Breast Reduction: Info, Prices, Photos, Reviews, Q&A

Breast reduction or another term called reduction mammaplasty removes excess breast fat, glandular tissue and skin to achieve breast size in proportion with your body and to alleviate discomfort which is associated with large breasts.

It usually leaves the appearance of smaller, lighter and firmer breasts.

Breasts sagging or appear to fall down can be the usual result of normal aging, pregnancy or weight loss.

Breasts can sag after surgery, it is expected

Think of breast reduction surgery as having two components: one is a reduction of the volume of the breast and the second is lifting the position of the nipple areola complex. Immediately after breast reduction, the breasts are very “lifted”.

However, in time, the skin relaxes, gravity continues to pull down on the breast and natural aging, which includes a loss of elasticity, continues. In short, many patients feel their breasts are sagging somewhat after reduction surgery; however, it is usually not to the extent that it was prior to surgery.

Surgeons use different techniques to combat this “sagging”; the vertical pedicle technique of breast reduction is one that can be used to try to minimize this sagging, however, not all patients are candidates for this type of procedure. (Tracy Pfeifer, MD, Manhattan Plastic Surgeon)

Breast Reduction Surgery Reduces Breast Size & Lifts Breasts Into Normal Position

Breast reduction surgery accomplishes several aesthetic goals. The procedure not only reduces breast size, but also lifts the breast into normal position and reduces areola size. Unfortunately, the effects of gravity are unrelenting. Although, the breasts are lifted with this procedure, there is continuous downward pressure following surgery.

This often results in recurrent breast sag. In other words, we can set the clock back, but can never stop it from ticking. Several factors contribute to the development of recurrent breast sag. These include the size of breasts following reduction surgery, the biologic tendency of the patients tissue to stretch, and the type of breast reduction performed.

In most cases, patients are not bothered by minor amounts of breast sag. Occasionally, severe breast sag occurs with the passage of time and patients require a secondary breast lift procedure. Despite the potential for secondary breast sag, breast reduction surgery is associated with extremely high satisfaction rates.

If you’re considering this procedure, consultation with a board certified plastic surgeon who has experience in this area would be appropriate. (Richard J. Bruneteau, MD, Omaha Plastic Surgeon)

Breast sagging can occur after breast reduction

There are a variety of breast reduction techniques available. All of them reduce the weight and size of breast skin envelope. Depending on the technique used, there can be issues with sagging of the breast in the months and years post-operatively.

The ‘inferior pedicle’ breast reduction technique often has this issue, and this is because of the substantial amount of breast tissue that remains in the inferior pole of the breast.

Its a great technique for the right patient, but there are other techniques that don’t have this issue. (Scott C. Sattler, MD, FACS, Seattle Plastic Surgeon)

Breasts after reduction still subject to gravity and should be supported.

After breast reduction the remaining breast tissue has weight and as such can be pulled inferiorward by gravity over time. This is why support with a bra is important after reduction surgery. (Vincent N. Zubowicz, MD, Atlanta Plastic Surgeon)

Depending on the technique used, your breasts will bottom out at different rates.

Breast reduction can improve the size, shape, and overall appearance of your breasts in addition to alleviating the many annoying and even debilitating symptoms of overly large breasts. Over time ALL breast reductions will “bottom out” or sag.

Bottoming out usually occurs more quickly when reduction techniques which use the skin envelope to shape and hold the reduced breast tissue are performed. “Parenchymal” techniques which use the breast tissue itself to shape the reduced breasts have more lasting results.

Nonetheless, over time the weight of your reduced breasts will cause the tissues to sag or droop. (James C. Grotting, MD, FACS, Birmingham Plastic Surgeon)

Changes after breast reduction

The appearance of the breasts may change somewhat after breast reduction, certainly once the swelling from the immediate post operative period resolves. In addition, gravity continues to affect the breasts and the results will be different after several years. (Olivia Hutchinson, MD, New York Plastic Surgeon)

Sagging after Breast Reduction

It is normal for gradual “settling” of the breasts after breast surgery, where gravity exerts some force on the breasts in a downward direction. There is no such thing as permanent superior fullness. The breasts will never be how they were before.

The amount of recurrent sagging can be related to many factors including the residual size of your breasts, your skin tone, age, pregnancy, and whether or not you wear a bra regularly. (Hayley Brown, MD, FACS, Las Vegas Plastic Surgeon)

Breast ptosis after breast reduction

Breast reduction is not a permanent cure for droopiness of the breasts. If you have a breast reduction at the age of 20, that does not mean you will have a 20 year old breast for the rest of your life.

As with anything else on the body, your breasts will be subject to the aging process. (Raffy Karamanoukian, MD, FACS, Los Angeles Plastic Surgeon)

Clarification

The breast reduction removes the excess weight of the breast gland, the stretched skin, and raises the nipple/areola. This recreates a smaller more youthful breast. However good a job the surgeon does, remember that time and gravity are always at work, and the new breast is not like the original.

Given this, there are two things that you may experience. The first is a relaxation of the repair, in which you will see the breasts round out at the bottom, and look better & better. At first the breasts may appear smaller, but during this period, they may look like they get a little larger as they assume their final shape.

This usually happens in the first few months after surgery. The second thing you may see in the first several years is “bottoming out”. Typically there is loss of support at the bottom of the breast and the lower pole (area between the nipple and the crease where the under wire goes), increases.

The nipple usually remains fairly constant in position, while the upper pole loses fullness. This bottoming out is easily fixed. Finally, you may in fact experience the breast “falling” if you get pregnant, gain and lose a lot of weight, or over a long period of time. (Scott E. Kasden, MD, FACS, Dallas Plastic Surgeon)

Breasts will sag over time

When performing a breast reduction, it is common to also perform a concommitant breast lift (mastopexy). Typically, we overcorrect, knowing that the breasts will fall over time. Eventually they will settle at a stable point.

In the average woman, this occurs about 6-9 months after surgery. Once you have reached this point, your breasts should remain relatively stable unless you gain weight, become pregnant, go on hormonal therapy, etc. (Otto Joseph Placik, MD, Chicago Plastic Surgeon)

Breast lift is the bonus of breast reduction surgery

A very large overdeveloped breast will almost always have a degree of droop to the breast which surgeons call ptosis. The amount of droop is evaluated by measuring the position of the nipple in relation to the fold or crease under the breast, something like a finger test where you place your finger in the fold and measure the distance above or below this point.

The nipple of course is the center proper, not the edge of the areola or colored portion of the skin. The best position is near an inch and a half above the fold.

This may also correspond to the middle of your arm at a point your plastic surgeon will refer to as the mid humeral line.

In my years of experience with breast reduction the nipple and reduction pattern is marked to provide this lift as the breast is reduced. The correction of the droop or floorward pointing nipple is just as important as size reduction to our patients as they hope for a result that is pretty to look at both in and out of a bra.

After breast reduction the nipple position should be stable and change only little over time. Your breast size can change with weight gain and loss, though the nipple will stay up front and center. This lift is the bonus of a well done breast reduction and is very lasting.

Your skin may become a little more lax over time but the shape should hold up just fine.. (Peter E. Johnson, MD, Chicago Plastic Surgeon)

It’s called “bottoming out”

Following a classic breast reduction surgery, the breast tissue can be pulled down by gravity stretching out the skin. This phenomenon is known as bottoming out and can be happening to you. See your plastic surgeon for an examination and he/she can tell you if this is the case. (Kenneth R. Francis, MD, FACS, Manhattan Plastic Surgeon)

Breasts that fall after breast reduction

The most common cause for “falling breasts” following a reduction mammoplasty is that they were not made small enough. Most woman with very large breast want a little taken off but not a lot. The majority still desire to be a “D” cup and not a “C”.

This causes the skin to stretch below the nipple or “bottom out” with time. The nipple/areolar complex remains in place but the skin below stretches. This may be your problem. It can be improved upon by removing additional skin from the inframammary fold.

It may occur again if no additional breast tissue is removed. (Gary H. Manchester, MD (retired), San Diego Plastic Surgeon)

You should lose the weight before surgery

In order to get your best result you should be within 10-15 pounds of your goal weight before surgery. If you lose 20-30 pounds after a reduction, you may become more lax than you would ike. (Richard P. Rand, MD, FACS, Seattle Plastic Surgeon)

Breasts weight can change with body weight

It is always best to be at or close to your desired weight prior to any body contouring procedure. The breast can respond differently on different women when it comes to weight loss. If you notice a good deal of change of the breasts with weight fluctuation then it will be better for you to get down to an ideal and realistic weight before surgery. (Jeffrey Zwiren, MD, Atlanta Plastic Surgeon)

Your breasts should not fall significantly 1 year after surgery.

Oopriyaa, Your breasts should not fall significantly one year after breast lift / breast reduction. Initially after surgery you may have considerable swelling which may takes several weeks to months to completely resolve. As the swelling resolves, the tissues settle which may take away from some of the projection of the breasts, but this usually leads to a more natural appearing breast.

Additionally, having surgery does not stop the aging process. So, your skin will continue to age just as it did prior to surgery. If you include pictures, we may be able to give you more specific advice. (David Shafer, MD, New York Plastic Surgeon)

Depends on the skin laxity

Most peoples breast will “settle” after surgery. The amount of sagging after surgery is mainly a function of your skin elasticity. The worse the skin quality the more the sag. Breasts with very good skin elasticity will sag very little after surgery. (Robert M. Jensen, MD, Medford Plastic Surgeon)

Breasts will settle after breast reduction surgery

It generally takes about three to six months after surgery for the settling to stabilize. The breasts still tend to look “lifted and reduced” relative to before surgery, but things can of course change with weight gain or loss and differences in surgical technique.

All plastic surgeons are not all the same. (John P. Di Saia, MD, Orange Plastic Surgeon)

Some breast ptosis

The breast will sag a little after a reduction due to the effect of gravity and the skin stretch. The only way for you to determine that is to look at the pre and post operative pictures taken over time. (Hisham Seify, MD, PhD, FACS, Orange County Plastic Surgeon)

Breast area usually lifted after reduction

After a breast reduction, the breast volume is reduced and the breast area is usually lifted. However, over time the breast will sag again as it would for any aging. (Steven Wallach, MD, New York Plastic Surgeon)

Breast sagging after a reduction

A breast reduction involves a breast lift as well. Therefore, you will not have the same sagging as prior to surgery. However, over time, your skin will stretch and the swelling will go away which will make it appear as though the breasts have “fallen”.

If you review your before and after photos with your surgeon, you will see this progression if you look at the photos 6 weeks post-op and 6 months post-op.

Generally, not much changes after 6 months. Over the long term, however, aging still progresses and you will see signs of aging which will much slower that the post-op changes you see in the first 6 months.
You will still be in a better position than before surgery. (Bahram Ghaderi, MD, Chicago Plastic Surgeon)

Breast tissue and skin relax over time after breast reduction

After a breast reduction, the breasts are typically perky and full in the upper pole. After some time the tissues relaxe and the upper pole is less prominent. The nipples should maintain their position. For a mastopexy (breast lift) I recommend a small implant to maintain breast shape long term.

This would not be appropriate in a breast reduction. (Talmage J. Raine, MD, FACS, Chicago Plastic Surgeon)