breast for 24-48 hours after surgery.

Immediately after the 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 the anesthesia wears off. You will probably be given pain medication, to help keep you comfortable as you head home. Make sure you have a trusted relative or friend to get you home safely and stay with you for the first night.

RealSelf Tip: If you’re concerned about excess 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, 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.

A breast reduction procedure isn’t painful at all, thanks to the anesthesia, but it’s common to have mild to moderate discomfort during recovery—especially during the first three days.

In the experience of Dr. Kalus, “Most patients do fine with over-the-counter analgesics, such as acetaminophen, but some may require prescription pain medication for a few days.” It’s common for surgeons to send patients home with pain medicine (often Norco, a combination of hydrocodone and acetaminophen). Your provider may also give you a slow-release numbing agent like Exparel during the procedure, to help keep you comfortable during those first few days.

You’ll have some bruising and may feel sore, as if there’s pulling, stretching, or tightness in the area for 2 to 3 weeks. 

“If liposuction is done along with a breast reduction, those sites tend to be the most sore,” notes Dr. Ellen Janetzke, a board-certified plastic surgeon in Bloomfield Hills, Michigan.

Most patients take 1 week of recovery time for their initial breast reduction surgery recovery, but 2 weeks is ideal, especially if your job is physical and involves heavy lifting.

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

  • Typically, plastic surgeons use dissolvable sutures that don’t need removal, but you will have a follow-up appointment after 1 week, and possibly others after that to ensure that you’re healing normally.
  • Most surgeons recommend wearing your surgical bra for 4 to 6 weeks post-surgery, followed by a sports bra for an additional 2 to 4 weeks. Avoid wearing underwire bras during this time; they can rub the incisions. 
  • Sleep on your back with your upper body elevated. 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.  
  • Within 6 to 8 weeks, the inflammation and swelling will have reduced by about 50%. Your breasts should feel soft, natural, and comfortable. 
  • Some patients lose sensation around the nipple post-op. Typically, it returns once the swelling goes down, but it can sometimes 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 help speed up this process. 

See breast reduction before and after photos

During the first 4 to 6 weeks post-op, your doctor will likely want you to wear a surgical bra or sports bra day and night (even when sleeping), except when you’re bathing. Avoid underwire bras, which can put undue pressure on the breast crease.

It will be difficult to lift your arms over your head until some of the soreness and swelling resolve. Plan to wear loose tops or pajamas that button in front for the first several days to a week. 

The size of your breasts will be very different, so you’ll need to get fitted for new bras once you’ve healed and the swelling has gone down.

Your breast size will be visibly reduced immediately after surgery, but it can take six months to a year before all swelling subsides and you'll see your final size.

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

The amount of weight you lose from the procedure itself will depend on how much tissue is removed. Your plastic surgeon may be able to provide an estimate during your initial consultation.

Even if the weight loss is minimal, women who undergo this type of surgery are frequently told by friends and family that they look as though they have lost a significant amount of 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.”  

The surgery can also help you live a more active lifestyle, which can support future weight loss. Just keep in mind that major weight loss post-procedure may change the proportions of your breasts or leave excess skin.

Breast reduction is permanent, but that won’t make you immune to hormonal changes, weight gain (or loss), gravity, and aging. All these factors cause breasts to change in size and shape, and potentially grow and sag over the years. 

In other words, your boobs will continue to age and change. 

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

Pregnancy, hormonal changes, menopause, and weight changes can all affect breast size and shape over your lifetime. Maintaining a healthy lifestyle and diet is essential to keeping your ideal cup size after surgery.

Since your breasts are partly made up of fat, you may have an increase in bra size if you gain weight. 

On the other hand, if you plan on losing a significant amount of weight after the procedure, discuss this with your plastic surgeon. They may advise that you wait until you’re closer to your goal weight before having breast surgery, so you don’t end up with sagging skin once the fat is gone.

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 side effects and risks. 

  • 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 temporarily decrease, and it can take up to 2 years to regain full feeling.
  • Smoking is known to reduce blood flow and impair healing, so avoiding tobacco for at least one month before and after surgery is strongly encouraged.

Breast reduction surgery has the potential to interfere with breastfeeding. Studies show that breastfeeding is possible 75–100% of the time when the nipple and areola are partially or fully preserved. In procedures where more breast tissue is removed from the area beneath the nipple and areola, this complication is more common.

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.

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.

Interested in a breast reduction?

Find a Doctor Near You

Updated May 15, 2023

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