Surgical Breast Reduction: What Are the Options?
in New York City & Manhattan

*Model

by Dr. Steven Wallach

Breast reduction surgery involves the removal of excess breast tissue, fat, and skin to achieve a breast size that is more proportionate to your body. There are several surgical techniques, and the best option depends on factors such as your anatomy, goals, and the extent of reduction needed. Here are the most common surgical methods:

1. Anchor (Inverted-T) Incision Technique

This is the most common and traditional method, often used when a significant amount of reduction is needed.

• How it works: The surgeon makes three incisions: around the areola, vertically from the areola to the breast crease, and horizontally along the breast crease (forming an anchor shape).
• Pros: Allows for major reshaping and lifting of the breast.
• Cons: Results in more visible scarring compared to other methods.

2. Vertical (Lollipop) Incision Technique

Ideal for moderate breast reductions and lifts.

• How it works: Involves two incisions—around the areola and a vertical line down to the breast crease.
• Pros: Less scarring than the anchor method; effective for reshaping.
• Cons: May not be suitable for very large breasts.

3. Donut (Periareolar) Incision Technique

Used for minor reductions or breast lifts.

• How it works: The incision is made only around the perimeter of the areola.
• Pros: Minimal scarring.
• Cons: Limited ability to reshape or remove large amounts of tissue.

4. Liposuction-Only Reduction

Best for patients with good skin elasticity and a desire for a subtle reduction.

• How it works: Fat is suctioned out through small incisions, typically under the breast or near the armpit.
• Pros: Minimal scarring, shorter recovery time.
• Cons: Not ideal if significant lifting or reshaping is needed.

Non-Surgical Alternatives: Do They Work?

Although surgery is the most effective method for permanent breast size reduction, some individuals explore non-surgical options, such as:

• Weight loss and exercise: For those with a high body fat percentage, weight loss may reduce breast size to some degree. However, breasts may remain disproportionately large, and sagging may increase.
• Hormonal treatment: In rare cases, adjusting hormone levels under a doctor’s supervision can affect breast size, particularly if hormone imbalances are a factor.
• Compression garments: While they don’t reduce size, they can temporarily flatten or support the breasts to improve comfort during daily activities.

Ultimately, these methods are rarely effective for those with significant breast size and related discomfort.

What to Expect During Recovery

Recovery from breast reduction surgery typically includes:

• 1–2 weeks off work for most non-strenuous jobs
• Swelling and bruising that may last for several weeks
• Avoiding heavy lifting or upper-body exercise for 4–6 weeks
• Wearing a surgical bra or compression garment to aid healing

Scarring is a common concern, but most scars fade over time and can often be minimized with proper care. The physical and psychological benefits often far outweigh the downsides of surgical recovery.

Is Breast Reduction Right for You?

Candidates for breast reduction should:

• Be in good overall health
• Have realistic expectations about results
• Be non-smokers or willing to quit temporarily before and after surgery
• Experience physical or emotional discomfort due to breast size

Teenagers and young adults can also be candidates, though many surgeons prefer to wait until breast development is complete.

Final Thoughts

Breast reduction surgery can be life-changing, offering relief from chronic pain, improved physical ability, and a more confident body image. With several surgical techniques available and a few non-surgical paths to consider, consulting with a board-certified plastic surgeon is the best way to determine which option fits your needs.

If you’ve been struggling with the burdens of overly large breasts, know that you’re not alone—and there are real solutions available. Choosing to explore breast reduction is not just a cosmetic decision; it’s a step toward greater health, comfort, and empowerment in your own skin.