Pendulous breasts can lead to chronic back pain, shoulder grooves, and rashes in the creases under the breasts, the inframammary folds. Breast reduction and breast lift procedures (reduction mammaplasty and mastopexy) involve the removal of excess skin and tissue to reduce the size of and/or to improve the overall shape and symmetry of the breasts. This procedure is performed in our outpatient surgical facility, the Museum Mile Surgery Center. Most patients report little to no pain and the majority of cases require only Tylenol for discomfort.

There are significant differences between breast reduction/breast-lift techniques. The type of incision used varies with each patient. The nipple is not removed; therefore, nipple sensation and ability to breastfeed are maintained in 95-98% of cases. The circumareolar lift (circular incision around the nipple/areolar complex) is the most limited lift. This lift should be done only in conjunction with breast augmentation, as the incision tends to flatten the breasts, and the addition of breast implants helps to restore breast projection and shape.

The most common technique is the standard anchor or inverted "T" (circular incision above with vertical extension and inframammary scar.) This type of reduction is indicated for larger size reductions and/or lifts. However, this technique relies on the skin, the weakest part of the body, to maintain breast shape. Therefore, the results can be relatively short-lived. In addition, the scar on the inframammary fold tends to thicken at both edges: the junction of the cleavage, and laterally towards the armpit.

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When possible, we prefer to use the vertical (lollipop) mammaplasty. This procedure uses the circular incision around the nipple/areolar complex with a vertical extension from the base of the nipple to the inframammary fold. This operation reduces the amount of scarring by eliminating the inframmamary fold scar. In addition, it lifts and shapes the breast gland itself, leading to an enhanced breast contour as well as improved longevity. In the overwhelming majority of patients, nipple sensation and the ability to breastfeed is unaffected.

Surgical drains are rarely used but, when employed, are inserted through a small incision under the armpit and are typically removed in 24 to 72 hours. Breast lifts and reductions may be performed on an outpatient basis, although the patient may choose to stay overnight with a nurse. The patient wears a supportive sports bra for approximately 3 weeks, and generally may return to work in one week with some restrictions.