• If your breasts are too large for your body frame and create back shoulder or neck pain,
• If you have heavy breasts with nipples and areolas (pigmented skin surrounding the nipples) that point downward
• If one breast is much larger than the other
• If you are unhappy and self-conscious about the large appearance of your breasts

Before the surgery, you’ll meet with the surgeon to talk about your medical history, including whether you've had a lump removed from your breast or have any other medical conditions that affect your breasts. the surgeon will also ask about your family's medical history.

Be completely open with the surgeon about your medical history and why you want a breast reduction. Be prepared to discuss any emotional issues you've dealt with regarding your breasts, how your breasts have physically felt to you, and any physical conditions you've had.

The surgeon may take photos of your breasts, measure them, and talk with you about how much breast tissue will need to be removed to achieve your goal. You will also learn about preparing for the surgery and planning for your recovery.

During your consultation, the 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 to ensure proper healing. You also may have to stop taking certain medications, including aspirin or other anti-inflammatory drugs such as Motrin or Aleve and the surgeon will give you instructions about what you need to do.

Women who seek breast reduction often have had children, are overweight, have a predisposition for large, disproportionate breasts, or are sensitive to estrogen. Large breasts often run in a family, inherited from mothers and grandmothers.

Following are some common reasons why you may want to consider breast reduction:

• You have backaches, neck aches, or skin irritation under your breasts.
• You have difficulty breathing and notice grooves in your shoulders from your bra straps.
• You have poor posture or numbness in parts of your breasts and upper chest from excessive breast weight.
• You find it nearly impossible to buy dresses and blouses and difficult to find tops and bras that fit.
• You are very unhappy with your appearance because of your breast size.
• You are in good health with no active diseases or pre-existing medical conditions.
• You have realistic expectations of the outcome of your surgery. You must be able to discuss what you want with your plastic surgeon so that you can reach an understanding of what can realistically be achieved.
• Your skin has adequate elasticity, so it can resume its former tightness following surgery.
• You are mentally and emotionally stable. Breast reduction requires patience and stability to deal with the healing period.
• You are old enough that your breast development has stopped.
• You have finished having children and breastfeeding because this can have significant and unpredictable effects on the size and shape of your breasts.

Nevertheless, many women decide to undergo breast reduction before having children and feel that they can address any subsequent changes later. If you plan to breastfeed in the future, you should discuss this with your plastic surgeon.

A history of irregular mammograms, undiagnosed lumps or other types of masses, severe obesity, diabetes, wound healing disorders, current breastfeeding, smoking, clotting disorders or a family history of them, and heart or circulatory disorders are all contraindications for breast reduction.

If you are in good general health and have a positive attitude and realistic expectations, you are most likely a good candidate for this procedure.

You’ll get general anesthesia, which means you will be put to "sleep" during the procedure.

Breast reduction surgery will take about 2 to 5 hours, sometimes longer. 

The surgeon could 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: 

• Liposuction; 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.
• The vertical or “lollipop”; This method is for moderate breast reductions and visible sagging. The surgeon will make cuts around your areola and down to the crease beneath your breast, remove extra tissue and fat, reshape the breast, and lift it.
• Inverted-T or “anchor”, The surgeon will make cuts around the edge of the areola, from the areola to the breast crease, and along the crease underneath the breast. This type of surgery is best for large reductions and for people who have a lot of sagging or unevenness.

Your surgeon may use drainage tubes and then stitch up your breasts and wrap them in a special gauze. You may also need to wear a surgical bra.

Expect to take at least a week off from work or school afterward. Some people need a couple of weeks, but each situation varies. The surgeon will instruct you on follow-up appointments for removing bandages and stitches.

While you recover, you'll need to stop physical activity for at least a month after surgery.

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.

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.

They are surgeries with high satisfaction rates. Breast tissue does not grow again, but in the following years, age and possible excess weight gain and sagging may occur. The increase in self-confidence is reflected in their physical activities, and their complaints such as back and shoulder pain disappear.

Scars are a normal side effect of breast reduction surgery. These scars will fade over time but will never go away completely. They might be worse if you lift heavy objects too soon after surgery. 

Other possible problems include:

• Infection
• Loss of feeling in your breasts or nipples, which could be brief or long-term
• Side effects of the medication to help you sleep during surgery (anesthesia)
• Bleeding
• Blood clots
• Swelling and bruising
• Damage to nerves, blood vessels, and other parts of your body
• The need for more surgery

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

Contact the 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