The procedure has seen a spike in popularity in the last year. Here's why doctors say it's a "game-changer" for many women. 

Amanda MacMillan
March 19, 2018

On a recent vacation with her family, comedy queen and body-positive icon Chelsea Handler posted on social media about a struggle many women can relate to: "I just want everyone to know, that this is my situation when I try to get into a bathing suit,” the 43-year-old said in an Instagram story as she posed in a bikini. "My boobs don’t fit into anything.”

Chelsea Handler/Instagram

Handler then added that “the breast reduction conversation is officially on the table.” And while it’s not clear how serious she was in that moment, the procedure she’s talking about is no laughing matter. In fact, breast-reduction surgery saw a spike in popularity in the last year, according to a recent report from the American Society of Plastic Surgeons.

We don’t know the extent of Handler’s frustration with her figure, but for a lot of women with large breasts, fitting into a bikini is just one of the problems they struggle with on a regular basis. And for many of those women, doctors say that a breast reduction can have serious health and quality-of-life benefits.

But there’s also a lot that women may not know about breast-reduction surgery. (After all, it's still performed much less often than breast augmentations, which typically produce the opposite result.) So in case Handler—and anyone else out there—really is considering going under the knife, here are a few things to know about the increasingly popular procedure.

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It may relieve painful and uncomfortable symptoms

“A lot of women with large breasts complain about shoulder pain, neck pain, and upper or even lower back pain,” says Alyssa Golas, MD, clinical assistant professor of plastic surgery at NYU Langone Health. “It’s usually chronic in nature—something they take ibuprofen for on a regular basis, or something their primary doctor has sent them to a physical therapist for.”

That pain can be caused by the weight of the breasts pulling on the upper body; some women also get painful grooves in their shoulders from their bra straps, as well. And while there’s no guarantee, says Dr. Golas, a surgical breast reduction often relieves a lot of this pain.

“Studies have shown that improvement in symptoms is really independent of breast size,” says Dr. Golas. In other words, it’s not that people with larger breasts automatically get larger pain reductions; rather, the procedure tends to help everyone (or at least most women) who are considered good candidates.

Another common problem with large breasts is that women can get red, itchy rashes underneath them—especially in the summertime or if they tend to sweat a lot. “Sometimes they respond to a topical cream or powder, but a lot of times they don’t,” says Dr. Golas. Surgery tends to help this problem as well, since it gets rid of the skin folds underneath the breasts.

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You can go home right after surgery, but recovery can take several weeks

“I tell my patients you come in and go home the same day, and you’ll be totally asleep during the procedure,” says Dr. Golas. “But I do tell them to plan to take a month off of work. Often people are feeling well and can go back after two weeks, but you always want to plan for the longer end of things, just in case.”

Most women will be “pretty uncomfortable” for a few days after surgery, says Dr. Golas, and, doctors may prescribe pain medication to help with recovery. “Then again,” she says, “some women don’t even need medication because they had so much daily pain before—the pain from surgery is nothing in comparison.”

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As with any surgery, there are risks

All surgical procedures come with a chance of bleeding and infection. For breast-reduction surgery—which removes fatty tissue from inside the breast as well as extra skin on the surface—there’s also a small risk of losing all or part of the nipple and areola, or of losing sensation in the nipple. (Doctors plan their incisions carefully to minimize these risks.)

Some women also have trouble breastfeeding after breast reduction surgery, says Dr. Golas, although about 65% of women are able to nurse successfully.

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It’s often covered by insurance

“If people are having symptoms like pain or rashes, and they’ve tried more conservative treatments that haven’t worked, a lot of times the surgery is covered,” says Dr. Golas. “Sometimes if you say it interferes with your ability to exercise, they may cover it as well.”

Insurance companies will often want to see that a patient has tried seeing a physical therapist or a chiropractor first, she says, or may want to see photos showing a rash or other physical problems. “If I think a person will really benefit from breast-reduction surgery, I’ll try to go through insurance first,” says Dr. Golas. “Then if they won’t cover it, we’ll talk about her options for paying out of pocket.”

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Most women are happy with the results

“Some women with really large breasts feel really self-conscious,” says Dr. Golas. “They have a hard time fitting into regular bras, they have trouble fitting into clothing, they feel like they really stick out and that people are constantly staring at them.”

For these reasons—as well as the physical pain and discomfort that comes with being extremely well-endowed—breast-reduction surgery can be a game-changer, says Dr. Golas. (And despite the common belief that bigger breasts are more desirable, a 2013 study found that many women feel better about their sexual health post-breast reduction.)

“In general, women are very happy after they have this procedure,” says Dr. Golas. “They feel healthier, more confident, more excited to exercise. A lot of times, their only complaint is that they waited so long!”