The Biggest Breast Reduction Myths, According to Plastic Surgeons

Breast reductions are more popular than ever. According to the American Society of Plastic Surgeons (ASPS), breast reduction surgeries have increased by 54 percent since 2019. Still, many patients spend years debating whether to move forward with the procedure. That hesitation often stems from the many unknowns surrounding surgery. Patients may have questions like: Will it hurt? Will I lose sensation? Will the scars be worth it? Anecdotally, those who’ve had the procedure often say the same thing: “I wish I’d done it sooner.” So, what’s holding them back?

We spoke to plastic surgeons who all say the same thing: many patients come in with the wrong idea about what breast reduction surgery actually involves. Here, they break down the most common myths and what to really expect before, during and after surgery.

Featured Experts

• Dr. Amy Sprole is a board-certified plastic surgeon in Wichita, KS
• Dr. Elie Levine is a board-certified plastic surgeon in New York
• Dr. B. Aviva Preminger is a board-certified plastic surgeon in New York
• Dr. Andrew Peredo is a board-certified plastic surgeon in New York

MYTH 1: Breast reduction is purely cosmetic

One of the biggest myths? That breast reduction is just for looks. In reality, it can be a life-changing solution for chronic back pain, neck strain and posture issues. According to Wichita, KS plastic surgeon Amy Sprole, MD, “Breast reduction surgery is often seen as medically necessary and beneficial for a wide variety of symptoms. Health insurance typically pays for the surgery when medical necessity criteria are met.”

It’s a view shared by New York plastic surgeon B. Aviva Preminger, MD, who says the procedure is “often a functional one that alleviates chronic back pain, posture issues and skin irritation,” adding that some patients even feel immediate relief from long-standing discomfort after surgery.

Function and aesthetics don’t have to be mutually exclusive, either. As New York plastic surgeon Elie Levine, MD, puts it, “I hear at least 10 times a week during consultations that at other offices the goal is medical and functional, not cosmetic. With my technique, the goal is not simply to reduce the size but to improve the aesthetics.”

MYTH 2: Only very large breasts qualify for surgery

This is a misconception that many patients bring into consultations. The truth is that it’s less about cup size and more about proportion. “Very petite people with large breasts relative to their frame can benefit just as much as someone with a fuller build,” says Dr. Sprole.

Feeling that your chest is too large for your body is highly individual, which is why Dr. Levine considers most women with a C cup or higher as potential candidates. “There are no set rules,” he says. “It’s about how you feel in your body.”

For anyone dealing with discomfort, difficulty exercising or self-consciousness due to breast size, a reduction may be the right choice. “The ideal candidate is someone whose breast size is impacting their quality of life,” notes Dr. Preminger.

MYTH 3: You’ll lose sensation or won’t be able to breastfeed

While concerns about losing nipple sensation or the ability to breastfeed are valid, they’re not as common as people think. Dr. Sprole explains that sensation loss is possible, especially with larger reductions, but “most patients return to normal or near-normal sensation within the year.”

From New York plastic surgeon Andrew Peredo, MD’s perspective, outcomes vary widely. “Some patients actually become more sensitive after the surgery, others less and some notice no change,” he says.

Breastfeeding ability tends to be preserved with modern techniques. “Virtually all women should be able to breastfeed and maintain sensation with my approach,” says Dr. Levine. “It’s really rare, like once every five years rare, that the nipple needs to be removed and repositioned.”

Still, it’s important to set realistic expectations. “Breastfeeding is difficult to predict,” says Dr. Preminger. “Many patients can still breastfeed, especially with nerve- and duct-sparing approaches, but even women who haven’t had surgery often struggle to nurse.”

Interestingly, she points out that very large breasts can make breastfeeding more difficult. “A reduction can sometimes actually help by decreasing the weight and engorgement that can interfere with latching and feeding,” she adds.

MYTH 4: The scars are huge and unsightly

It’s true that incisions are involved, but most patients are surprised by how well they heal. As Dr. Sprole explains, “Most people scar quite favorably with incisions that are designed to be discreet and inconspicuous. By the end of the first year, the scars have usually faded significantly.”

A proactive approach to scar management is key. That’s why Dr. Levine schedules regular post-op visits. “I follow up with every patient personally every 6 weeks for the first year,” he says. “We focus on scar massage, silicone treatments and, if needed, steroid shots or laser treatments.”

Dr. Peredo uses the anchor incision (also called the inverted T), which he says delivers the most natural-looking shape. “The vertical scar typically heals very nicely because there isn’t much tension,” he explains. “And the horizontal scar hides under the breast, where a bra underwire would sit, making it virtually invisible unless someone is looking from underneath.”

MYTH 5: The results are permanent and unchanging

Many assume that once a reduction is done, the results will last forever, but the reality is more dynamic. Breast tissue can respond to life events like pregnancy, hormonal changes or weight fluctuations. “Breast size can definitely change over time,” says Dr. Sprole. “That’s why it’s best to have the surgery when you’re at a healthy, stable weight.”

Changes are expected, but this doesn’t necessarily mean you’re out of options. “Gravity, pregnancies and weight fluctuations are the biggest culprits,” notes Dr. Levine, “but results can be revised years later if needed and typically without additional scarring.”

For Dr. Peredo, it comes down to a simple rule: “Gravity always wins. As we age, we produce less collagen and elastin, so skin loses its ability to bounce back. Weight gain or hormonal shifts can stretch things out again.”

MYTH 6: Your breasts will end up too small or look fake

One of the top concerns patients bring up is the fear of looking over-reduced or unnatural. According to Dr. Sprole, this concern is understandable, especially for insurance-covered cases that require a minimum amount of tissue removal. “It’s more common for people to worry they’ll still be too large,” she says. “It’s important to explain that a certain amount of tissue must remain behind to maintain healthy blood flow and proper healing.”

Natural, proportionate outcomes are always the goal. “Just because someone feels their chest is too large doesn’t mean they need to go small,” explains Dr. Levine. “My patients want to look youthful, natural and appropriate for their frame.”

To enhance shape and avoid flatness, Dr. Peredo performs an “auto augmentation,” where the patient’s tissue is rearranged to create volume in the upper breast. “It can give the look of an implant without actually using one,” he says. “We can also add mesh or an internal bra to counteract future sagging, but true upper pole fullness typically requires an implant.”

Customization and patient collaboration are at the center of Dr. Preminger’s approach. “I use 3D imaging and encourage patients to bring inspiration photos to help align our goals,” she says. “A tailored approach always leads to a better, more confident outcome.”