Breast Reduction Essentials: Your Guide to Informed Decisions

By: Dr. J. Timothy Katzen


Introduction to Breast Reduction Surgery

In the evolving landscape of plastic surgery, breast reduction surgery, medically termed reduction mammaplasty, has emerged as a significant procedure. A breast reduction address not just aesthetic concerns but also a patient’s physical and emotional well-being. Breast reduction involves the removal of breast fat, tissue, and skin. The goal of a breast reduction is to achieve a breast size in harmony with the body's overall proportions. The decision to undergo breast reduction is not just a cosmetic choice; it often stems from a desire to alleviate discomfort and enhance one's quality of life. Women across various age groups opt for this surgery to resolve chronic back, neck, and shoulder pain, often these patients caused by the weight and size of large breasts. Generally, a breast reduction lasts 2 to 5 hours and is conducted under general anesthesia, ensuring patient comfort throughout the procedure.

The technique involves:

  • Precise incisions around the areola.
  • Extending to the crease, under the breast, and across the lower fold.
  • Allowing for the removal of excess tissue and the reshaping of the remaining breast.

A pivotal aspect of the procedure is repositioning the nipple and areola to a more aesthetically pleasing location. Often this is accompanied by a reduction in the areola size to match the newly formed breast contour. In certain cases, liposuction is integrated into the procedure to enhance the shape of the breast and surrounding areas, providing a more aesthetic improvement. Despite its popularity, breast reduction surgery is not recommended for individuals who smoke or are opposed to the idea of scarring on the breasts. Additionally, breast reduction surgery's timing is crucial. Since breasts that have not fully developed in younger patients, a breast reduction might need to be delayed. Until post-surgery, the impact on patients extends beyond physical transformation. Many report a substantial reduction in pain and discomfort, relief from the indentations caused by bra straps, and a resolution of skin rashes and other issues under the breasts.Often, breast reduction leads to improved self-image and confidence, contributing to overall quality of life. However, potential patients must have a thorough consultation with their plastic surgeon, discussing not only the benefits, but also the potential risks and complications associated with breast reduction. The American Society of Plastic Surgeons reports that the demand for breast reduction surgery has increased by 11% between 2016 and 2017. (1) Insurance coverage for the procedure, especially when performed for medical reasons, has also played a role in making this surgery more accessible to a broader population. Additionally, aesthetic goals, such as achieving a breast size and shape that is more proportionate to the body, also contribute to the increasing number of women opting for breast reduction surgery. (2)

The Rising Popularity of Breast Reduction Surgery and Celebrity Influence

The popularity of breast reduction surgery has been on a significant upswing in recent years, a trend partly fueled by the openness and advocacy of celebrities who have undergone the procedure. Ariel Winter, a prominent actress known for her role in the hit TV show "Modern Family," is one such celebrity who has been vocal about her breast reduction journey. Her candid sharing of experiences has played a crucial role in destigmatizing the procedure and highlighting its positive impacts on health and lifestyle. Winter's decision, made public in 2015, opened a dialogue about the challenges faced by women with disproportionately large breasts, including physical discomfort and unwanted attention. Her experience resonated with many, shedding light on the emotional and physical struggles that accompany large breast sizes, such as chronic back pain, difficulty in finding suitable clothing, and the psychological impact of societal scrutiny. Other celebrities who have undergone breast reductions include Queen Latifah, Drew Barrymore, Heidi Montag, Marie Osmond, Star Jones, and Kelly Dodd.

The influence of such public figures has contributed significantly to changing perceptions around breast reduction surgery. It has shifted the narrative from focusing solely on aesthetics to a more nuanced understanding encompassing health, comfort, and quality of life. The sharing of personal stories by celebrities like Winter has encouraged women to consider breast reduction as a viable solution to their long-standing breast issues, leading to increased awareness and acceptance of the procedure. The impact of celebrity endorsements on healthcare decisions, particularly in plastic surgery, cannot be understated. Support and approval can inform, inspire, and reassure potential patients, offering them a sense of solidarity and understanding.

Furthermore, the rise in breast reduction surgeries reflects a broader cultural shift towards embracing body positivity and individual well-being over “conventional” beauty standards. Women are increasingly seeking procedures that align with their personal health goals and lifestyle aspirations rather than adhering to external beauty ideals.

Risks and Considerations in Breast Reduction Surgery

Infection: Despite the numerous benefits and growing popularity of breast reduction surgery, potential patients must understand the associated risks and considerations. One of the primary concerns is the risk of infection, which, although rare, is possible in any surgical intervention. Patients are usually prescribed antibiotics to minimize this risk. Patients are advised to follow postoperative care instructions meticulously to ensure a clean and safe recovery environment.

Scars: Scaring is another important consideration. The procedure involves incisions around the areola, down to the crease under the breast, and across the lower fold. This will result in visible scars. Typically, these scars fade over time, Breast scar extent and visibility vary from person to person and depend on individual healing processes. Plastic surgeons endeavor to minimize scarring by employing precise techniques and offering post-surgery care advice to reduce scar. However, patients should have realistic expectations regarding the presence of breast scars as a natural outcome of the surgery.

Another risk associated with breast reduction surgery is changes in breast and nipple sensation.

Nipple Sensation: Some women experience temporary or, in rare cases, permanent changes in nipple sensitivity post-surgery. This can be due to the repositioning of the nipple and areola or the nerve disruption during breast tissue removal. Most patients find that sensation returns to normal as the healing progresses, but discussing this potential outcome with your plastic surgeon is important beforehand.

Breast Feeding: The possibility of difficulties with breastfeeding is also a concern for many women considering breast reduction surgery. The procedure could impact the milk ducts and nerves essential for lactation. While many women can breastfeed successfully after the surgery, others may experience reduced milk production. Women who plan to breastfeed in the future should discuss their concerns with their surgeon to understand the potential impact of the breast reduction surgery on breastfeeding.

Psych: Lastly, the psychological impact of the surgery should not be overlooked. Usually, breast reduction surgery leads to improved self-esteem and quality of life; however, the immediate postoperative period can be challenging for some. Adjusting to the changes in body image, dealing with the recovery process, and managing expectations can be emotionally demanding. Support from healthcare providers, mental health professionals, and support groups can be invaluable during this time.

While breast reduction surgery offers numerous benefits, it is imperative for individuals considering the procedure to have a comprehensive understanding of the associated risks. A detailed consultation with a qualified and experienced plastic surgeon is essential to make an informed decision, ensuring that the potential benefits outweigh each patient's risks. Here is a visual animation of what happens during a breast reduction surgery.

Distinguishing Between Breast Lift and Breast Reduction

While all breast reductions include a breast lift, not all breast lifts include a breast reduction. A breast lift is a cosmetic procedure to elevate and reshape the breasts to achieve a more youthful and perky appearance. This procedure addresses the sagging of breasts, which can occur due to aging, weight fluctuations, or post-pregnancy changes. During a breast lift, excess breast skin is removed, and the nipple and areola are repositioned higher on the chest wall.

In some cases, the size of the areola may also be reduced to complement the new breast shape. However, it's important to note that a breast lift does not significantly change the size of the breasts. The primary goal is to restore the breasts to a more aesthetically pleasing position without removing a substantial amount of breast tissue.

In contrast, breast reduction surgery goes beyond cosmetic enhancements. During a breast reduction, the plastic surgeon removes a significant amount of breast tissue, fat, and skin to achieve a breast size that is more proportionate to the patient's body and alleviates the discomfort associated with large breasts. As a result, the breasts are lifted and made smaller and lighter. This aspect of breast reduction makes it a medically necessary procedure for many. Breast reduction surgery qualifies qualifying for insurance coverage if performed to relieve physical symptoms.

Recovery from Breast Reduction Surgery

Recovery from breast reduction surgery is a critical phase that plays a significant role in the overall success and satisfaction with the procedure. After the breast reduction, recovery typically lasts several weeks. During which this time, patients experience gradual healing and adjustment to their new breast size and shape. Swelling, bruising, and discomfort are normal body responses to the surgical intervention. Pain management is an essential aspect of post-surgical care. Patients are prescribed pain medication to alleviate discomfort during the first few days following the procedure.

Patients are advised to wear a special surgical bra or compression garment to support the healing breasts and minimize swelling. This garment not only aids in shaping the breasts, but also provides comfort and support during recovery. Patients must follow their plastic surgeon's instructions regarding wearing this garment and caring for their surgical sites.

Next Steps

Board Certification: Choosing the right plastic surgeon for breast reduction surgery is a critical step that significantly influences the outcome and safety of the procedure. To ensure you find a qualified professional, begin by verifying board certification. A plastic surgeon certified by the American Board of Plastic Surgery or its international equivalents has met rigorous education, ethics, and practice standards. This certification is a fundamental indicator of a plastic surgeon's expertise and commitment to high standards of care.

Before and After Pictures: Experience, specifically in breast reduction surgery, is crucial. Plastic surgeons who frequently perform this procedure are more likely to deliver refined results and have a deeper understanding of the nuances involved. Visiting the plastic surgeon's website should offer a gallery of before-and-after photos, providing a visual testament to their skill and aesthetic style.

Reviews: Patient reviews can offer insights into others' experiences and satisfaction levels. However, it's important to approach these reviews critically, understanding that they may provide a partial picture.

Consultation: The initial consultation is a vital opportunity to assess the plastic surgeon's communication skills, empathy, and willingness to address your concerns. They should explain the procedure, risks, recovery, and expected outcomes in detail. Hospital privileges are another key factor, indicating the plastic surgeon's adherence to specific professional standards.

Revisions: Lastly, if necessary, the plastic surgeon's approach to handling complications and their policy on revisions should be clear. Understanding the level of aftercare and support is also crucial. Ultimately, beyond qualifications and experience, your comfort and trust in the surgeon are essential. I invite you to schedule a consultation to discuss your individual goals and concerns. Call J. Timothy Katzen, M.D. Beverly Hills to schedule your one-on-one breast reduction consultation. For your convenience, Dr. Katzen has offices in Beverly Hills, CA, Las Vegas, NV, and Dubai, UAE. In addition, virtual consultations can be arranged. Virtual consultation options include FaceTime, Zoom, Skype, and WhatsApp. Call (310) 859 - 7770 today to schedule your consultation to achieve your desired body.

American Society of Plastic Surgeons Reveals 2022’s Most Sought-After Procedures. American Society of Plastic Surgeons. Retrieved January 17, 2024, from

A Matched Comparison of the Benefits of Breast Reduction on Health-Related Quality of Life

Elfanagely, Omar; Othman, Sammy; Rios-Diaz, Arturo J.; More

Plastic and Reconstructive Surgery. 148(4):729-735, October 2021.

Breast Reduction

Hall-Findlay, Elizabeth J.; Shestak, Kenneth C.

Plastic and Reconstructive Surgery. 136(4):531e-544e, October 2015.

    • Precise incisions around the areola.
    • Extending to the crease, under the breast, and across the lower fold.
    • Allowing for the removal of excess tissue and the reshaping of the remaining breast.

Before and After Photos: Breast Reduction

Before and After Photos: Breast Reduction

* All information subject to change. Images may contain models. Individual results are not guaranteed and may vary.