Breast reduction surgery, or reduction mammaplasty, removes excess breast tissue and skin, making breasts smaller and firmer. Most women who undergo reduction surgery, are seeking relief from physical symptoms caused by the excessive weight of large breasts, including shoulder grooves from bra straps, skin irritation beneath the breasts, back, shoulder and neck pain and breathing problems.

Last year, the procedure was performed on 97,637 women by board-certified plastic surgeons, according to the American Society of Aesthetic Plastic Surgery (ASAPS). The level of patient satisfaction from breast reduction is among the highest of any plastic surgery procedure.

Breast reduction surgery may be performed in a hospital or an outpatient surgery center and is performed under general anesthesia. Surgical techniques for breast reduction vary, but the most common procedure involves an anchor-shaped incision that circles the areola (the pigmented skin surrounding the nipple), extends downward and follows the natural curve of the crease beneath the breasts. The surgeon removes excess glandular tissue, fat and skin, and moves the nipple and areola into their new position. He then brings the skin from both sides of the breast down and around the areola, shaping the new contour of the breast.

Stitches are usually located around the areola in a vertical line extending downward and along the lower crease of the breast. In some cases, surgical techniques can be used that eliminate the vertical part of the scar.

After surgery, a small tube may be placed in each breast to drain off blood and fluids for the first 24 to 48 hours. Bandages are removed a couple of days after surgery, although a special surgical bra is worn for several weeks, until the swelling and bruising subside. Normal activities can be resumed after several weeks, and it is often possible to return to work within one or two weeks, depending on your job.

Although major complications from breast reduction surgery are infrequent, potential problems may include a reaction to the anesthesia, bleeding and infection. Diminished sensation in the nipple and areola areas usually is temporary, sometimes taking more than a year to return to normal. Permanent loss of sensation is rare. Incisions will initially be red or pink and will gradually fade over time, although they will remain visible.

Insurance coverage is sometimes available for breast reduction surgery. Many factors determine your eligibility, including the terms of your insurance plan and the amount of breast tissue to be removed. Your insurance company may require a letter of predetermination from your plastic surgeon, prior to surgery.

For more information, including how to find a board-certified plastic surgeon in your area, visit the ASAPS Web site.