Breast enhancement surgery — frequently referred to as a boob job — remains the most common form of plastic surgery, according to the American Society of Plastic Surgeons. Other popular cosmetic procedures include Botox, butt augmentations, and neck lifts. But there are plenty of women who also go the opposite route of breast implants. Breast reduction surgery, unlike its counterpart, is often completed due to medical reasons, not aesthetic ones.

Women who suffer from macromastia or gigantomastia, both of which involve unusually large and heavy breasts, typically turn to breast reduction surgery because non-surgical treatments offer little to no relief for their symptoms. Macromastia can cause severe chronic pain in the back, neck, and shoulders, and contribute to poor posture, shortness of breath, difficulty sleeping, and even obesity, since large breasts make it difficult to exercise without pain. Typically, women are prescribed anti-inflammatory meds or physical therapy, and can be encouraged to lose weight, but even weight loss can’t solve the problem.

“ While often desirable for health reasons, weight loss has been repeatedly shown not to be effective treatment for symptoms related to heavy breasts,” the American Society of Plastic Surgeons writes on its website. “It's all about gravity. A large breast becomes progressively longer and heavier due to the effects of gravity; not because the breast skin stretches like a yo-yo but because it increases in volume.”

 

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Here’s how it works. Breast reduction surgery is done under anesthesia, so patients are asleep during the procedure. That also means they'll have to stop smoking and possibly even take oral contraceptive pills for a few weeks. They'll also have to fast for five to six hours before the surgery. The actual surgery, which lasts from 90 minutes to four hours, begins with the surgeon marking the areas of breast tissue that will receive surgical incisions. First, the nipple is moved up to its new position, and then the excess skin and breast tissue are removed.

Research has shown that breast reduction surgery improves patients’ quality of life significantly by allowing them the ability to exercise. It also reduces chronic pain and mental health issues.