Nowadays having overly large breasts is a dream for some women and a nightmare for others. While getting breast implants is among the most commonly performed plastic surgery procedures in the United States and all over the world, more and more women choose to undergo the exact opposite procedure: breast reduction. The breast reduction procedure is recommended when the patient is confronted with daily struggles as well as medical conditions caused by the excessive size and weight of the breasts. In many cases, women with overly large breasts complain about constant and persistent pain on the neck, shoulders, and back, as well as difficulties in breathing and engaging in physical activities. After undergoing the breast reduction surgery, the patient will notice an increase in functionality and often a boost of self-esteem associated with getting rid of the discomfort. The procedure is performed with a high success rate nowadays, especially when performed by a talented, board-certified plastic surgeon. However, breast reduction is associated with side effects as well as permanent consequences, just like any other surgical procedure. In this article, we will discuss the details of the breast reduction procedure as well as how this intervention can affect your breastfeeding capability. What is breast reduction surgery? Overly large breasts are often associated with obesity or being overweight. The excessive weight of the breasts is not only an aesthetic issue, but in time, it can become a real health issue. With the passing of time, the skin becomes saggy and the level of breast ptosis is accentuated. Pain on the spine, neck, and shoulders will often occur, as well as irreversible deformations of the spine such as kyphosis and scoliosis. At the same time, skin conditions can also develop on the inframammary fold. Women with overly large breasts can also be faced with a limitation in physical activities. While the most frequent cause of large breasts is actually being overweight or obese, there are multiple cases in which young and fit patients can be struggling with this condition as well. Breast reduction surgery involves the removal of a part of the mammary gland. The amount of tissue to be removed is variable, depending on the initial volume of the mammary gland and the results the patient wants to achieve after the surgery. In a vast majority of cases, a full C cup and even a D cup are desirable results after breast reduction surgery, so the plastic surgeon might advise you to consider these options when defining the goals of the intervention. Different patients have different reasons for undergoing this intervention. If the procedure is required for aesthetic purposes only, your plastic surgeon might advise you to postpone it until after you are done having children as it can affect breastfeeding capability. Breast reduction and breastfeeding Breast reduction surgery should only be performed by a board-certified plastic surgeon in an accredited medical facility. The intervention can last between three and six hours, often with the patient under general anesthesia. The hospitalization after breast reduction surgery is less than 24 hours in a vast majority of cases, unless complications occur and the plastic surgeon decides that you should be under medical staff supervision for longer. There are multiple surgical methods that can be used to remove variable quantities of the mammary gland and the associated skin and fat tissues. The elimination of the excess glandular tissue involves scars on the breasts. The partial resection of the mammary gland can also alter its functions to produce milk. After the surgery, to avoid the formation of a hematoma, drain tubes can be inserted on the breasts. The drain tubes are required for no longer than 24-48 hours. Patients notice that the post-op discomfort is moderate. In the first few days after the procedure, pain can occur. The plastic surgeon will prescribe medication to alleviate the pain. At the same time, bruises and edema can also occur after the surgery, but they will subside on their own without additional treatment over the next few weeks. Breast reduction surgery is a complex and lengthy procedure; however, there are no severe complications associated with it if the procedure is performed respecting the protocols and the patient is careful during the pre- and post-operative stages. However, just like any other surgical intervention, there are risks associated with it. The risks of breast reduction surgery are related to the age and health condition of the patient. These risks will be analyzed and discussed with the plastic surgeon during the pre-operative consultation. During this initial meeting with the plastic surgeon, you can also find out all the details about how your breasts will be affected by the surgery in terms of the ability to breastfeed. The procedure can make ulterior breastfeeding difficult, if not impossible. This is the reason why your plastic surgeon might advise you to postpone the procedure until after giving birth and breastfeeding. However, in special cases when the breasts are excessively large, the procedure can also be performed on young patients who haven’t give birth yet, as long as the development of the mammary tissues is completed. In these cases, the patient needs to understand and accept the risk of not being able to breastfeed after the procedure. The factors that have an impact on the capability to breastfeed after breast reduction are related to the amount of mammary gland tissue removed and also how soon after surgery the ulterior pregnancy occurs. As a general rule, the larger the amount of mammary gland to be removed, the lower the chances for breastfeeding after surgery. When the mammary gland is removed, the milk ducts that are inside the tissue that is excised will be eliminated as well. This means that the milk duct network is sectioned and damaged and it might never be able to be restored. Moreover, the procedure often involves the reposition of the nipple and areola complex which play an important role in breastfeeding. If breastfeeding is important for you, the recommendation is to schedule breast reduction surgery only after you know your family is complete and you don’t plan an ulterior pregnancy. Otherwise, you should also consider the fact that the aesthetic result achieved during breast reduction might be altered by the changes of the breasts that occur during a new pregnancy and after. Discuss this issue in detail with the plastic surgeon during the pre-operative consultation and make sure you understand the long-term consequences associated with this procedure before scheduling your intervention. Conclusion Breast reduction surgery is recommended for healthy women who want to reduce the size of their breasts while also getting a breast lift. There are several medical conditions that can be treated with breast reduction surgery, but the most important benefit is getting rid of constant pain on the back, neck, and shoulders that is often associated with having overly large breasts. Before scheduling the intervention, the patient should meet the plastic surgeon for a pre-operative consultation and discuss with him the details of the procedure, the side effects, and long-term consequences. Among the consequences that the patient should be aware of, understand, and accept is the possibility not to be able to breastfeed after the procedure.