From the process to the procedures, a plastic surgeon outlines everything you need to know before undergoing breast reduction surgery.
Posted
by Featured Provider Katherine Billue on Monday, September 13, 2021

Whether it's for cosmetic or medical reasons, many women choose to reduce the size of their breasts. But before altering your body and appearance in any way, it’s important to weigh the impacts of your decision.
Katherine Billue, MD, a plastic surgeon at The Iowa Clinic’s Medical Spa in West Des Moines, offers up seven critical considerations to see if breast reduction surgery makes sense for your health and well-being.
1. Breast reduction surgery has benefits beyond appearance.
Some women are self-conscious about their breasts or want a change due to the attention they get. Others want their breasts reduced for cosmetic reasons such as a more proportional size or a less saggy, more lifted appearance.
But large, heavy breasts can cause real medical problems in addition to these cosmetic concerns.
“You can be plagued by consistent neck, back or shoulder pain. It might be difficult or uncomfortable to run, exercise or stay active,” says Dr. Billue. “You can also suffer from chronic skin irritation and develop rashes under your breasts.”
Whether you’re in constant pain or you’re unhappy with their appearance, reducing the size of your breast can boost self-confidence, increase comfort and improve your quality of life.
“Breast reduction can also allow you to finally wear a regular bra and find clothing that fits your body correctly,” Dr. Billue adds.
2. But there are also risks.
Breast reduction surgery has risks typical of any surgical procedure — infection, reactions to anesthesia, blood clots, excessive bleeding, nerve or blood vessel damage and more. You may also experience side effects with the breasts themselves, including:
- Temporary or permanent loss of sensation in and around the areola
- Loss of ability or trouble breastfeeding
- Asymmetrical shape or size
- Excessive firmness
3. There are things you can try before choosing surgery.
If you’re wary of going under the knife or not quite ready to make the change, there are some non-surgical alternatives that may help alleviate your pain and discomfort.
“There’s not a good substitute for greatly reducing your breast size, but some things do help in small ways,” Dr. Billue says. “A good, supportive bra can give you the necessary support and alleviate strain on your back, shoulders and neck. Weight loss, physical therapy and exercise can reduce breast size, although it’s unlikely to change your breasts as much.”
These non-surgical remedies are worth a shot to alleviate your breast issues. If you’re still not getting the results you want — or experience continued pain and discomfort — you can always opt for breast reduction surgery.
4. Breast reduction surgery may be covered by insurance.

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While cosmetic breast reductions are rarely covered by insurance providers, other reasons for surgery often are. If you’re getting your breasts done due to health issues like back pain or skin problems, you may be covered. Reconstructive breast surgeries are typically covered as well.
Reach out to your insurance provider to see if your reasons for a breast reduction are covered. It can greatly reduce the out-of-pocket costs for your breast reduction surgery.
5. You have to meet some physical requirements to get a breast reduction.
Prior to your procedure, your plastic surgeon will evaluate your current health and eligibility. They’ll conduct a physical exam, ask you questions about your medical history and may take photos and measurements of your breasts. You may also need a mammogram or other lab tests to evaluate your breast health.
“Breast reduction surgery does have some risks. We have to understand your health and how it impacts your level of risk, ease of recovery and even eligibility for surgery,” Dr. Billue says.
You have to be healthy enough to undergo anesthesia and recover properly. So poorly managed, uncontrolled health problems like diabetes, heart disease, high blood pressure or lung disease may rule you out. If you’re otherwise healthy and approved for surgery, you may be asked to:
- Stop using herbal supplements, anti-inflammatory drugs or blood thinners such as aspirin, as these can cause excessive bleeding during the procedure.
- Quit smoking four weeks prior to breast reduction surgery and continue avoiding it afterward. Smoking decreases blood flow and weakens your immune system, which can delay healing or increase the likelihood of infection and complications.
- Discontinue the use of immune-modulating drugs (for example, those taken to manage autoimmune disorders such as Crohn’s disease).
6. Recovery from breast reduction surgery may take a while.
Giving yourself time to heal is important. It can take as long as eight to 12 weeks to fully recover and resume regular activities. But the recovery process differs depending on your health, procedure and the surgeon who performs it.
Your breasts and incisions will be bandaged to protect them and you may have a temporary drainage tube. So you’ll have some restrictions after surgery, Dr. Billue says, which typically include:
- No running, intense exercise or lifting anything over 10 pounds for six weeks.
- You must sleep on your back.
- No swimming or taking a bath until healing is complete.
- No driving until you are done taking your prescription pain medications.
- Wearing a prescribed support bra to help reduce swelling.
To ensure a smooth recovery, follow the restrictions and your surgeon’s guidance closely.
7. Your scars will heal.
Scarring is inevitable. You may notice a lot of scars, typically around the areola, down the middle of the breast and under the fold of the breast. And that’s not exactly the cosmetic change you were looking for.
“While scarring is unavoidable, it usually fades over time. And there are things you can do to manage it,” Dr. Billue says. “A few weeks after your procedure, you can start using a lotion that contains vitamin E and cocoa butter, applying it in a circular motion. In addition, you can supplement with silicone sheets or silicone over your scars.”
As your scars and breasts heal, you’ll leave behind the last reminders of your large breasts and start living the life you wanted.
Meet This Featured Provider
Learn More About:
Plastic Surgery, 
Medical Spa, 
Women's Center
Katherine Billue, MD joined The Iowa Clinic in 2020 after completing her Plastic Surgery residency in Omaha. She was impressed by the culture of The Iowa Clinic and was excited about the opportunity to work with great surgeons in a patient-centered environment.
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- plastic surgery