For every woman who complains that her breasts are too small, there may well be one of her opposite number, who laments her breasts being too large. In spite of what men may think, bigger does not always mean better. Women who seek breast reduction do so for a number of reasons, the most common being chronic pain and discomfort to the head, neck, back and shoulders due to the uneven weight concentrated in their bosoms. In certain instances, these women have difficulty with breathing and problems with circulation. The weight of excessively large breasts also makes the wearing of brassiere cumbersome, even tortuous, because the bra straps end up digging harshly into the wearer’s skin. Sometimes, a woman may be ashamed for her large breasts, as they may be disproportionate to the rest of her body, or cause her to become self-conscious about the inappropriate or scornful expressions that she receives from other people.

Breast reduction surgery is normally performed under general anesthesia. The procedure begins with one of several incision options – a ring-shaped area of skin around the areola that will be excised, a vertical or keyhole shaped cut underneath the areola, or an anchor-shaped incision that bypasses the areola and excises a new position for the nipple and the remaining skin. The vertical and ring-shaped incisions are typically used when the reduction needed is relatively minor, and have the advantage of leaving smaller scars and better breast protrusion. The anchor cut, otherwise known as the inferior pedicle technique, is a common option for women who require more significant reduction, and produces satisfactory results, although the extensiveness of the surgery leaves some women with box-shaped breasts.

The nipple normally remains tethered to its original blood supply during the surgery, and is simply raised and repositioned accordingly. If the areola needs to be reduced to be more proportional to the smaller breast, skin around the areola’s perimeter will be cut away. Excess breast tissue from the underside is removed, and the incision edges are brought together to reshape the breast. Sutures are layered deep into the breast to provide support and set its shape, and skin adhesives or surgical tape are applied to close the skin. The incision scars from the operation, which start out reddish and swollen, are permanent, but will fade and improve in appearance over time.

There are instances where the breast to be reduced is extremely large and droopy, and simple repositioning of the nipple may be impractical given the amount of reduction that must be done. In such cases, the nipple is removed entirely and grafted elsewhere on the new breast. This graft causes the loss of sensation in the nipple and areola and eliminates the ability of the woman to breastfeed.

The initial recovery period for patients who undergo this procedure is several weeks, though it may take between six months to a year for the new breast shape to finally settle as the body adjusts to its reduced size. During first few weeks after the operation, patients are advised to refrain from strenuous physical activity, which would disrupt the delicate healing process.

Aside from the normal risks associated with major surgeries, such as excessive bleeding and infection, side effects peculiar to breast reduction include altered nipple sensation and erogenous function, recurrent breast drooping, and difficulty with breastfeeding, as the glands responsible for lactation may be disrupted during the surgery. In spite of these drawbacks, however, breast reduction remains one of the more popular cosmetic surgical procedures in the United States and elsewhere, and surgeons report general happiness and satisfaction in recipients of the procedure.