Breast reduction is also known as reduction mammaplasty. This is a procedure intended to reduce the size of a woman's breasts and improve their shape and position. Frequently, the areola (dark skin around the nipple) is also made smaller. Functional symptoms (medical disorders) caused by excessive breast weight may be relieved or improved by this operation. A breast lift, or mastopexy, is designed to improve the shape and position of the breasts without reducing their size. It is used for breasts which sag but are not large. Sagging of the breasts may occur with normal development for some women or as part of aging. Pregnancy, breastfeeding and weight loss are other conditions which increase breast ptosis (sagging). Some patients will have a better shape to their breast if an implant is used at the time of mastopexy.

There are a variety of techniques for these operations. Most commonly there is an incision around the areola, another between the areola and breast crease, and the third within the crease under the breast. This is an "anchor –shape" or inverted "T" incision. Occasionally, especially with mastopexy, these incisions may be modified and more limited. Some operations may require only the incision around the areola.

In extraordinarily large or bulky breasts, for technical reasons, we sometimes remove the nipples completely and put them back as "free grafts". The sensory nerves are all cut, and even though a certain amount of sensation returns after healing, it will never be normal and erotic sensation is lost completely. The milk ducts are interrupted in this operation, so nursing would be impossible. You will be informed in advance if your breasts are in this category.

For a reduction mammaplasty, one day of hospitalization is usually needed if there are no complications. A mastopexy can be done as an outpatient procedure, requiring no hospitalization. Usually suction drains (plastic tubes) are left in place after surgery with breast reduction, and possibly with a mastopexy. A general anesthetic is used on all reduction mammaplasties and some mastopexies. Some mastopexies can be performed using local anesthesia and intravenous sedation.