Many women with very large breasts suffer physical discomfort, bad posture and embarrassment. More and more women are now opting for breast reduction surgery.

Having very large breasts can cause back and breast pain as well as low self-esteem. You may be very self-conscious and resort to wearing loose clothing to conceal your shape. Breast reduction surgery can help restore proportion to your body, help you carry out those activities that you couldn’t before and regain any lost self-confidence.

Breast reduction plastic surgery is usually performed under general anaesthesia, so you will sleep through the procedure. The breast comprises glandular tissues, fatty tissues, and skin: all three areas are surgically reduced as needed.

Before entering the operating room, the surgeon will ask you to sit upright. While sitting, surgical markings will be drawn on your breasts. The markings outline the "sitting-up" position of your breasts, to make the correct incisions later during surgery when you are lying down. The drawings will typically take the form of an anchor — encircling the areola and extending above the areola to the new location of the nipple. The markings also extend down vertically below the nipple and horizontally following the natural curve of the crease beneath your breast.

The incision is made along the surgical markings. Flaps are created on both sides of the breast and the excess skin, fat, and glandular tissues are extracted. In most cases the nipples are moved to a higher position on the breast, but remain attached to the nerves and blood vessels. For very large breasts, however, the nipples may need to be moved and grafted to a completely new location. In these cases, the nipples are removed from the underlying connecting tissues and you will lose sensation in the nipple and areola.

The nipple and areola are usually moved to a new position. The position of the nipple is usually vertically level with the crease on the underside of the breast. After surgery, the flaps of skin (that were once above the nipple) are refolded around and beneath the breast, pulled to the front of the breast around the nipple, and sutured in place. The reduction of breast tissue and skin reduces the weight of the breast and reshapes it into proportion.

Upon completion of the procedure, stitches remain around the areola and nipple area, in a vertical line beneath the nipple and horizontally under the breast. If the breasts were not too overly large, then some surgical techniques can avoid the horizontal scar altogether.

The incisions and tissue movement will cause your breasts to be sore, swollen, and bruised. Pain can be treated by a prescription from your plastic surgeon. You can expect to wear bandages for about two days after surgery. Activity should be kept to a minimum for a week or two. There should be no heavy lifting or pushing for three or four weeks. Caring for young children immediately after surgery is not recommended. For extra support, a special soft surgical bra or athletic bra may be recommended by your doctor. Stitches are removed in two to three weeks.

There are many factors that determine candidacy for breast reduction. Among other points, the best candidates for breast reduction surgery are well-adjusted women whose oversized breasts cause health and medical problems, interfere with routine activities, disrupt sleep, or suffer related self-consciousness issues. This article prepares you for your initial consultation, details how the surgery is preformed and describes what to expect after surgery.

Patients normally wait until their breasts are fully developed before breast reduction surgery is performed. When breast size causes pain or if the breasts are causing disruptive self-consciousness in a teenage girl, the procedure may be performed in the teenage years.

For women who plan to breastfeed, breast reduction surgery is not recommended. Women who are extremely obese or who have heart, lung, or kidney problems may not be good candidates

The best candidates for breast reduction surgery are well-adjusted women who understand the purpose of the procedure. Good candidates include those whose oversized breasts cause medical problems, including back and neck pain, trouble breathing, and postural problems, which can lead to skeletal deformities.

Good candidates are also those whose oversized breasts disrupt sleep, restrict movement, and interfere with routine activities. Oversized breasts may also hang against the underlying skin, causing hygiene problems leading to irritation, rashes, and infections.

Candidates often experience frustration trying to find clothes that fit well. The weight of the breasts may cause bra straps to irritate the shoulder area, or chafing under the breasts. For some women or teenage girls, oversized breasts can make them self-conscious and undermine their self image. Athletic activities are very limited.
Patients with any combination of these conditions or symptoms may be good candidates for breast reduction surgery.

Breast reduction surgery is typically a highly successful procedure and patients are usually very pleased with the results. Just as with any surgery, there is a chance of complications. In breast reduction surgery, part of the breast tissue is removed to reduce the weight of the breast. This results in breasts with a smaller, lighter, more aesthetically pleasing appearance. Like all surgeries, The list of complications may include infection, bleeding, or reaction to anaesthesia. Immediately after surgery, there may be some pain, which can be treated by a prescription from the plastic surgeon. If the pain is more severe, additional follow-up visits may be scheduled.

Surgery may increase the possibility of reduced blood supply or nerve damage to the breast or the nipple. If this occurs, sensation can be temporarily or permanently lost in areas of the breast or the nipple or both. For very large breasts, it may not be possible to move the nipple and areola while leaving them attached to the nerves and blood vessels. In these cases, the nipple and areola may be removed and grafted into a new location on the breast, which may cause permanent loss of sensation. There is also a risk that breastfeeding will not be possible after surgery.   

Another side effect of breast reduction surgery is that it leaves permanent scars on the breasts. The vertical and horizontal scars are most visible, and scars remain after the breast is completely healed. Smoking blocks oxygen received by the body during the healing process, so for smokers, breast surgery scars are typically larger and less smooth. Any internal bleeding or excessive bruising caused by breast reduction surgery may also lead to increased scar size.

Some women are able to have a surgical procedure that requires fewer incisions, or incisions that are not as long. If the breast skin is elastic and the breasts are not too large, then liposuction can be used to remove the fatty tissue and shorter incisions can be used.

Another possible side effect of reduction plastic surgery is that the breasts may not be symmetric in size and shape after surgery. Also, the nipple may not be positioned properly, or the nipples may not be the same height. During the procedure, the surgeon must remove a considerable portion of tissue and move the nipple while the patient is in a lying position. Advanced surgical skill is needed to estimate the exact nipple location and size-and-shape change, so that the breasts are symmetric when the patient returns to an upright position.

Breast reduction surgery is typically performed to create a more proportional chest curvature with your overall body shape, and to alleviate problems with activities, health, and clothing. The procedure can also help achieve symmetry where breasts are not equal in size. The plastic surgeon can change the shape and firmness of the breasts to create a more aesthetic appeal. Nipple surgery may also be performed to reduce areola size. In fact, the breast reduction candidate may require a breast lift to achieve a fully satisfactory outcome.