Breast reduction vs breast uplift: how do I decide?

Breast surgery is the UK’s most popular aesthetic surgical procedure, with over 13,000 operations carried out per year. Breast surgery can come in the form of implants, breast uplift (mastopexy), or a breast reduction – but which of these is best for you? The answer depends on each individual patient, their unique body shape, and what results they want to achieve.

Patients opt for breast surgery for a number of reasons, such as being unhappy with the size or shape of their breasts for being too large or small, asymmetry, drooping (ptosis), or downward-pointing nipples. While breast augmentation in the form of implants (such as synthetic or natural tissue) dominates the conversation, many patients find that their breasts are not to their personal liking or comfortable in their day-to-day life because they are too heavy, droopy, or large. In such cases, a procedure such as a breast reduction or breast uplift may be a suitable solution. In this article, a consultant plastic surgeon provides an overview of the goals for each approach so that patients can be informed in their decision.

Here are some of the key differences between a breast uplift and a breast reduction, and the results they can create:

Breast reduction

The main purpose of a breast reduction is to decrease the volume of the breast by removing fat and tissue to achieve an overall smaller breast size.

Implants might be the best option if:

• You feel your breasts are too large or heavy
• Your breasts are different sizes
• Your breasts are starting to sag a little
• Your breasts limit your physical activity
• Your breasts cause pain or irritation in the neck, shoulder, back, or the skin underneath them
• Your breasts are impacting your self-confidence
• Your breasts contribute to breathing issues

Breast uplift

Breast uplift aims to lift sagging or drooping (ptotic) breasts, restoring a more youthful appearance. The two main reasons for ptotic breasts are weight loss and post pregnancy changes. Some young patients will also experience ptosis as their skin quality is not sufficient to deal with the weight of the breasts. In all cases, ptotic breasts are distressing as they cause aesthetic and functional (difficulty with bra) problems.

Breast uplift surgery could be the solution for:

• Sagging/drooping breasts
• Nipples pointing downwards, below the breast crease
• Breast asymmetry
• Signs of ageing and wanting to return to a more youthful profile
• Wanting to reduce the overall size of the breast or to reduce the size of the areola

Which should I choose?

In terms of safety and process, both procedures are very similar and require about four weeks of recovery time. Standard risks of swelling, bruising, and scarring are expected in both procedures, and there may be issues with breastfeeding or sensation afterwards.

As a rough guide, breast reduction is the best way to minimise the overall profile of the breast, while a breast uplift procedure may be the better option for undesirable sagging or shape. Sometimes a combination of the two may be the best way to achieve the desired result; a breast reduction often comes with a partial uplift in order to appropriately rearrange the leftover tissue and skin in a suitable way, though this combined procedure is longer and requires slightly more time for observation and recovery. A breast reduction may, ironically, also be conducted with implants to ensure naturalistic volume while still reducing size.

Of course, every person is different and needs a treatment tailored to them. It is imperative to consider all the options carefully, making sure you understand the advantages and disadvantages and exactly what the procedure entails.