Breast reduction is one of the procedures in plastic surgery that has the highest patient satisfaction. That is because of the pain on the neck, shoulders and back from macromastia.

Now I think there's two factors that cause the pain. One is the weight of the breast. The second is that the breasts are low. When the breasts are low, your back and neck have to strain all day long to keep your body erect. So if we were to lift the breast and put them on the chest in the proper location, that to some extent is going to decrease the amount of pain the person has. I think both the lift and the reduction in size are the two things that are improving the back pain. So that's why breast reduction is such an important procedure.

I have patients that have pain all day at work. At the end of the day, they just can't stand it and things like that. Those are the patients for breast reduction who really makes a profound effect.

One of the problems or the main complication of breast reduction is the breast falling again or bottoming out. So the whole effort of the breast reduction is to try to prevent that from happening.

I think there are some things that are helping and one is a short scar where we're using a vertical scar and eliminate the horizontal scar because scars never heal to the same strength of the original skin. The less scar we can put on the bottom of the breast, the less we weaken the bottom of the breast, the less the breast falls down.

There are other things that are new. We can use some of the skin and make a sling. So now we have two pieces of skin under the bottom of the breast to increase the strength.

So those are the things that I think that are very important for breast reduction. I think that's why breast reduction is such a satisfying procedure for patients. It's because of the neck, shoulder and back pain that is caused by macromastia.

A lot of times insurance companies will tell the patients that, "Well, lose weight and then your breast pain will go away." Patients that have true problems with macromastia and pain secondary to large breasts, I've not seen one patient lose weight and the symptoms resolved. It really comes down to the surgery and things like that to help people. I think that's why that's an important procedure.

Who's a Good Candidate for Breast Reduction?

Dr. Wendell Perry discusses the high satisfaction rate for breast reduction, and who makes an ideal candidate.