Reduction mammaplasty is the technical name for breast reduction, surgery that reduces the size of your breasts by removing excess fat, glandular tissue and skin.

As with other forms of cosmetic plastic surgery, you need to have a clear and realistic idea of why you want the surgery and what you hope to look like after it. You should discuss your expectations with your surgeon. Although many women have breast reduction to cure physical discomfort, the surgery will change your appearance, and it is important to understand that changing your appearance cannot solve all of the difficulties that you might face in life.

It is also important to note that breast reduction surgery removes many of the milk ducts in the breast, and it is not recommended for women who want to breast feed.

Breast reduction surgery can be an outpatient procedure or it may require a short hospital stay. The procedure normally takes about two to four hours, though more complicated cases can take longer. You will probably be given general anesthesia, so you will be asleep during the surgery.

The most common breast reduction procedure begins with the surgeon making a three-part anchor-shaped incision. The first part circles the areola; the second moves vertically down from the areola to the crease beneath the breast; the third moves horizontally beneath the breast, following the natural curve of the crease.

After the incisions are made, the surgeon removes the unwanted fat, glandular tissue and skin and usually moves the nipple and areola up to a higher position. If the nipple and areola can be moved without detaching them from their original nerves and blood vessels, they may keep their ability to feel sensation. At the end of the operation, the surgeon may temporarily put a small, thin drainage tube under the skin of each breast to drain blood and fluids that collect there. Finally, the surgeon closes the incisions with small stitches and puts a bandage on the area to protect it from infection. There are several breast reduction techniques besides the one listed above. The technique used will depend on the specific details of your case, including how much reduction you want. For example, sometimes the horizontal incision below the breast is not needed. In other cases, liposuction can be used to remove excess fat.

After the surgery, your breasts will be covered and protected by gauze dressings and either an elastic bandage or a surgical bra. These dressings and the drainage tubes will be removed during the first week after the surgery, but you will continue to wear a support bra for several weeks.

Your breasts will be swollen and bruised for a few weeks after the surgery. During the first few days you will probably have some pain, and for a week or more you may feel discomfort when you move around. Medicines will control this. Your stitches will be removed within one to three weeks, and you should be able to return to non-physical work about two weeks after surgery, though it will be several weeks before you feel completely up to speed and you will need to limit your exercise and activities during this time. You will also want to avoid sex for a week or so because arousal can cause your breasts to hurt.