13 things I wish I'd known before getting breast reduction surgery

My breast reduction surgery was one of the best decisions I’ve ever made. In fact, the only part I regret is not having done it sooner. But it took me years to face my fears and consider the procedure, and then another few to actually go through with it.

It was a surprisingly complicated and emotional journey — I had a lot of trauma wrapped up in what were technically mere sacks of fat hanging from my chest. For me, having big boobs felt like a core part of my identity, their development having gone hand in hand with my coming of age as a woman.

I was only 11 when my breasts started to develop, and by the end of year seven I wore a full C cup. By middle school's end, I'd officially sized out of noughties' Victoria's Secret's maximum cup size of a double D, though I shamefully continued shoving my chest into them for years after the fact. I didn’t understand larger sizes existed for at least another 10 years. At my largest, I believe I wore somewhere around a G or H cup. I hated the size of my breasts and, more than anything, the unwanted attention they got me.

I may have been a literal child, but I was constantly tormented, bullied, body-shamed, and sexually harassed for being "the girl with big boobs” — both by my peers at school, and much older men in public. As a result I began correlating my self-worth to my breasts. Once, at bar mitzvah party, a boy sized up me and my best friend. He said if my best friend had my breasts, she would be the perfect woman. The rest of my body was unnecessary.

I never forgot this comment. It proved that, without my boobs, I wasn't worthy. Naturally, I worried that if I were to lose my breasts, the person I was would cease to exist. But at the same time, I wanted the attention and objectification to come to an end.

There were physical problems with having such large breasts, too. My back and neck always hurt, and running and exercising felt impossible (running “the mile” in PE was traumatic for me). And I couldn’t wear cute clothing like any of my friends did. My breasts were so large that wearing a simple tank top or, God forbid, a V-neck top was immediately deemed “immodest” or “inappropriate,” especially at school. The problem wasn’t the clothing, though: peers and friends wore the exact same items with no problem. The real issue was my body. But I was too young to understand and assumed this meant something was wrong with me.

At 18, I finally had enough and scheduled a consultation with a plastic surgeon. I was told I needed to lose a decent amount of weight to go through with the surgery safely. That, combined with how scared I was, made me realise it wasn’t the time.

A year later I had just gotten out of a nasty relationship and wanted to start over in more ways than one. Consistently exercising and on a strict diet, I had lost more than enough weight for the procedure. In hindsight, I realised I had an eating disorder, and was actually quite underweight for my body. This is relevant to the procedure, which I'll explain below.

The surgery was a success — I reduced my breasts to a full D cup, and recovery was nowhere nearly as bad as I had expected. It’s now been 12 years, and as I said, it remains one of the best decisions I’ve ever made. But I also understand that any form of the unknown seems scary.

Whether you're considering breast reduction surgery for yourself or just want to hear someone's experience, here's everything I wish I had known before my breast reduction surgery — plus what you should know.

People rarely regret breast reduction surgery

My biggest fear was that I'd regret surgery after the fact. I couldn't have been happier with my decision to get a breast reduction — and according to plastic surgeons, most patients feel similarly.

“Breast reduction is a very commonly performed breast surgical procedure, with arguably the highest patient satisfaction,” Sachin M. Shridharani, MD, board-certified plastic surgeon at Luxurgery in New York City, tells GLAMOUR. “Patients that are plagued with a lot of the concerns that require breast reduction are typically alleviated of so many of those symptoms after undergoing this procedure and just are very grateful. In general, we know we have psychologically overall improved outcomes just for their well-being, not just physically but also emotionally."

It won’t change people’s attraction to you

I was genuinely concerned that men would stop being attracted to me after my surgery. One boy I liked said that reducing my breasts was “a slap in the face to God” during my recovery. We obviously didn’t work out but not because of the surgery. He tried creeping back into my life for years, but I was no longer interested — his red-flag comment gave me the ick.

No one I’ve ever dated or been involved with has been “turned off” by the fact that I got a reduction. Even when I had more apparent scars, no one cared, and if they did, they're certainly not worth it. The same people who loved me before loved me after my surgery.

You shouldn’t get surgery until you’re ready—mentally, emotionally, and physically

Everyone feels emotionally and mentally “ready” at different times, but there are some physical requirements for surgery. “Breast reduction is recommended for women who are fully developed, and that age can vary,” says Melissa Doft, MD, double-board certified plastic surgeon at Doft Plastic Surgery in NYC. “A good indicator is the age at which a patient started to menstruate. When the age is younger, then breast reduction can be considered a younger age. If the age is older, then it is prudent to delay surgery until a woman's bra size is consistent for a period of time.”

I was 19 when I got my surgery, but patients' ages vastly vary. “We've performed breast reduction on women in early high school, in their mid to late teens, and certainly on women who are much older, well into their 60s and 70s,” Dr. Shridharani says. “It's really a function of making sure that there is good emotional maturity but also breast maturity, so typically the recommendation is to wait at least until the teenage years to be able to have the procedure. Anything younger really needs a pretty extensive endocrine and pediatric workup to understand why the hormones have changed so rapidly.”

There are many reasons for why people get breast reduction surgery

“Most people get a breast reduction not only because they wish to have smaller breasts but due to a group of symptoms which commonly occur from large breasts: neck, back, and shoulder pain, rashes under their breasts, difficulty with certain activities, deep shoulder grooves, and difficulty finding bras that fit,” says Dr. Doft. That said, Dr. Shridharani notes that there are plenty of patients who opt for the procedure for aesthetic and cosmetic purposes as well.

And then there's the emotional component. For younger women, we know it's often associated with concerns around humiliation and embarrassment "because they're young and in school and are often teased or [receive] undue attention from young and older men,” adds Dr. Shridharani, unfortunately proving that my teenage experience wasn't unique. “There are a lot of psychological elements to having very large breasts that often lead to women wanting a breast reduction.”

Breast reductions can be covered by insurance

“Breast reductions can be covered by health insurance, and usually the reasons are because of the extensive symptoms,” Dr. Shridharani explains. “But it also requires substantial workup. It can take even up to a couple of years to prove to an insurance company that you are suffering from back and neck pain, shoulder pain, and/or have rashes, and often there needs to be several visits with a dermatologist to rule out the rashes or cause of the rashes because of the issues with how much skin on skin there is.”

Other concerns also need to be worked up by a spine surgeon or chiropractor, or a professional who can vouch for the fact that there is extensive back, neck, shoulder pain that is affecting the overall quality of life, he adds.

You will need to make pre- and post-op lifestyle changes

Prepare to make a few lifestyle modifications. “It is best to be at your ideal weight prior to surgery as the surgery will be tailored to that weight,” says Dr. Doft, “and you should avoid medications and supplements prior to surgery that can cause bleeding. Examples are NSAIDs (Motrin, Advil), aspirin, Coumadin, Plavix, and supplements like fish oil.”

You will also need to limit alcohol and quit smoking, at least temporarily. “I don't like patients drinking alcohol at least two weeks before surgery so they don't have a lot of dehydration, or what they're drinking doesn't impact the way that they're going to bleed or bruise,” says Dr. Shridharani, and you'll need to quit smoking at least a month beforehand. “Smoking is a big no-no. We want patients off of vape, nicotine, any type of smoke including marijuana, cigars; all of those things have the ability to impact not just anaesthetic but also the way that the lungs are healthy and can actually take the oxygen in when the ventilator is breathing for the patient, so to speak.”

While Dr. Shridharani asks people to quit forever, sometimes people resume because of their lifestyle. In that case, he asks them to wait to smoke for at least another six weeks after surgery.

You can decide your post-op breast size

“Patients are involved in the process, in my practice at least, of choosing their final size and getting a sense as to how much volume and how much weight we're going to remove,” says Dr. Shridharani. “We have several consults and talk about different sizes, different shape, how much weight the patient has—what do we need to do with the nipple areolar complex in terms of moving it to get the right outcome?”

If insurance is covering your procedure, however, it's important to note that certain companies sometimes require an amount of volume to be reduced. “In our practice, we don't like to participate in that sense of a mandatory amount,” Dr. Shridharani says. “If someone mandates, well, we have to take this much out in order for your insurance company to cover it, that could lead to a very unhappy patient. It could be too much removed.”

Breast reductions include a breast lift

“This is one of the most common questions that I am asked,” says Dr. Doft. “In performing a breast reduction, the nipple is elevated and the breasts lifted.”

The surgery itself is fairly quick.

“The surgery itself actually consists of having general anaesthetic and the actual procedure, which takes anywhere between two to four hours in most instances,” says Dr. Shridharani. “The range really depends on what needs to be done and how much tissue needs to be removed. Patients do not have to stay in the hospital overnight, but several of our patients will often opt to stay nearby in a hotel with a private duty nurse, or they could go home and have a loved one take care of them.”

Physical recovery takes about two to four weeks, but post-op lifestyle changes may last longer

“The recovery time itself ranges for every person, but usually the first week or so is going to be where the patient is the most tender,” Dr. Shridharani explains, adding that you don't want to be alone after the surgery itself—ask a friend or family member to stay with you while you recover. “After about a week or two, you feel much, much more like yourself and are asking, ‘When can I go back to work?’ Which you certainly can. We don't want patients to do heavy lifting or anything greater than usually about 10 to 15 pounds for the first week or two, so there's no tension on the incisions themselves.” It's also advised that you don't drive for a few weeks.

As for full exercise, Dr. Doft recommends waiting six weeks, and wearing a surgical or sports bra during that time as well. “Some surgeons will transition their patients into a supportive bra prior to six weeks,” she adds. You can also expect post-op bruising to clear up in about two weeks.

You will have scars

I still have my breast reduction scars. Do I care? Not at all. They're barely noticeable or visible, and I'm so happy with my results that I'll take scars over my “before” any day. This is the case for most other patients.

“What I find over and over again are breast reduction patients are so grateful that they couldn't care less about the appearance of the scar and would much rather just deal with a little bit of an incision or scar, but have the shape, the size, and more importantly, the quality of life that they were hoping to be able to achieve and have as young or more mature women,” says Dr. Shridharani

As for what the scars look like? “The typical pattern is going to be a scar around the areola, a vertical part like a lollipop, and then sometimes an anchor or a scar that goes across what we call the inframammary fold,” Dr. Shridharani explains. “Scars last forever. I wish I had a magic scalpel or a magic wand and could erase them, but at the end of the day, if we cut the skin, there's going to be a scar. The goal as a plastic surgeon, though, is to have the best possible surgical techniques to minimise the appearance of a scar, so we use really great surgical technique, use the best sutures, the best instruments, and again, hopefully have really great hands and can help optimise scarring. But sometimes even under the best of circumstances, a patient's skin type, their genetics, their ethnicity, all can play a role in how someone scars. At the end of the day, if someone does not want a scar on their breast, then don't have this procedure.”

Your nipples might change.

I still have feeling in my nipples, but it's important to know that losing it is a possibility. “It is possible to lose feeling in your nipples, 10% of patients do according to the literature, and it is possible to breastfeed afterward, although not everyone can,” says Dr. Doft. “The areola is made smaller during the procedure. The classic size is 42 milimetres.”

Bodies, and therefore your breasts, can change over time

It’s now been 12 years since my surgery, so I’m sure you’re wondering how my boobs are now. Well, remember how I said I was underweight at the time? Once I returned to a healthy weight, my boobs grew too—that’s normal and how weight gain works. Due to extreme weight fluctuations over the past decade (ranging around 50 pounds), my breasts slowly increased in size as well.

“The breast is made of fibrous tissue and fat; if you gain weight, the fat cells will expand and the breasts will become larger,” Dr. Doft says. “Hormonal changes like pregnancy and menopause can affect breast size. I have not had a patient whose breasts grew back to their original size. It is more common that their breasts increase by a cup size.”

Danielle Sinay is the associate beauty editor at GLAMOUR US. Follow her on Instagram @daniellesinay.

This feature originally appeared on GLAMOUR US.