Breast reduction – why the grass is greener on the other side

With many of my patients, the grass always seems to be greener on the other side! Women with smaller breasts come for consultations about enlarging their breasts, whilst women with large breasts come to see me about reducing the size of their breasts. Large breasted women often comment to me that they can’t understand why anyone would want to put up with the functional problems that they suffer from – neck and shoulder ache, back ache, sores under the breasts, as well as the social implications of being large breasted (which are all reasons why I try to encourage breast augmentation patients not to go too large!).

It is the fact that having large heavy breasts results in the functional issues, as well as the aesthetic concerns, that maintains its place as one of the most “worth it” procedures we perform as plastic surgeons. The instant relief that women feel on waking up with smaller breasts puts any post-operative discomfort into the shade, as they are overwhelmed with satisfaction!

There are a variety of techniques to performing a breast reduction, and the best technique (or the choices available to you) can only be determined after a careful examination. These techniques vary in their scar pattern, their surgical technique and what is done to the nipple/areola.

By far the majority of techniques will result in a scar around the areola and a scar vertically down from the areola to the breast crease. Some also include a scar that runs along the breast crease. On occasion, a “scarless” breast reduction can be performed using liposuction alone – but this tends to be reserved for post-menopausal women whose breasts are mainly composed of fat.

Contrary to popular belief, most breast reduction techniques do not involve removing the nipple. Instead, the nipple is kept attached to the breast tissue and repositioned higher up, maintaining its original blood supply, and hopefully its nerve supply. I say hopefully, as whilst modern techniques in breast reduction aim to disrupt the sensory nerves as little as possible, there is always the risk that nipples are numb or reduced in sensitivity after a breast reduction operation.

The operation itself usually takes a couple of hours and can be accompanied by liposuction, particularly if there is a full extension of the breast around the sides (known as “side boob” to some, so I am lead to believe). It may be done as day case surgery, or with an overnight stay, and most people can return to work at around two weeks. As with most significant plastic surgery operations, no heavy lifting or vigorous exercise should be performed for around 6-weeks.

I cannot think of a patient of mine to date who has regretted undergoing a breast reduction. As well as the functional improvements as alluded to above, the techniques usually incorporate a breast lift and reduce the diameter of the areola (which is usually desired) providing a good shape and aesthetic outcome.

Breast reductions continue to be an ever popular operation, and righty so, due to the holistic benefits it can bring. For more information, please get in touch to find out more. I would also recommend reading the information booklet available on my website – – go to Treatments & Procedures, Breast Reduction, and then download the PDF on the page.

If you would like any further information on breast surgery or to see one of our Consultant Plastic Surgeons, please contact us on 01892 536960 or email us at

Purity Bridge Team