Reducing volume while creating a breast that is lighter, better proportioned and well shaped.
Large or heavy breasts can affect comfort, activity, clothing and the overall proportions of the body.
Breast reduction removes excess tissue and skin while lifting and reshaping the remaining breast. The aim is not simply to make the breast smaller, but to create an appropriate volume and shape for the individual patient.
Three elements are considered together.
The amount and distribution of breast tissue determine how much can be removed while preserving an appropriate breast form.
The breast and nipple are repositioned on the chest as part of the reduction rather than treating size and descent as separate problems.
The remaining breast tissue is deliberately shaped to create projection and proportion rather than relying on the tightened skin envelope alone.
The scar pattern depends on the amount of skin excess and reshaping required. I favour the shortest pattern that still allows the breast to be shaped properly.
Where appropriate, I favour a predominantly vertical pattern, with a scar around the areola and vertically down to the inframammary fold.
A short horizontal component can be added where required to deal with residual lower-pole skin without unnecessarily extending the scar.
With substantial breast size or skin excess, a full inverted-T or Wise-pattern reduction may provide the control needed for a reliable and well-proportioned shape.
The nipple and areola remain attached to a living segment of breast tissue—the pedicle—while they are repositioned. I commonly use a superior or superomedial pedicle, selected according to breast dimensions, nipple position and the degree of reduction required.
Breast reduction is selective. Tissue is removed where it contributes unwanted volume, while useful tissue can be retained and repositioned to help construct the final breast. This allows volume reduction and aesthetic reshaping to occur as part of the same operation.
Patients often have a preferred size in mind, but bra cup sizes are inconsistent and cannot precisely define a surgical result.
During consultation we can discuss the degree of reduction you would like and the proportions that suit your frame. The achievable size is influenced by the starting anatomy, breast width, tissue distribution, nipple blood supply and the need to preserve a stable breast shape.
I would rather give a realistic range and explain the trade-offs than promise a particular cup size that surgery cannot reliably guarantee.
Recovery varies with the extent of reduction and the individual patient's healing.
Swelling, bruising and tightness are expected. Dressings and a supportive postoperative bra are generally used during early recovery.
Comfort and mobility progressively improve. Activity is increased gradually while heavy lifting and strenuous upper-body exercise remain restricted.
The breast shape continues to settle and scars mature over subsequent months. Changes with ageing, pregnancy and significant weight fluctuation remain possible over time.
The risks relevant to the proposed reduction and individual anatomy are discussed carefully during consultation.
Consultation allows us to understand the symptoms and practical problems caused by breast size, the reduction you would like, and the breast shape and proportions we are trying to create. From there, I can explain the likely scar pattern, operative technique and the degree of reduction that can reasonably be achieved.
Arrange a consultation →Written and reviewed by Dr Constant van Schalkwyk, Specialist Plastic Surgeon ·
