As its name suggests, breast reduction or reduction mammoplasty reduces the breast volume through tissue and fat removal. Aside from creating a smaller size, the surgery is also performed to address physical symptoms caused by macromastia, manifested by overlarge breasts, such as back pain, rounded shoulder, and poor body posture.
While the primary goal of reduction mammoplasty is to make the breasts smaller, body sculpting expert Dr. Tarick Smaili said the surgery—because its incisions are the same with breast lift—can also create a lifting effect. A properly executed procedure, he added, also includes repositioning and reshaping of the areola complex or the pigmented part of skin.
The standard technique, also called the anchor-shaped reduction because of its incision pattern, provides plastic surgeons the most control over the final breast size and appearance. It uses a vertical incision between the nipple and inframammary fold, a horizontal cut within the natural crease, and another one around the edges of areola complex.
A less invasive technique called the vertical or lollipop reduction, which removes the horizontal incision across the natural fold, can also effectively reduce the breast size and at the same create a lifting and narrowing effect, making this particularly ideal for improving a markedly wide breast.
While a “true” breast reduction always involves skin excision and tissue removal, some doctors attempt to reduce the breast size with liposuction alone, a procedure that eliminates the fat through the use of a slender steel probe attached to a vacuum pump. For a vast majority of patients, the approach will not provide them the desired result and may even lead to a saggy appearance.
In essence, liposuction does not create any lifting effect because it does not reshape the ligaments or tighten the skin. But for a few carefully selected younger patients, the procedure can reduce the breast size and make it lighter, which could help the skin shrink to a certain degree.
While breast reduction creates a lifting effect [almost] the same way as the breast lift surgery because they share the same incision techniques, the latter does not reduce the breast volume and only aims to correct the saggy appearance.
Aside from the “weakened” breast ligaments and stretched skin, the saggy appearance is also caused by the excessive weight. For this reason, some breast lift patients can benefit more if their doctors will also make their breasts smaller and less prone to the effects of gravity.