I'm only 22, but I get back aches from the weight of my breasts. They are saggy and heavy. What can I do?

Dear Rational6958,
breast reduction is best suited for women who wish to decrease the size of their breasts. While there are different techniques used to perform this surgery, I prefer the vertical incision (lollipop pattern) breast reduction technique instead of the anchor scar pattern, which reduces more noticeable scarring than usual. I also use a SAFE liposuction technique to reduce additional fat around the stubborn axilla area and bra line. This way, my patients are achieving beautiful results with minimal incisions which reduces downtime and delivers an overall better breast shape long term.If you are considering breast reduction surgery, you should consult with a board certified plastic surgeon to discuss your options and make sure your surgeon understands your goals. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD

I am sorry to hear about the problems your disproportionately large breasts cause  you. Based on your description you may be an excellent candidate for breast reduction surgery.   However, much more information is needed to determine whether you should proceed with surgery, and if so when (timing).  In my practice, I individualize the “timing” of surgery based on a lot of information that is transmitted during the consultation process.
“Typical” patients who present for breast reduction surgery are women who have disproportionately large breasts, causing problems such as neck/back/shoulder discomfort, postural changes, bra strap grooving, skin irritation/rashes under the breasts, and/or difficulty with activities of daily living and/or exercise etc. There may be both physical as well as psychosocial “stress” caused by the disproportionately large breasts.
Reducing breast tissue mass and elevating the breasts on the chest wall tend to improve or alleviate many of the symptoms associated with the disproportionately large breasts.
Patients considering breast reduction surgery should also consider the potential downsides (risks/complications) associated with the procedure as well. Poor scarring, for example may be associated with the procedure.  Additional surgery may be necessary in the short or longer term for a multitude of reasons.
  When the time is right, I would suggest in-person consultation with board-certified plastic surgeons who can demonstrate lots of experience achieving the types of outcomes you would be pleased with.
Then, it will be important that you communicate your goals clearly with your plastic surgeon and make sure that you have realistic expectations prior to proceeding with any type of surgery. In regards to breast size desired, also communicate carefully. In my practice the use of goal pictures are helpful in this regard; a discussion of cup size can be confusing and imprecise.   Therefore, I would not suggest that you communicate your goals and/or base your satisfaction with the outcome of surgery on achieving a specific cup size.  I also find that the use of pictures is more helpful than the words “natural” or "proportionate” etc., which can mean different things to different people.
Many of my patients choose to have enough breast tissue removed to help alleviate symptoms while retaining enough breast tissue to remain proportionate to the remainder of their torso.
I hope this helps.