In my plastic surgery practice, many women come to me wanting larger breasts. However, I also have many patients who would like their breasts to be smaller. Very large breasts, especially on small-framed women, can cause physical discomfort, neck pain, back pain, rashes, problems with exercise, and even embarrassment. 

 If you feel your breasts are too large and have become uncomfortable, breast reduction surgery can bring about dramatic, life-altering changes for you. As well as reducing the size and weight of your breasts, this procedure also improves the shape of your breasts and nipple areas, allowing you to feel good about yourself and your appearance, sometimes for the first time.

I also perform breast reduction on men, usually due to a condition called gynecomastia in which their breasts are abnormally enlarged.

You may be a good candidate for breast reduction if:

• The size of your breasts is out of proportion with your body.
• One breast is disproportionately larger than the other.
• You have discomfort, back problems, or other health problems from overly large breasts.
• Wearing a bra with wide straps for at least 12 months has not helped.
• Physical therapy for at least six months has not helped.
• You are a man whose breast enlargement has not responded to medication and whose breast development is stable.
• Your general health is good.
• You have realistic expectations for improvement and not perfection. 

Who is not a good candidate for breast reduction

You may not be a good candidate if:

• You are pregnant, breastfeeding or recently stopped breastfeeding.
• You have an abnormal mammogram or an undiagnosed breast condition.
• You have a history of poor wound healing or a clotting disorder.
• You are severely obese.
• You have a severe illness or infection. 

What happens during breast reduction surgery?

Breast reduction surgery is usually performed through incisions on your breasts with surgical removal of the excess fat, glandular tissue and skin. In some cases, excess fat may be removed through liposuction. If breast size is largely due to fatty tissue rather than excess skin and your breasts are not too saggy, liposuction alone may be used in the procedure for breast reduction.

The technique used to reduce the size of your breasts will be determined by your individual condition, breast composition, amount of reduction desired, your personal preferences and your plastic surgeon’s advice.

Step 1: Anesthesia

Medications are administered for your comfort during breast reduction surgery. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.

Step 2: The incision

Incisions include:

• A circular pattern around the areola. The incision lines that remain are visible and permanent scars, although usually well concealed beneath a swimsuit or bra.
• A keyhole or racquet-shaped pattern with an incision around the areola and vertically down to the breast crease

Step 3: Removing tissue and repositioning

After the incision is made, the nipple is then repositioned. The areola is reduced by excising skin at the perimeter, if necessary. Underlying breast tissue is reduced, lifted and shaped. Occasionally, for extremely large pendulous breasts, the nipple and areola may need to be removed and transplanted to a higher position on the breast.

Step 4: Closing the incisions

The incisions are brought together to reshape the now smaller breast. Sutures are layered deep within the breast tissue to create and support the newly shaped breasts; sutures, skin adhesives and/or surgical tape close the skin. Incision lines are permanent, but in most cases will fade and significantly improve over time.

Step 5: Enjoy the results

The results of your breast reduction surgery are immediately visible. Over time, post-surgical swelling will resolve and incision lines will fade. The goal is for you to be happily satisfied with your new breast size and shape.           

If you are interested in breast reduction

If you are thinking about having breast reduction and would like to schedule a free consultation, please contact me. I will send you additional information prior to your appointment.

More information on breast surgery
You might also find these pages helpful on my website: 

• Breast Procedures
• Breast Augmentation
• Breast Lift
• Breast Reconstruction
• Breast Reduction
• Breast Revision

Board certified by the American Board of Plastic Surgery (ABPS), a member of the American Society of Plastic Surgeons (ASPS) and the American Society for Aesthetic Plastic Surgeons (ASAPS), and a Fellow of the American College of Surgeons (FACS), Samuel J. Beran, MD is a highly accomplished plastic surgeon with offices in Manhattan, Harrison and Mount Kisco, NY. With more than 20 years’ experience and a thorough command of the most advanced techniques and technologies, Dr. Beran consistently provides his patients with the highest level of plastic, cosmetic and reconstructive surgery of the breast, face, skin and body. Recently, Dr. Beran was named a “Top Doctor” by RealSelf for his dedication to responding to consumer questions and patient feedback. The “Top Doctor” designation is awarded to less than 10% of the RealSelf physician community.