Breast Reduction Guide: Top Questions & Answers

Reviewed for medical accuracy by Dr. Elisa Burgess in February 2016

A breast reduction removes excess fat, skin, and tissue to create smaller, perkier breasts. The procedure usually results in lifting the nipple and areola to a higher position, and it may help eliminate back, shoulder, neck, and head pain.

If you’re considering breast reduction, you probably have a lot of questions. We’ve drawn on the expertise of our doctors and the RealSelf community to give you answers to those most commonly asked on our site.

In This Overview:

What Is Breast Reduction Surgery?
Is Breast Reduction Right for Me?
How Much Does It Cost?
How Do I Choose a Surgeon?
How Should I Prepare for a Breast Reduction?
What Happens During the Procedure?
What Should I Expect During Recovery?
What Results Can I Expect?
What Else Do I Need to Know?

What Is Breast Reduction Surgery?

Breast reduction surgery is in an invasive procedure that removes fat, skin, and tissue while lifting the breasts. The result is a more streamlined, younger-looking bust.

The most common method of reducing breast volume requires three incisions: one around the areola (a periareolar incision), another running vertically from the bottom of the areola to the crease underneath the breast, and a third following the natural line of the breast crease.

The surgeon removes the excess tissue and fat through these incisions before lifting the nipple and areola to a higher position. The size of the areola may also be reduced, and liposuction might be used to adjust the contour. Back to top

Is Breast Reduction Right for Me?

If one or more of the following apply to you, you may be a good candidate for breast reduction:

  • Your breasts are overly large in proportion to your body frame
  • You have heavy, pendulous breasts with downward-pointing nipples and areolas
  • You have one breast that’s much larger than the other
  • You experience back, neck, shoulder, or head pain caused by the weight of your breasts
  • You have skin irritation under your breasts
  • You experience a restriction of physical activity due to your breasts’ size and weight
  • You’re self-consciousness about the largeness of your breasts

Breast reduction can be performed at any age, but plastic surgeons usually recommend waiting until breast development has stopped after puberty. You will need to be in good overall health.

To help determine what size is right for you and communicate your goals to your surgeon, San Diego plastic surgeon Dr. Tom J. Pousti recommends collecting photographs of breasts you think are too large, too small, and just right for your figure.

“Most patients undergoing breast reduction surgery wish to achieve enough of a reduction to help with their symptoms while remaining proportionate with the remainder of their torso,” says Dr. Pousti. Back to top

How Much Does Breast Reduction Cost?

The price of breast reduction varies based on a number of factors, but expect a price tag of at least $6,000. The procedure may be covered by your health insurance. “The more documentation you have from your primary care doctor, physical therapist, chiropractor, etc., the better,” says Dr. Pousti. Documenting your medical need to have this procedure may help your case to have it covered by insurance. Back to top

How Do I Choose a Surgeon for Breast Reduction?

As with any elective procedure, the most important factor in choosing a doctor is experience. “When a woman chooses a plastic surgeon for breast reduction, it is important to ask if the surgeon is board certified with the American Board of Plastic Surgery,” explains Lake Oswego, Oregon, plastic surgeon Dr. Elisa A. Burgess. “It is equally important to ask if breast surgery is a significant part of their practice.”

Consider having consultations with at least three different doctors. During the consultation, expect to be asked about your desired breast size. You will also have your breasts examined, measured, and photographed.

Questions to ask your surgeon include:

  • How often do you perform breast reduction surgery?
  • How do you plan to minimize scarring?
  • How often do you work with breasts my size?
  • What is your proposed surgical plan for my breast reduction?

Be sure to discuss any planned massive weight loss and let them know if breastfeeding will be important to you in the future. This will help your surgeon design the best plan for your breast reduction.
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How Should I Prepare for Breast Reduction?

If you have a family history of breast cancer, your doctor may recommend a pre-op mammogram, followed by another mammogram following surgery. (Some doctors recommend this occur a few months post-op while others may wait a year.) This will help detect any changes in your breast tissue. Breast reduction surgery does not increase your risk of developing breast cancer.

If you smoke, plan to stop well in advance of your surgery date. You will also be advised to stop taking aspirin and certain anti-inflammatory drugs that may increase bleeding.

Your doctor may advise you to exercise or change your diet before surgery. “I recommend to all of my patients to get in the best possible shape they can prior to their surgery,” says Munster, Indiana plastic surgeon Dr. David A. Robinson. “This includes losing weight, if they are overweight, stopping smoking, and exercising.” The more you can do before surgery, the better your results and healing.

Be sure to follow your surgeon’s specific pre-op instructions. One essential tip for the day of the surgery: wear a shirt that buttons up the front. “It will be easier to get into when it comes time to leave the hospital,” says Dr. Burgess. Back to top

What Happens During a Breast Reduction Procedure?

Breast reduction surgery typically takes between two and three hours. You’ll be put under using general anesthesia. Your surgeon will likely make three different incisions per breast to remove excess tissue, fat, and skin. The skin located above the nipple will be used to reshape the breast, and liposuction may be used to contour the new shape.

Typically, the nipples and areolas remain attached to underlying tissue. This means you should retain sensation and the ability to breastfeed following surgery.

Breast reduction may be an inpatient or outpatient procedure. If the former, you will likely spend one night at the hospital or surgical facility. If the latter, you will need someone to drive you home and monitor your recovery for the first one to two days post-op. Back to top

What Should I Expect During Recovery?

Recovery from breast reduction surgery varies person to person, but you can expect to be sore in the first few days after surgery. “Most patients feel like they are wearing a tight bra,” says Dr. Burgess of post-op pain. “Fortunately, there is no bone or muscle surgery with a breast reduction, so I think it’s a little less painful with a quicker recovery [than some breast surgeries].”

Make sure you have friends or family on hand to care for you the day of surgery and, if possible, one to two days post-op. They can help administer medications and deal with drains, dressings, showers, and brief walks to stay active.

If your surgeon has placed any drains, Dr. Burgess recommends buying clean feminine hygiene pads or other padded dressings. “They can be helpful to have on hand to capture drainage,” she says. Expect your drains to be removed after a couple of days.

You’ll also likely wear a support bra for the next few weeks, as the swelling and discoloration of your breasts decreases (a process doctors say may not be fully resolved for six to eight months).

You may be instructed to sleep on your back to avoid putting pressure on your breasts, and you might notice reduced sensation in the nipples and areolas. This is usually temporary, but sensation may not fully return for weeks, months, or sometimes years.

Following surgery, most doctors recommend one to two weeks off work with no strenuous exercise (lifting above 10 pounds) for four to six weeks. You should also abstain from any sexual activity for at least one week; your doctor may advise you to wait longer. Your breasts must be handled extremely gently for at least six weeks following the procedure. Mild, periodic discomfort during this time is normal, but report any severe or lasting pain to your doctor.

These changes may seem scary, but understanding your risks will help. “Breast reduction patients routinely have surgery, recover quickly, and celebrate freedom!” says Savannah, Georgia, plastic surgeon Dr. Luke J. Curtsinger. “They are able to exercise better, sleep better, and breathe better.” Back to top

What Results Can I Expect From Breast Reduction?

Your breast reduction results should remain fairly consistent barring two situations: gaining or losing a significant amount of weight, or becoming pregnant. While neither situation will “undo” the breast reduction, they will change the appearance of your breasts and may alter your results.

Expect the incisions from your breast reduction to be red and/or pink immediately following surgery. These incisions will heal and fade over time, but they will never fully disappear.

“There is no way to get around having scars. Science has yet to find a way to truly do ‘scarless’ surgery,” says Missoula, Montana, plastic surgeon Dr. Michelle A. Spring. “That being said, most patients are very happy to trade off having scars for an improved breast shape, fewer aches and pains associated with large, droopy breasts, and looking better in clothing, swimsuits, bras, and maybe even feeling comfortable going braless for the first time.”

Women who have a breast reduction may seek a breast lift if they grow dissatisfied with the appearance of their breasts following the wear and tear of gravity and aging over the course of years. This procedure will aim to restore a youthful contour to the bust.

As you continue to heal, prepare to have a whole new figure and one that will likely change in the year following surgery. “The last phase is where the breast externally looks healed, but the breasts soften and drop a little,” says Dr. Burgess. “This can take six to 12 months.”

To get an idea of the kind of results you can expect, here are three of the most viewed before and after photos on RealSelf. Back to top

Breast Reduction 1Photo courtesy of Lake Oswego, Oregon, plastic surgeon Dr. Elisa A. Burgess
Breast Reduction 2Photo courtesy of San Diego plastic surgeon Dr. Tom J. Pousti
Breast Reduction 3
Photo courtesy of Missoula, Montana, plastic surgeon Dr. Michelle A. Spring

What Else Do I Need to Know?

Will My Nipples Be Removed During Surgery?

It’s a common question, says Dr. Burgess, but no, in most cases the nipples aren’t removed during surgery unless the patient is very, very large-breasted.

What If I Get Pregnant After My Breast Reduction?

Your breasts will change with pregnancy, but it won’t necessarily “ruin” the results. “Maintaining a stable weight under the guidance of your OB/GYN will be helpful in minimizing breast changes,” says Dr. Pousti. “Otherwise, expect some changes in size and/or position of the breasts that may or may not benefit from revision surgery in the future.”

Can I Breastfeed After a Breast Reduction?

You should be able to breastfeed, but breast reduction surgery goes across the milk ducts. Doctors differ on how much of an impact this has on breastfeeding: some say their patients have been able to breastfeed, some say it decreases a woman’s ability to do so. So be sure to discuss all possible outcomes with your doctor. He or she may recommend waiting for surgery until after your family is complete.

Have a question we didn't answer in this guide? Ask a plastic surgeon.

More to Explore:

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Dr. Burgess

This guide has been medically reviewed for accuracy by Dr. Elisa A. Burgess. Dr. Burgess is is a board-certified plastic surgeon practicing in Lake Oswego, Oregon. She specializes in a wide variety of plastic surgery procedures, including cosmetic and reconstructive procedures for the breasts, body contouring, and facial rejuvenation. Learn more on her RealSelf profile.

Disclaimer:This content is for educational and informational purposes only. It is not a substitute for medical advice, diagnosis, or treatment provided by a qualified healthcare professional. Your reliance on any information or content provided in the guide is solely at your own risk. You should always seek the advice of your physician or healthcare professional for any questions you have about your own medical condition. RealSelf does not endorse or recommend any specific content, procedure, product, opinion, healthcare professional or any other material or information in this guide or anywhere on this website.

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