Breast Reduction


Living with oversized breasts can be uncomfortable, painful, and embarrassing. Finding bras and clothing that fits well is often times challenging and frustrating. Breast reduction surgery provides the ability to have normal sized breasts with a youthful, perky appearance, which can lead to improved self-confidence, health, and overall wellness. Dr. Horowitz and Dr. Nichter have been performing breast reduction surgery for over 20 years and many of their patients find the procedure to be life changing.

Some of the common complaints we hear from our female patients are:

  • Uncomfortable with people staring at their breasts
  • Tired of trying to find bras and clothing to contain their breasts
  • Frustrated with wardrobe limitations
  • Back, neck, and shoulder pain
  • Breathing issues
  • Hygiene problems
  • Feeling humiliated or embarrassed in public
  • Lack of self-confidence


Breast reduction is a surgical procedure intended to reduce the size of a woman’s breasts while also improving overall shape and position. Oftentimes, the areola is enlarged, so a reduction is necessary to provide proper proportion. Functional symptoms caused by excessive breasts may be relieved or improved with surgery.

Candidates Include:

  • Breast reduction is ideal for any woman who feels her breasts are too large and heavy.
  • Other issues such as movement restriction, pain, poor posture, indentations from bra straps, chafing or irritation under the breasts may or may not be present.
  • Women with excessive breast size who feel a lack of attractiveness and self-confidence.
  • Women with large breasts that interfere with normal daily activities or the ability to exercise.

Breast Reduction Results

The end results should speak for themselves, and should include:

  • Smaller breasts and a more attractive breast shape and position.
  • Freedom from health problems associated with having large breasts.
  • Improved self-image and confidence.
  • More wardrobe options available.
  • Ability to enjoy normal daily activities and physical activity.

During the consultation process, your selected surgeon will meet with you to discuss your goals with having breast reduction surgery. Your health history will be discussed to ensure you are a candidate for surgery (please bring a list of prescribed medications with you ). Assuming you are medically qualified for surgery, Dr. Horowitz or Dr. Nichter will then measure your breasts and chest wall, as well as evaluate your overall body shape and size. Recommendations will be given as to which procedures is necessary to achieve your desired look.


Breast reduction surgery is performed in our affiliated Newport Beach outpatient surgery center. General anesthesia is used under the guidance of a board-certified anesthesiologist.

There are a various techniques used for breast reduction surgery. The most common one used by Dr. Horowitz and Dr. Nichter is the “Vertical” technique. We call this a “lollipop reduction.” An incision is made around the margin of the areola, while another incision is made vertically down the lower breast starting from the bottom of the areola to the breast crease. The circular incision combined with the straight line creates a “Lollipop” appearance. This options requires half the scar of the standard Anchor (inverted “T”) incision. This method also does a better job of narrowing the breast and providing outward projection, resulting in better shape with less scarring.

Women with massive breast size will likely require the Anchor incision, which is essentially a Lollipop incision with an added horizontal incision in the breast crease. In extreme cases the areola and nipple is reduce in size and transplanted as a graft to the preferred position.

An important issue to understand after having breast reduction surgery is the possibility of the breasts sagging again in the future. After surgery gravity will continue to take effect, and there can be a tendency for the breasts to sag over a period of time. Women vary a great deal in this respect. In general, the smaller the breasts the less tendency for sagging to reoccur. If the breasts sag again, further excision of the skin on an outpatient basis can be used to correct the problem. If we lift heavy breasts without making them smaller, sagging will persist. Again, to avoid this, it is necessary to remove enough excess breast tissue to prevent this issue. Another option is to aggressively remove breast tissue and replace it with implants. Implants will provide a longer lasting perky result.

A great experience in every aspect. Dr. Horowitz is concerned with his patients. I went to Dr. Horowitz for a breast reduction. Not only did he do a great job, but my follow up and after care was beyond expectations. I am glad I shopped around as long as I did; It allowed me to find a great doctor.

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Oftentimes additional procedures may be recommended to enhance your breast reduction result.

Common add-on procedures include:

  • Breast Lift
  • Breast Augmentation
  • Liposuction of the breast roll and/or back
  • Liposuction of the abdomen

Insurance Guidelines

Large breasts can occur for a variety of reasons including family genetics, post-pregnancy changes, excessive weight gain, or over-active adolescent growth. Common problems associated with larger than normal breasts may include back, neck, and shoulder pain, poor hygiene and breast pain or tenderness. Other problems include skin irritation, skeletal abnormalities, breathing troubles, emotional issues, and interference with physical fitness and normal daily activities.

In some instances, breast reduction surgery may be covered by insurance. After meeting with on of our breast reduction doctors, we recommend contacting your insurance company to discuss possible reimbursement of your surgical expenses. We are a cash based practice, so we cannot bill your insurance on your behalf. We will provide you with any documentation needed.

What to Know as You Heal

The most important advice we can give our patients is to take it easy after surgery. Don’t push yourself to do things at a faster pace than your body is ready for. When you get home after surgery, you will still be groggy from the anesthesia, so try to sleep. When you feel up to it, have a shake, smoothie, crackers, Sprite, or similar to settle your stomach so you can take your medications. Don’t eat large meals or greasy meals right away. Try to eat foods which promote going to the bathroom. Constipation can be a problem during recovery, so eat vegetables or drink prune juice.


For a minimum of one week following surgery, do not sleep your side or stomach. If need be, place a pillow on each side or purchase a medical wedge pillow to keep you from moving around. You should also prop yourself up with at least two pillows to promote blood flow and keep swelling to a minimum. If sleeping is difficult, call our office to discuss the possibility of taking medication to help you sleep. When you are awake and resting, make sure your head and chest are elevated.


Initial discomfort may be minimal due to the anesthesia. As it wears off over the first 24 hours, you will experience an increase in pain. This can be controlled with the oral medication we prescribed you. The sooner you can stop taking the prescribed pain medication and swap it for Tylenol, the better you will feel overall. Pain medication can cause constipation. After the first 4-7 days you should see a noticeable decrease in pain, however discomfort, swelling and discoloration of the breasts are expected for several weeks. Usually, our patients return to most normal activity within two weeks.


Dressing will be wrapped around your chest after surgery. Keep them on until instructed otherwise. The incisions are covered with light dressings, and the breasts may be placed in a bra.


Once the dressings are removed, you will be instructed to wear a sports bra or surgical bra. The bra holds the breasts symmetrically during initial healing. You will wear this all day everyday for 2-3 weeks or longer depending on how you are healing. Of course, you can remove it when you bathe. Having more than one on hand is ideal, so you can swap the bras out as need be to wash them. The type of post-surgical bra will be discussed at your pre-op appointment.


Do not shower while you have the dressings on unless otherwise instructed by your surgeon or one of our nurses. If you still have dressings on by the 3rd day, you will likely be advised to shower and wash your breasts. After, towel dry the tape on your breasts.


If drains were needed, the collection bulb will stay secured to your dressing or clothes with a safety pin. When the bulb becomes half-full, it will need to be emptied. This could occur every four hour or so. To drain, open the bulb from the top, pour out the contents, and write down how much fluid was removed and at what time. Very Important: DoNOT attempt to remove the bulb from the tubing. Squeeze the bulb before securing the plug at the top of the bulb. Drains are typically removed around 4 – 5 days after surgery. If the fluid becomes transparent or there is a very little amount draining out, the drain can be removed.


Physical activity that causes exertion should be avoided the first two weeks following your breast reduction surgery. If you begin working out or performing heavy household duties or similar, you will likely notice an increase in swelling and pain. We do encourage you to begin light walking as soon as you feel up to it. Start with short walks around your house and each day work up to moving around a little more. Increase your walking time as you feel able to do so. Walking and general moving around does promote healing. As a rule of thumb, if any exercise causes you pain, stop and rest. Regular aerobic, yoga or weight lifting exercise (upper body) regimens are recommended around one month to six weeks post-surgery.


Women with sedentary jobs can sometimes return to work within 7 – 10 days after breast reduction surgery. You will continue to feel tired and sluggish for another week or so. If your job requires lifting or physical activity, either ask for more time off or discuss the option of returning back to work with modified job duties until you are able to resume your regular responsibilities.


Our surgeons typically use sutures which will dissolve on their own. It is not uncommon for some sutures to remain or knot. These will be trimmed around 2-3 weeks post-surgery.


Breast scars will likely be visible for up to one year. They will fade over time. Until scars have faded entirely, do not expose them to the sun for at any time. Even if you have a shirt or bathing suit on, you should wear sunscreen. Please talk to our staff about purchasing a medical grade sunscreen from our office. We sell Elta MD, ZO by Obagi, and SkinMedica.


As your sensory nerves heal, you will could feel intermittent tingling, burning or pain. Any discomfort should slowly dissipate. Massing your breast can reduce the sensation and provide comfort.


Your breast will most likely NOT heal identically or at the same rate. Swelling, discomfort, shape, and scarring may be noticeably different as your breasts heal. At the end of the healing process 3 months or longer, your breasts should look natural and similar to one another. Note: every woman’s breasts have some degree of natural asymmetry and could be more visible after surgery. There is no such thing as perfect. If you are concerned about any issues with the healing of your breasts, contact our office (949) 565-2121 to schedule an appointment.


As mentioned previously, incisions can take up to one year or longer to fade. While they will not fade completely, they should be acceptable after a period of time. Initially the may look crusty, red, raised and possibly uneven. Don’t be alarmed – remind yourself to be patient through the healing process.After 8-12 months, the scars are relatively inconspicuous. If you would like to discuss the option of using a scar healing ointment such as BioCorneum®, please contact our office to purchase.


The nipples and some areas of the skin may be numb or sensitive after surgery. Sensation may return within a few weeks or months, but may be diminished or overly sensitive. Numbness of the areola and nipple may be permanent.


Virtual Consultations & Destination Services in Newport Beach, CA

Pacific Center for Plastic Surgery is committed to helping you make your trip to beautiful Newport Beach as pleasant and luxurious as possible. Don’t let distance hold you back from meeting our amazing plastic surgeons. Dr. Jed Horowitz and Dr. Larry Nichter see patients from all over the world, and they make patients’ comfort and happiness their top priority. If you want to book a virtual consultation, or you need help finding places to stay in the Orange County area, please call our office today at (949) 565-2121 or request a consultation online.