Macromastia is the name for the condition suffered by a special category of women whose large and heavy breasts cause problems such as back pain, muscular pain, deformation of the spine due to incorrect position, skin conditions caused by sweating under the breasts, and inability to sleep on the tummy, as well as a not-so-great physical appearance, especially after a certain age when breasts will unavoidably start sagging. Breast reduction is a surgical procedure in which skin, fat, and tissue are removed from the breast in order to achieve an improved look, a smaller size, and a firmer and fuller breast. The intervention eliminates the discomfort caused by big breasts as well as creating more harmonious body proportions, and can help improve your self-confidence and capacity to undertake physical activities. Your plastic surgeon will be the one to recommend and perform this procedure. There are multiple methods and techniques used to reduce the size of the breasts. The most common technique is the Wise pattern breast reduction. Usually, the breast reduction is performed under general anesthetic and can take up to four hours, but depending on the patient it can be longer or shorter. The multitude of surgical techniques used to reduce the size of the breasts can be differentiated by the size and the placement of the incisions as well as the method used to remove the excess glandular tissue. The most popular incision pattern follows a contour similar to a keyhole, and through there we can get access to the breast tissue. The scar created by this method is similar to an anchor or an inverted T shape. During the last few years, more new breast reduction methods have been developed in order to limit and improve the appearance of the post-operative scars. The Wise pattern breast reduction method has the advantage of a lower risk of skin necrosis, as there is no incision made under the breasts. While being one of the oldest methods used, it is also the most suitable and recommended for women with extremely large breasts. The technique allows the plastic surgeon to remove a considerable amount of fat, glandular tissue, and skin. Even though the Wise pattern is the most commonly performed type of breast reduction in the USA, I have developed a technique called the Wonder Breast reduction that creates shorter scars and provides a look like you have implants without implants. Once healing is complete, the patient will be able to see the full benefits of the Wise pattern breast reduction method. Of course and as always, your plastic surgeon will be the one to recommend the best procedure to perform the breast reduction for your specific case.