Dieting & exercise unless they are performed in excess to affect hormone levels will have little or no effect on breast gland volume. Though they may lead to a decrease in overall body fat they cannot spot reduce breast size and cannot lead to a consistent decrease in breast size in all cases. Different surgical procedures can be used to reduce breast size depending on a specific patient's needs and the surgeon's experience. Since the very large breast can give rise to multiple medical problems surgical breast reduction may be covered by health insurance. It is not a cosmetic procedure per se.

In breast reduction or reduction mammoplasty the surgical procedures used employ an incision around the nipple possibly with an incision along the skin crease under the breast. Circumareolar or donut breast lifts and circumareolar breast reductions can only be performed to lift the nipple about 3cm. If you try to do more the outer donut circumference becomes too much greater than the inner donut circumference. This leads to a corrugated skin surface around the nipple-areola complex that can be quite disfiguring. It will also flatten the breast peak in the front to back direction. For elevation in the 3 to 6cm range a vertical incision/scar under the nipple areola complex is required to take up this excess skin (lollipop approach or vertical scar excision). For even greater elevation of the nipple another incision must be made along the infrabreast crease (anchor or inverted T approach) to avoid leaving corrugated skin at the midpoint of this crease which is also unsightly. Severe corrugation can also create healing problems.

Liposuction has been used for breast reduction but is only of use if the excess breast tissue is composed mostly-entirely of fat (which is not always the case) and the skin is sufficiently elastic to shrink after liposuction. This skin only exists in younger patients who incidentally have more breast gland tissue than breast fat tissue. Liposuction also damages the tissue so that it may not be possible for a pathologist to examine the removed tissue in the search for possible cancer cells.

Both cases were performed using the anchor or inverted T approach. This approach can give a good result in an African American as well as a blonde haired blue eyed individual.

Breast reduction surgery can enhance your appearance and your self confidence. Realistic expectations are important to be happy with any surgery. As each patient is an individual, different results can be expected in each patient.