Breast Reduction
1. Introduction
Breast reduction can help relieve the physical symptoms associated with large or heavy breasts such as:
- Breast discomfort
- Neck ache
- Backache
- Shoulder pain
- Skin irritations underneath the breast fold
- Problems with clothes
- Indented bra-straps
- Difficulties and discomfort during exercise
On a purely cosmetic level, the operation can help patients who are unhappy with the shape, weight and droop of their breasts, by creating smaller and more uplifted breasts. Many patients with large breasts can be very self-conscious of their appearance and find that they attract unwanted attention.
2. What surgery is available, and what techniques are involved?
Most breast reduction surgery begins with the nipple, which is lifted into a new position and kept alive on a pedicle, of tissue. Excess skin and breast tissue is then removed, and the remaining breast tissue reshaped to create a smaller and more elevated breast.
The methods of reduction and reshaping vary, and depend upon the patient’s breast size, wishes and needs. While the principle of all breast reductions remains the same, different techniques do result in different types of scarring in the breast area.

Anchor-type or Inverted T reduction
The most common and traditional type of breast reduction uses an anchor-type incision, also known as an inverted T. This technique results in an anchor-shaped scar, starting around the nipple, travelling vertically down and then horizontally across the breast crease.
Vertical scar reduction
Another common type of reduction procedure is the vertical pattern breast reduction. With this technique, patients end up with a scar around the nipple that travels vertically down, but with no scarring underneath the breast. The reduced scarring is a distinct advantage. However, the vertical pattern is less effective and reliable when dealing with particularly large breasts. Furthermore, because there is no horizontal excision of skin, the vertical incision is ridged up. This can cause the skin around the scar to look gathered in the early days after the operation, and a vertical pattern breast reduction will in general take longer to settle than an inverted T procedure.
Many plastic surgeons perform both the inverted T and the vertical pattern, more often than not reserving the vertical pattern for medium-sized breast reductions. However, some surgeons will offer the vertical pattern for larger-scale procedures also, and this is something that patients can discuss in their pre-operative consultation.
Circumareolar reduction
