Once upon a time, I was part of the Big Boob Club. My left breast was triple D, the right was a regular D (I had something called congenital breast asymmetry, and it’s more common than you’d think). I had back pain, could never get comfortable when I went to bed (stomach sleepers, rise), and working out with massive boobs was less than inspiring. All of the above inspired me to get a breast reduction (plus a lift and some liposuction because, frankly, why not?!).
Long story short: it changed my life, and I’d tell anyone considering getting a reduction to go full steam ahead (after a proper consultation from a board-certified plastic surgeon, of course). But as with any procedure that requires anesthesia, there are so many things I wish someone had told me before going under the knife. Your nipples look weird and crinkly for months, silicone scar tape is much more effective than the drugstore scar gel, and plunging neckline surgical bras exist, so you actually won’t be super restricted in the wardrobe department.
In the spirit of paying it forward, I set out to create the ultimate guide to getting a breast reduction. I spoke to top board-certified plastic surgeons who can weigh in on the nitty-gritty details like medicines to avoid and how to know if you're a candidate, and I'm sharing my personal tips for healthy healing.
As always, your doctor knows best (make sure to talk with your physician about any personal concerns related to your medical history), but the FAQs below offer a comprehensive rundown on everything you need to know before getting your breast reduction.
What Is a Breast Reduction?
Contrary to a breast augmentation, which adds volume to the breasts, a reduction removes breast tissue. According to the most recent ASPS Plastic Surgery Report it is one of the most popular procedures, experiencing a seven percent rise year over year, with over 70,000 patients getting a breast reduction in 2023. “It’s one of the most transformative procedures that can be performed in plastic surgery. It is truly a life-changing surgery that can reduce, lift, and reshape a woman's breasts, as well as reposition the nipple areola, empowering her with self-confidence,” explains board-certified plastic surgeon Lyle Leipziger, M.D. “A personalized breast reduction tailored to each woman's anatomy will not only reduce size and remove excess skin tissue and fat, but also elevate the breasts back to a more youthful position.”
Am I a Candidate for a Breast Reduction?
While there is no one-size-fits-all answer (you’ll need to have a conversation with a board-certified plastic surgeon), most breast reduction candidates “typically have had discomfort or have been dealing with a breast size that is too large for their desired lifestyle,” explains board-certified plastic surgeon Bianca Molina, M.D. “Many women may also develop breast changes with pregnancy, breast feeding, or menopause that leads them to consider breast reduction when they hadn’t previously”
It’s possible you’ve been experiencing neck and upper back pain, irritation working out, hygiene issues with rashes underneath the breast, difficulty finding a proper fitting bra, or simply a desire to have equal-sized breasts, explains board-certified plastic surgeon Rukmini Rednam, M.D. However, there are few age restrictions—most doctors recommend being 16+, which is when the breast tissue is fully formed. However, reductions can be done on women (or men) well into their 80s. Essentially, if you want a breast reduction, and you're a healthy candidate, you should get one.
What to Expect During a Breast Reduction Consultation?
If you’re contemplating going full steam ahead with a breast reduction, you’ll want to book a consultation with a board-certified plastic surgeon. Make sure you do your research—every doctor has a different style and technique, so I highly recommend looking at some before and after photos on the doctor’s website.
Once you enter the doctor’s office, you’ll likely be asked to fill out some paperwork before being escorted into a private room. “A patient can expect a thorough evaluation of their medical history as well as a comprehensive physical exam of the breasts,” says Dr. Leipzigar. You’ll be given a surgical gown (it will tie in the front), and the doctor will likely touch or draw on your breasts in an effort to explain the surgical results. In my case, my doctor was even able to show me a virtual rendering of what my body would look like after the operation.
“We always look in the mirror together to determine what can realistically be achieved with a breast reduction and discuss scar placement,” explains Dr. Rednam. You’ll also review the necessary changes in preparation for surgery and what needs to be done post-operation (more on that below).
How to Prepare for a Breast Reduction
You booked your appointment (congrats!!), but just know that you’ll need make a few changes in the weeks leading up to surgery. Don’t take these instructions as gospel—every doctor does things differently and will likely hand you printed instructions so you don’t forget any key steps.
The SparkNotes: “Before surgery, stop blood thinners like aspirin, NSAIDs, and certain supplements like vitamin E and fish oil at least two weeks in advance to reduce bleeding risk,” explains board-certified plastic surgeon Lara Devgan, M.D. You’ll also want to avoid smoking and nicotine products (they impair healing) as far out as six weeks before surgery and maintain a stable weight. Finally, you’ll want to receive preoperative medical clearance from your internist or primary care doctor to ensure you are medically safe for the procedure, says Dr. Leipziger.
Will Insurance Cover Breast Reductions?
It’s complicated, but insurance may cover some, if not all, of your reduction. Every plan will have different criteria, and the evaluation process will involve a thorough consultation from a board-certified plastic surgeon, considering height, weight, and breast size. “Most insurance plans use two items to determine medical necessity; first, medical issues due to large breast size that have failed to be corrected by other medical treatements,” explains Dr. Rednam. “Second is the schnurr scale, which is based on BSA, or body surface area. IT’s used to calculate the amount of breast tissue in grams for a reduction to meet criteria for insurance coverage.”
That being said, just know that if insurance does cover your reduction, they typically also dictate the extent to which your breasts can be reduced. For a hypothetical example: if you have DD-sized breasts and file under back pain, insurance might say you can be reduced to a D, but not a B to correct the pain.
If your breast reduction is not covered by insurance, you’re looking at anywhere between $15,000 to $18,000, depending on location and doctor.
Every plan will have different criteria, and the evaluation process will involve a thorough consultation from a board-certified plastic surgeon, considering height, weight, and breast size.
How Long Does a Breast Reduction Take?
This varies so much on patient anatomy and the difficulty of the surgery, but typically, you’re looking at anywhere between two to five hours. This will include intake (your doctor will draw with market on your breasts and sides to know where they’re making incisions), going under anesthesia, the operation itself, and letting the anesthesia wear off in the recovery room.
What Are the Risks of a Breast Reduction?
“The risks of a breast reduction include the same general risks of surgery such as bleeding, infection, wound healing issues, and complications of anesthesia,” says Dr. Molina. “Some other risks specific to breast reduction include changes to nipple sensation or nipple loss, prolonged wound healing at the incision lines, or fat necrosis, which are typically correlated to very large breast reductions.” It’s important to discuss all the potential risks with your doctor and stay in close communication with them during the first few weeks of healing.
Do I Need Drains With a Breast Reduction?
Surgical drains, which essentially help draw fluid from a surgical site to outside of your body (sexy, I know), have historically been used during a breast reduction. The plastic straw-looking device is kept sturdy inside a surgical bra (aka your recovery BFF) and often connects into a small pouch that looks like a fanny pack. “Drains help remove excess fluid and reduce swelling, improving healing,” says Dr. Devgan. They are typically removed one to three weeks after surgery.
But! Medicine has come a long way. “Now, many surgeons perform drain-less reductions,” says Dr. Devgan. How is this possible? Internal suturing techniques have been able to minimize fluid buildup and create easier, less bulky recovery.
Should I Get a Breast Lift With My Breast Reduction?
I’m a believer in the go-big-or-go-home mentality, so I personally had breast reduction with both a lift and some lipo around the “bra roll” area. It’s pretty common (and often advised) to do all at once for optimal shape and contour, says Dr. Devgan, even if it does make recovery a bit harder. “The breast reduction will reduce breast size, but the breast lift will elevate the breasts to a more youthful position,” explains Dr. Leipziger. “The combined procedure is completely transformative.” Lipo, which is typically done on the side of the body and occasionally the back, is, in my opinion, the most painful part of recovery. That being said, it made a huge difference in how comfortable I feel wearing a bra.
Will My Nipples Look Different After a Breast Reduction?
If there was one thing I wish I knew before going into surgery, it’s that my nipples wouldn’t look the same. This isn’t true for everyone. Sometimes, nipples will be left attached to a portion of the breast during the procedure and simply be reattached when it’s time to get stitched up. The scarring around the aereola will then fade over time.
However, if the reduction is big (like mine was) or your nipple was low on the breast, your doctor will likely want to make it proportionate to your smaller boobs. “Nipples and aereolas can be elevated as part of this process to create a more aesthetically pleasing result,” says Dr. Leipziger. Depending on the intensity of the surgery, the nipple may be reconstructed and re-attached, which runs a risk of decreasing nipple sensation, adds Dr. Rednam.
What Is Breast Reduction Recovery Like?
Speaking from personal experience, the first two days are going to be the most intense. You won’t be able to lift your arms or get up from a lying-down position without assistance. There’s some swelling and bruising (this was the worst in areas where I got liposuction), but the level of pain is best described as soreness more than pain.
Your doctor will likely prescribe some narcotic medicine, but most patients can manage with over-the-counter pain relievers, says Dr. Molina. “Healing takes almost a year to be fully complete. However, by six weeks, the scars have 80 percent of their strength and people are able to return to almost all their normal activities,” adds Dr. Rednam.
Just remember: consistently wear your surgical bra 24/7 (these from Amazon were my favorites). You’ll have a limited range of motion for the first week or two (hence the front closure), but the compression ensures proper healing through the six-week mark. You also have to sleep on your back, so make sure you have some comfy pillows.
By six weeks, the scars have 80 percent of their strength and people are able to return to almost all their normal activities.
Dr. Rednam
How to Fade Breast Reduction Scars
My biggest advice: don’t stress about scars! I was so worried about how my scars would heal, and while it takes time (about a year), they really do fade into the background with proper scar care.
“The most common scar pattern seen is an anchor scar,” says Dr. Molina, explaining it involves an incision scar around the areola (circle), a vertical line along the front-mid portion of the lower breast extending down from the areola, and then a horizontal incision that is hidden in the breast fold underneath the breast. “In those who do not need a large amount of breast tissue taken off, it may be possible to do a reduction with a lollipop incision with the scars around the areola and vertically extending down to the bottom of the breast.”
Once incisions are fully healed, you’ll want to use silicone sheets or tapes on the incision 24/7, only taking them off when showering. You can wear them up to six months. Scar massage, aka gentle rubbing of the area, can also be helpful to flatten raised marks. “Scars also go through pigment changes and may be red, pink, or brown and will fade over time, but it is important not to expose the scars to sunlight as this could lead to permanent pigment changes,” adds Dr. Molina.
The Takeaway
I'm now five years out from my breast reduction—and back to wearing normal bras (if I even wear one, thank you breast lift). My scars are nearly entirely faded; you wouldn't notice them with a naked eye. And I feel more confident in my body than ever before. Was recovery a breeze? No—it's major surgery and it's important to both be prepared and have a care team. But I would 100 percent do it all over again.
Why Trust Marie Claire
Samantha Holender has not only had a breast reduction herself, but she is also an expert in aesthetics, having written about Botox, fillers, lasers, facelifts, and more. She has nearly a decade of experience in the beauty industry and consulted five different plastic surgeons for this story.
