The breast reduction procedure is a surgical intervention that reduces the dimensions of the breasts by removing excess skin, fat, and glandular tissue. At the same time, during this procedure, the breasts are lifted and the areolas are reduced in size, giving the breasts an aesthetic, natural, improved look. The breast reduction procedure is recommended for women with heavy, sagging breasts. Sometimes these patients describe the dimensions of the breasts as gigantic. This can cause chronic back and shoulder pain, as well as difficulty breathing, chronic skin rash under the breasts due to sweating and moist conditions, and difficulties related to finding and wearing bras and suitable clothing. Breast reduction surgery will transform your big, soft, sagging breasts into normal-sized breasts that are lifted and firmer, with an improved shape. While the procedure involves risks and potential complications like all other surgery, breast reduction surgery is one of the most satisfactory plastic procedures. Before making the decision to undergo a breast reduction procedure, you will need to schedule at least two appointments with the plastic surgeon. During these meetings, you will discuss the volume you want for your breasts, and the height and dimensions of the new areolas. You will be given all the details about how the procedure will be performed and how the scars will look after the surgery. Depending on the volume of the breasts, the breast reduction procedure may be performed by transferring the nipple and areola on a pedicle in order to preserve sensitivity in the area. The excess fat, mammary glands, and skin will usually be removed from the lower part of the breast. In the case of very big breasts, it can be difficult and present risks to transfer the areola on a pedicle, but most surgeons still prefer to do it that way instead of transferring the areola as an independent graft. In cases where the breasts are too big and the distance to transfer the nipple to the correct place is very long, a nipple graft is performed to transfer it without the risk of nipple necrosis or losing the nipple. In this procedure, the areola and nipple are removed and then transferred like a skin graft to the correct anatomical place. In any breast reduction surgery, even when the areola is transferred on a pedicle, there will be scars around the areola, usually in a vertical line, and often in the area under the breasts. If the volume of the breasts to be reduced is not very big, we can use a surgical technique that will leave a less visible scar (vertical scar or L shape scar). The scars after the breast reduction procedure are permanent, but they will become less and less visible with time, and in approximately two years’ time it will be difficult even for the patient to tell where they were. If the healing was delayed due to complications or blood flow issues (usually caused by smoking or passive smoking), the scars might be visible even after a year or two. The good news here is that we can perform another surgery to correct them if it proves to be necessary. This situation is rare, though.