Breast Reduction Surgery

Common reasons patients with large breasts (macromastia) undergo breast reduction include:

  • Back and neck pain.
  • Rashes beneath the breast.
  • Bra-strap grooving on the shoulder.
  • Discomfort with exercise.
  • Desire for smaller, more manageable breasts.

During breast reduction surgery, breast tissue and skin are removed, contouring the breast into a smaller more aesthetically pleasing shape. Similar to a mastopexy, or breast lift, the nipple is raised and centralized on the breast in the most ideal position. Patients with macromastia, or large breasts, typically have a constellation of symptoms including back pain, neck pain, rashes and shoulder “bra-strap” grooving, which are often significantly improved following this procedure.

Commonly used techniques impart a “square” look to the breast. In my opinion, this is not ideal and I have therefore adapted the way I perform breast reduction surgery to create a round, coned shape with a central nipple location. This results in a more natural shape and projection. Nipple sensation is typically unchanged and even improves in some cases.

An aesthetically pleasing breast reduction involves addressing the breasts themselves as well as the surrounding tissues, a component that is often ignored. A beautiful painting is complemented by the frame, which in this case is the axillary, or armpit, and lateral chest “bra fat.” Your initial consult will include an evaluation of these regions as potential targets for treatment. This attention to detail can significantly enhance a breast surgery result.

Breast Reduction Procedure


The satisfaction rate following breast reduction surgery is exceptionally high. Patients uniformly describe their more manageable, perky breasts as life changing and wish they had undergone surgery sooner. Activities become easier, discomfort disappears, and clothing is more complementary with a smaller, more aesthetically pleasing shape.

Reduction Methods

Contouring the breast into a smaller more aesthetically pleasing shape.

The incision is disguised in the areolar margin with a vertical extension to the breast crease, allowing the skin to be tightened while simultaneously elevating the nipple and areola. There is less scarring than the anchor pattern and the areola can often be reduced in size if the patient desires. This technique is useful in patients with moderately sized breasts who only require a small reduction in volume and elevation of the nipple.

The incision is similar to the lollipop incision in that it is disguised in the areolar margin with a vertical extension to the breast crease. There is an additional horizontal incision that is hidden in the breast crease, which allows for maximal skin removal, tightening and nipple/areolar repositioning. The areolas can be reduced in size if the patient desires. This is the most frequently used technique, as it facilitates maximal volume reduction and shaping in patients with large to very large breasts.

What to Expect

All procedures are done in a balanced and natural esthetic.


During the in-depth consultation we will thoroughly review your goals and expectations. Patients are encouraged to bring photographs of several breast results that best represent their desired look. These will not only help me understand the result you have imagined but also shape our discussion on how your goals will be achieved.


Surgery is performed at an accredited surgery center in Newport Beach, California, USA and typically lasts 3-5 hours depending on the degree of shaping required to achieve your desired look. Under the care of a Board Certified Anesthesiologist, general anesthesia (fully asleep) is used to ensure maximal comfort and safety.

The “Lollipop” and “Anchor” incisions used in a breast reduction tailor the skin in a way that aesthetically augments the reshaped underlying breast tissue. Care is taken to place the incisions in existing creases so as to minimize the visibility of scarring.


Patients are discharged home the same day and generally experience very minimal discomfort, often returning to work the week following surgery. I ask my patients to gradually resume their exercise regimen over 3-4 weeks following the procedure in order to ensure optimal healing. I ask that my patients wear a supportive bra without underwire for 6 weeks following surgery.


The results are expected to be long lasting provided patients maintain an active lifestyle and avoid significant change in natural breast volume (i.e. substantial weight change and pregnancy). Skin gradually loses its innate elasticity as we age, which unavoidably compromises the robustness of the result in time. As such, patients may desire additional revisionary procedures to re-elevate and tighten the breasts.


Some patients become fixated on achieving a specific bra cup size. I steer my patients away from this thinking because it is poorly standardized and has high inter-brand variability. A visual representation removes this ambiguity, allowing me to better understand what you want to achieve so that we can develop an accurate operative plan. In order to preserver sensation and viability to the nipple, a certain amount of breast tissue must be retained. This amount varies between patients and depends on the existing size of your breasts.

In order to reduce the breast volume, breast tissue must be removed. Studies show, however, that greater than 65% of patients are able to breast feed following breast reduction surgery, however, 35% required formula supplementation. These percentages are the same for patients who have large breasts and have not undergone surgery.

Often, it will improve. In theory, the nerves that supply the nipple are stretched by the weight of the large, pendulous breast, causing them to work less efficiently. Following breast reduction the pull on these nerves is relaxed, returning lost sensation. The incidence of hypersensitivity or hyposensitivity is roughly 2% and gradually resolves with time. A much smaller percentage experiencing complete loss of nipple sensation.

Before & After

Stunning, natural results from patients.

Breast Reduction Before & After

Breast Reduction

Breast Reduction Before & After

Breast Reduction

Request a Consultation


Receive an in-depth consultation where we will thoroughly review your goals to personalize a plan focused on a natural and aesthetic result. Dr. Donald S. Mowlds, MD is located in beautiful Newport Beach, CA but is also available via a virtual consultation for out-of-town patients.

    Breast Procedures

    All procedures are done in a balanced and natural esthetic.

    Breast augmentation utilizes silicone or saline implants to enhance both breast volume and shape.

    A breast lift, or mastopexy, involves repositioning the breast tissue and nipple on the chest wall, restoring a youthful appearance and feel.

    Breast implants are not lifetime devices. As such, many women ultimately require revisionary breast procedures to replace their implants. Breast shape changes with time so revision breast surgery often includes additional procedures designed to create a natural, youthful breast.

    Implant removal surgery involves removing existing breast implants and the surrounding scar tissue (capsule). The breasts are often re-shaped to optimize aesthetics.

    During breast reduction surgery, breast tissue and skin are removed, contouring the breast into a smaller more aesthetically pleasing shape.

    Restoration of form and function is one of the tenants of plastic surgery and breast reconstruction, specifically, epitomizes this mantra.

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    Services & Procedures

    All procedures are done in a balanced and natural esthetic.