Breast reductions: A look at this trending procedure and what it entails

Breast reductions are one of the most highly rated surgeries for patient satisfaction because they offer both pain relief and an aesthetic improvement in one procedure. It's no wonder this procedure has seen a notable boost in popularity during the last several years among women of all ages. According to the 2023 ASPS Plastic Surgery Statistic Report, there was a 7 percent increase in breast reductions last year alone.

However, what is breast reduction, and what does it entail? Who are the most common patients seeking out this type of procedure? What does the future of breast reduction surgery look like?

We spoke with ASPS Member Surgeons Peter Krasniak, MD, and Ashley Howarth, MD, for answers to these questions, along with insights on breast reductions and their thoughts around their growing popularity.

The basics of breast reduction

In simplest terms, a breast reduction is one that reduces the physical size and weight of breast tissue in a patient. Often performed due to medical needs, this procedure can help to offer relief from pain and discomfort that can be caused by large and heavy breasts. These procedures are uniquely not limited to adult women and can also be used to treat adolescent patients who are experiencing pain or discomfort from large breasts.

"Breast reduction techniques nearly always involve two elements – skin reduction/tightening and breast tissue reduction," said Dr. Krasniak. "The pattern of skin reduction leads to the eventual scars on the breast. This can be done in several ways based on the breast characteristics and surgeon's experience and preference."

One of the biggest concerns for plastic surgery patients is scarring. While scarring is unavoidable for breast reduction, surgeons work to strategically place scars to minimize visibility, along with keeping the nipple and areola tissue untouched.

"The most common [incision technique] is called a Wise pattern, which leaves an 'anchor' pattern scar, with incisions vertically, horizontally in the breast fold and around the areola," said Dr. Krasniak. "There are also techniques that only use a vertical incision and the incision around the areola, sometimes referred to as the 'lollipop' incisions. For breast tissue reduction, again, the surgeon has multiple options, but in general, the techniques revolve around leaving tissue behind the nipple in order to keep the nipple and areola healthy."

With breast reduction, as with any plastic surgery procedure, it's important to note that the actual methods and techniques used will depend on both the surgeon and the patient.

The breast reduction patient profile

It is notable that patients in all age groups are getting breast reductions. The reasoning remains consistent across all generations.

"Patients today seek not only functional relief from physical discomfort but also an aesthetically pleasing outcome," said Howarth. "The popularity has surged across all age groups, with more awareness and acceptance. Breast reduction is now one of the most common surgical procedures in my practice, and the results are among the most satisfying for patients."

The most common reasons patients seek breast reduction are to reduce physical discomfort and pain, which can limit exercise and other physical activities as well. However, another notable consideration is an increase in self-confidence.

"Also, a distinct part of having large breasts almost always is sagging, or ptosis, of the breast and nipple down below the normal level up on the rib cage," said Dr. Krasniak. "So, though there are physical symptoms patients often have, we also see patients who are equally dissatisfied with the droopiness and how their breasts look."

Upon undergoing breast reduction, these patients will feel immediate satisfaction, both physically and emotionally.

"These patients often experience significant physical and emotional relief post-surgery, enhancing their quality of life immediately," said Dr. Howarth. "The decision to undergo breast reduction is a personal decision that can be life-changing, impacting both physical and emotional well-being. In my practice, many women who have had breast reductions express that they wish they had done it sooner. For instance, young women unable to participate in sports or exercise due to discomfort find they can enjoy physical activities post-surgery. Mothers, like one of my patients who struggled with back pain, experience significant relief. Additionally, working women often report improved posture and comfort, enhancing their professional and personal lives. I have older women thrilled they can now wear clothing they were not able to before and buy bras from a store rather than special order them."

The future of breast reduction procedures

When looking at the future of breast reduction, there is plenty to be excited about, including new devices and methods.

"You may hear about surgeons borrowing techniques from breast lifts, such as using tools to attempt to prolong the result of the breast reduction, particularly in terms of the skin tightening and lifting components of the procedure," said Dr. Krasniak. "These techniques include the use of an artificial scaffold material to help support the breast tissue, though this would be an off-label use of these products."

While we may be thrilled to see these advancements in the near future, it's important to always come back to basics.

"The best breast reduction techniques are those that provide long-lasting results, minimize scarring and ensure a predictable recovery," said Dr. Howarth. "While we are continually learning and improving our methods, the importance of finding an experienced, board-certified plastic surgeon cannot be overstated. This ensures the patient receives the most up-to-date and effective care available."

Tips for your breast reduction journey

For any plastic surgery procedure, there are a few key steps that you can take to set yourself up for success and the best possible results – and a breast reduction is no exception.

The first step in setting yourself up for success with a breast reduction is to find the right surgeon to perform the procedure. Always make sure that you are working with a board-certified plastic surgeon who is an ASPS member to ensure that you are getting the expertise and attention that you need.

"Finding a plastic surgeon trained in breast surgery is important in ensuring your outcome," said Dr. Krasniak. "Using the ASPS Find a Surgeon tool can help with this decision."

Another important step to take in getting ready for a breast reduction is to clearly communicate your expectations and the anticipated results with your surgeon of choice.

"Be honest and upfront with your expectations during the consultation," said Dr. Howarth. "I want every patient to feel confident going into surgery so they can be even more confident coming out of it. Be honest, communicative and follow the instructions provided by your surgeon to ensure the best possible outcome."

One of the benefits of breast reduction is that it can be covered under some insurance plans under the right circumstances.

"If you are wanting your procedure covered by your insurance, it can be helpful to know what criteria your insurance provider requires," said Dr. Krasniak. "Insurance companies routinely require your surgeon to provide an estimate of breast weight removed during the procedure, which is based on your overall body type and measurements. Discussing this number with your surgeon, as well as whether he or she thinks this would be realistic within the framework of your own goals for surgery, may guide you to determine whether a pure breast reduction versus a breast lift with a small reduction is actually the right procedure for you."

Getting life-changing results with a breast reduction

Breast reduction has consistently been one of the most highly rated plastic surgery procedures in terms of patient satisfaction, offering patients much-needed relief from pain and soreness associated with heavy breasts, along with providing transformative aesthetic benefits.

"Some of the most satisfied patients I have are those who have had a breast reduction," said Dr. Howarth. "It truly can be a life-changing and empowering procedure. If you have thought about it, go get the consultation. You will be in great hands with a board-certified plastic surgeon."

To find a qualified plastic surgeon for any cosmetic or reconstructive procedure, consult a member of the American Society of Plastic Surgeons. All ASPS members are board certified by the American Board of Plastic Surgery, have completed an accredited plastic surgery training program, practice in accredited facilities and follow strict standards of safety and ethics. Find an ASPS member in your area.