Breast Reduction Surgery: An Overview

Medically Reviewed by Zilpah Sheikh, MD on November 21, 2023
9 min read

Breast reduction surgery (also known as reduction mammoplasty) is an operation to remove extra fat, tissue, and skin from your breasts. You might consider it if you have very large breasts (sometimes called macromastia or gigantomastia) that are making you self-conscious or causing neck pain, back pain, or other symptoms. This surgery is for people of any gender, including men with large breasts (gynecomastia). About 100,000 people get it each year.

Because it's a major surgery, you should know the benefits, potential complications, and what's involved in recovery.

Breast reduction surgery vs. top surgery

In top surgery, a surgeon reshapes your breast tissue so that you can appear more feminine or masculine. This can involve adding or removing breast tissue, moving the nipples, or making other changes. Top surgery can be helpful if your gender identity doesn’t match the sex you were assigned at birth. Many transgender and nonbinary people choose to have top surgery.


You might decide to get breast reduction surgery for many reasons. One of the most common reasons is that your large breasts cause physical discomfort. They might cause:

  • Headaches
  • Poor posture
  • Deep notches in your shoulder from tight-fitting bra straps
  • Difficulty breathing while you’re lying down
  • Back, neck, and shoulder pain
  • Nerve problems like numbness or tingling
  • Rashes, infections, and skin irritation beneath your breasts

Large breasts also could make it difficult for you to fit into clothes or take part  in certain activities, like exercise. Over time, this could affect your body image and self-confidence. It can even affect your health.

Breast reduction surgery also can help with gynecomastia, a condition that affects some men and people who were assigned male at birth. It is when you have extra fatty tissue in the breast(s). If you have the extra tissue removed, it can boost your self-confidence.

Breast reduction candidate

If you experience physical or mental symptoms from very large breasts, you might benefit from this surgery regardless of gender.

But certain things might prevent or postpone your surgery. For example, you might not be able to have it if you smoke, are very overweight, or have other health conditions that could affect your recovery.

You might consider postponing breast reduction surgery if:

  • Your breasts are still growing. Teenagers and young adults can have this surgery, but they might need a second surgery if their breasts continue to grow.
  • You are planning on breastfeeding. This surgery can affect your ability to breastfeed, although some techniques can preserve it.
  • You are trying to lose weight. Weight loss or gain can impact breast size.

First, make an appointment with a surgeon who is board-certified by the American Board of Plastic Surgery. Before the surgery, you’ll meet with them to talk about your medical history, including whether you've ever had a lump removed from your breast or have any other medical conditions that affect your breasts. Your surgeon will also ask about your family's medical history.

Be completely open with the surgeon about why you want breast reduction. Be prepared to discuss any emotional issues you've had related to your breasts, how your breasts have physically felt to you, and any physical conditions they’ve caused.

The surgeon may take photos of your breasts, measure them, and talk with you about how much breast tissue you want to remove. The change in breast size varies from person to person, but most patients lose one to two cup sizes. 

You will also learn about preparing for the surgery and planning for your recovery. You may get a mammogram and breast exam before the surgery.

During your consultation, your surgeon will ask about your habits, including whether you smoke and what medications you take. You may have to quit smoking for a period before and after surgery so you heal properly. You also may have to stop taking certain medications, including aspirin or other anti-inflammatory drugs such as ibuprofen or naproxen. Your surgeon will give you instructions about what you need to do.

You need to be in good physical shape to be sure you heal properly, so follow your surgeon's instructions before and after breast reduction surgery. This might mean avoiding smoking or medications that thin your blood.

Before the surgery, get your home ready for recovery. Have these things on hand:

  • Plenty of ice
  • Gauze and clean washcloths and towels
  • Loose, comfortable shirts
  • Special ointments or creams as recommended by your surgeon for the incision sites

You should also plan for someone to drive you to and from the procedure and stay with you for at least the first night, if you're not staying in the hospital. 

Your doctor will give you general anesthesia, which means you will be put under during the procedure. Breast reduction surgery will take about 2 to 5 hours, sometimes longer. 

Your surgeon will use one of a few surgery methods, depending on the shape and size of your breasts, how much tissue they need to remove, and how you want to look after surgery: 


The surgeon will make small cuts in your skin and insert a thin tube connected to a vacuum that suctions fat and fluids from your breast. This option is best for small reductions and for people whose skin will “snap back” into place. It often results in less scarring than other surgery techniques.

Vertical or lollipop

This method is for moderate breast reductions and visible sagging. The surgeon will make circular cuts around your nipple area and then a straight cut down to the crease beneath your breast. Then, they will remove extra tissue and fat, reshape the breast, and lift it. The resulting scar may look like a lollipop.

Inverted T or anchor

This type of surgery (also called a Wise incision) is best for large reductions and for people who have a lot of sagging or unevenness. The surgeon will make cuts around the edge of the areola, straight down from the areola to the breast crease, and horizontally along the crease underneath the breast. 

Breast lift augmentation

During breast reduction surgery, the surgeon also can raise your nipples, giving you a breast lift (mastopexy). They might use the same cuts described above or make small cuts above your nipple. This procedure is different from breast augmentation (implants), which is a surgery to make your breasts bigger. 

Regardless of the specific procedure used, your surgeon will then stitch up your breasts and bandage them with a special gauze. They may attach drainage tubes to remove extra fluid from the surgical area. You might wear these tubes for a few days before the surgeon removes them.

For this procedure, the surgeon uses a technique that reduces the size of the breasts without lifting them. The surgeon also can move the nipples and areolas. You can have the surgery on one or both breasts. This surgery usually takes 2 to 3 hours. It will leave visible scars on your chest.

Expect to take at least a week off from work or school afterward. Some people need a couple of weeks, but each situation varies. Your surgeon will instruct you on follow-up appointments for removing bandages and stitches. For a few weeks after the surgery, you may need to wear a sports bra or surgical bra that you can fasten in the front.

After the surgery, you should expect to feel tired and to have breast pain. Your surgeon will give you an oral painkiller to ease you through the first few days. You should also avoid heavy lifting and physical activity for at least a month.

Some people have an emotional reaction, such as feeling depressed, after the surgery. That can be normal, but make sure you tell your doctor about all your concerns.

Like any other procedure, it comes with potential side effects and complications. Most are mild, but some rare complications are more serious and require additional medical attention.

Common problems after breast reduction surgery

Many people have bruising or swelling after the surgery. This can usually be managed with nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen.

This surgery also can impact feeling in your breasts. The breasts are threaded with many thin nerves, which are important for your sense of touch. During surgery, it might be difficult for the surgeon to avoid these nerves. As a result, the surgery sometimes causes a loss of feeling in your breasts or nipples. This is usually temporary and goes away after 1 to 2 months, but it could be long term. You can ask your surgeon about techniques that are less likely to cause this side effect. 

Some people have difficulty breastfeeding after breast reduction surgery. If you plan on breastfeeding, you might consider postponing the surgery.

This surgery leaves scars on the lower halves of the breasts. These scars will fade over time but will never go away completely. They can usually be hidden under clothes but will be visible when you’re shirtless.

There are some things you can do to minimize scarring, such as asking your surgeon about laser treatments. You also can avoid lifting heavy objects too soon after surgery. 

Other possible problems include:

  • Infection
  • Side effects of the medication to help you sleep during surgery (anesthesia)
  • Bleeding
  • Blood clots
  • Damage to nerves, blood vessels, and other parts of your body
  • Fluid buildup beneath the skin (seroma)
  • Loss of blood flow
  • Breasts that don’t match in size and shape
  • The need for more surgery

Rarely, certain complications, such as poor healing of the nipple area, may require a skin graft.

Contact your doctor right away:

  • At the first sign of infection, including redness, tenderness or unusual swelling at the surgical site, or fever
  • If you have any unusual discharge from the incision site (including pus)
  • If any of the stitches come out before you are due to have them removed

Experts estimate that breast reduction surgery can range from around $6,000 to more than $9,700. The price can vary based on geographic location, the surgeon’s experience, and your specific procedure. Insurance might pay some or all of these fees for people who can show medical need. But if it is for purely cosmetic reasons, you might need to pay for it yourself. 

Like with other surgeries, there are many kinds of fees involved. Insurance may cover all, some, or none of them. Consider the cost of things like:

  • Anesthesia fees 
  • Operating room facilities
  • Medical exams
  • Prescriptions
  • Surgeon’s fees
  • Sports bras, ice packs, and other items you will need after surgery

Does insurance cover breast reduction surgery?

Some insurance plans cover it, and others don’t. Many have specific requirements that patients must meet, such as a documented history of back pain due to heavy breasts. To give your insurance company more information, your surgeon can send in a letter with photos of your breasts and details about your physical symptoms. 

Start talking with your insurance company early on because it might take a while for them to make a decision. Ask exactly what they will pay for. For example, will insurance cover things such as lab costs or anesthesiologist fees? Asking in advance will help prevent surprises after the surgery.

Does insurance cover top surgery?

Some insurance plans might not cover top surgery. Before surgery, check your policy’s full terms of coverage and call your insurance company to confirm coverage. 

If you have already had surgery and your insurance company is unwilling to pay, you can ask them to reconsider their decision (called an appeal). However, this doesn’t guarantee that they will cover the surgery.

If your insurance plan doesn’t include transgender care, it might be unlawful sex discrimination. If you feel that your plan is discriminatory, you can file a civil rights complaint to state or federal authorities.  

You’ll notice the results immediately, but swelling might last for a few weeks or months. After you recover, the changes are usually long-lasting but can be affected by aging, weight gain, pregnancy, and other things

Studies show that after this surgery, people tend to have less pain, fewer headaches, better posture, and fewer rashes. It also becomes easier for them to exercise and purchase comfortable bras. As a result, they often experience an increase in self-esteem, body image, and quality of life. In fact, up to 95% of people who get breast reduction are satisfied with the results.