Women who are unhappy about having large breasts and/or want to treat symptoms such as back pain, breathing problems and poor posture, may benefit from reduction, during which fat, glandular tissue and skin are removed from the breasts. The resultant smaller breasts increase patient comfort, and look more in proportion to the rest of the body. Ideal candidates for reduction are women with oversized breasts that are causing medical problems, low self-esteem, and/or physical or social discomfort. Women who are pregnant or breastfeeding cannot undergo reduction.

The Reduction Procedure

Reduction is performed under general anesthesia. Depending on the technique used and the individual case, it takes from 2 to 5 hours to perform. One of the following incisions is often used:

• Two rings, one larger than the other, around the areola
• A keyhole shape, around the areola and down to the breast crease
• An anchor shape, beginning in the breast crease, and extending up to and around the areola

Liposuction alone is sometimes used to reduce breast size. One advantage is that it leaves little-to-no scarring. However, because liposuction removes only fatty tissue, patients must have more fatty than glandular tissue in their breasts. Liposuction is also often used on men whose breasts are enlarged.

Recovery from Reduction

After reduction, patients typically experience soreness, swelling and bruising for several days. Bandages are removed after 2 days, and replaced with a surgical bra. Physical activity should be limited for 1 to 2 weeks, while exercise and other strenuous activity should be avoided for at least 4 weeks. Stitches are removed after 2 to 3 weeks, at which point most patients return to work and other regular activities.

The results of reduction are noticeable immediately after surgery. As swelling and bruising subside, the breasts' appearance improves. Scars fade with time, and usually cannot be seen when a patient wears a bathing suit or low-cut top.

Risks of Reduction

In addition to the risks associated with any surgery, risks related to reduction, depending on the technique used, include the following:

• Loss of sensation
• Scarring
• Asymmetry
• Excessive firmness
• Inability to breast-feed
• Loss of skin/tissue where incisions meet
• Partial or total loss of areola and nipple

Although reduction provides long-lasting results, breasts are still subject to the effects of aging and gravity.