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Experience freedom with a breast reduction surgery in San Antonio

If you have very large, heavy breasts, you likely shop for special sizes of bras, cannot wear standard clothing sizes and may have back pain, neck pain, rashes, or less confidence than you should. Imagine being able to wear bras you love, standard clothing sizes, and have breasts that look youthful, perky, and ideally balanced – our patients tell us it is life-changing!

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Why choose Hill Country Plastic Surgery?

Our highly trained, board-certified plastic surgeons believed deeply that every patient deserves the highest level of personalized care. We are honored to be considered among the most talented breast surgeons in the San Antonio and Houston areas. We can help you delight in the look and feel of your body. We understand making the decision to undergo breast reduction surgery can be stressful but serve as your partner and guide at every step of the process. We are here to listen, understand, and we act as your partner in a transformation and enhance your feelings of self-confidence in your figure.

Transform your life and experience the joy of living.

We are focused on ensuring the transformation we achieve in your breast reduction in San Antonio is positive, empowering, and personalized. With your breast size corrected, we hope it will fuel other positive changes in your life as you find “you” again with your new figure! Reducing large breasts does much more than reducing breast size.

You may have physical pain and discomfort in the neck and back. Posture can be affected, it may be difficult to wear certain clothing or find bras that fit and are supportive enough, and you may have dents in your shoulders from bra straps. You may also have frequent rashes under or between your breasts. If the discomfort is directly due to the weight of your breasts, a reduction will help relieve this pain.

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What does breast reduction entail?

Breast reduction surgery, also known as reduction mammoplasty, removes excess breast tissue, fat,  and skin to reduce the size and weight of overly large breasts. Several approaches are possible, and the surgical techniques used will be selected to reflect your personal condition.

Surgical techniques for custom breast reduction

There are multiple techniques for breast reduction surgery. You are a unique individual, and your surgery will be customized specifically to address your condition. The types of surgical approaches that may be used include:

Vertical breast reduction

A vertical incision is made on the breast and around the NAC (like a lollipop). This incision pattern can be used with all grades of ptosis.

Inverted T scar

This uses the traditional Wise (anchor) pattern which is also used for breast reductions. This is good for severe droop and size of the breast and for patients with lack of resilient skin quality.

Liposuction only

In patients who have little excess skin, good shape and lift of the breasts, good skin quality, breasts with mostly fatty tissue, and are looking for a small reduction in size, liposuction only may be an option. Liposuction can also be combined with a regular breast reduction to reduce the amount of fatty tissue to the side of the chest and to shape the breast. Liposuction is usually not covered by insurance.


The limitations of a breast reduction are that it will lift the breast, but it does not add volume to the top of the breast, called the superior pole. A breast reduction will give you a smaller version of the breasts that you already have.

The breast anatomy – A basic description

During your consultation you may hear your surgeon discuss a “pedicle.” A pedicle is the tissue of the breast that is left behind and that supplies blood flow to the nipple. The main two types of pedicles are a superomedial pedicle and an inferior pedicle. The choice of pedicle is based on your anatomy and on surgeon preference.

The nipple and areolar are kept for most breast reductions. For patients with excessively large breasts or in a redo-breast reduction, it may require a free nipple graft. A free nipple graft is where the nipple and areola are removed from the breast tissue underneath and placed in its new position as a skin graft.

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Will I need an overnight stay?

For medically indicated breast reductions where a large amount of tissue is removed or if you have medical conditions, you may need to stay overnight for monitoring. Some patients require the use of drains after surgery. This will be discussed before your surgery. You will be placed in a compression garment after your breast reduction which you will need to wear for the first 6 weeks. It is recommended that you do not wear any bras with an underwire until three months after surgery.

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Limitations, risks, and complications

Risks of the procedure include allergies to tape, suture material, skin ointments, or injected medications, bleeding, blood clots, breast asymmetry, contour and shape irregularities, changes to nipple or breast sensation, seroma (fluid accumulation), poor scars, partial or total loss of the nipple and areola, skin changes, firmness or lumps in the breast tissue scar, poor wound healing, pain, and infection. After breast reduction surgery, you may need small revisional surgeries. All breast tissue that is removed is sent for evaluation by the pathologist to check for breast cancer cells.

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Your consultation – what to expect

During your initial consultation with your surgeon at Hill Country Plastic Surgery, we will discuss your concerns and goals before recommending treatment options that are tailored specifically to your needs. Prior to your consultation, we recommend that you review the procedures on our website so you are familiar with the terms we will be using during our discussion. If you have pictures of how you would like your breasts to look after surgery, please bring them and have them easily available.

  • Once we hear your concerns and what you hope to achieve, we will discuss all the treatment options that are available to you. Every patient is unique, and we will develop a tailored surgical plan that addresses your specific goals. In addition, we will thoroughly review your medical history, surgical history, medications, allergies, family medical history, and other important details such as your family breast cancer history. It is very important that we obtain accurate information in all these areas as it may impact the outcome of your surgery. If you have had a recent mammogram or other breast imaging, please have it sent to the office prior to your first appointment with your surgeon.
  • While discussing different treatment options, we will examine your breasts and take measurements of your breasts and evaluate your skin quality and the location of your nipples and areolas to help us plan your surgery. Pre-operative (before surgery) photos will be taken either at your initial consultation, or during your pre-operative visit.
  • After your consultation, you will receive access to your notes on the patient portal in addition to information about your specific surgery. If you have not activated your patient portal, this can be done at your appointment by asking any of our staff to assist you. If you have questions after your appointment, you can contact our office or message us through the patient portal. Some patients will require medical clearance from their primary care physician or a specialist or additional tests before undergoing surgery.
  • Once you have determined that you would like to have surgery and have completed any clearances and tests that were requested, contact our office at (210) 658-3555 to schedule a pre-operative appointment with one of our surgeons.

Breast reductionFAQs

Am I a good candidate?

What is the difference between a breast lift and a breast reduction?

How do I know what type of breast reduction is right for me?

Will insurance cover my reduction?

Can you reduce the size of my areolas?

How young is too young for a breast reduction?

What if I gain or lose a lot of weight?

Will I be able to breastfeed after breast reduction surgery?

What is the difference between a plastic surgeon and a cosmetic surgeon?

What other procedures can be done with a breast reduction?

Am I a good candidate?

Good candidates for breast reduction are in good health and do not smoke. It is also important to have realistic expectations for the surgery. A breast reduction will change the way that you hold your body, the way clothing fits, and will change your outward appearance. A medically indicated breast reduction will make your breasts smaller so if the goal is for the breast to be more lifted and not smaller, a breast lift is a better option.

What is the difference between a breast lift and a breast reduction?

A breast lift (mastopexy) lifts the breast while a breast reduction reduces the size of the breast and lifts it. If you are happy with the size of your breasts in a bra but would like for them to be lifted, a breast lift would be the best procedure to address this. The scars are similar between the two procedures because most of the differences in the surgery occur under the skin.

How do I know what type of breast reduction is right for me?

The type of reduction you should undergo is dependent on the shape and size of your breasts. In general, the more skin and breast tissue that must be removed, the more extensive the incisions. During your consultation, your surgeon will discuss all the options and give you recommendations.

Will insurance cover my reduction?

This is dependent on the benefits of your insurance plan. In general, if you have a documented medical reason for having a breast reduction and have a large amount of breast tissue to remove are reasons for a medically-indicated breast reduction. Usually this requires a referral from your primary care doctor.

Can you reduce the size of my areolas?

Yes! This is part of the procedure. The average width of the areola is about 4 cm, and we will reduce the areola to this size. We do not do any changes to the nipple.

How young is too young for a breast reduction?

This depends on many factors. It is best to wait until the breasts are fully developed, but if excessively large breasts are causing significant emotional and physical distress, we can do the breast reduction at a younger age.

What if I gain or lose a lot of weight?

Extreme weight gain or weight loss may cause changes to the breasts, leading to changes in your results. If you are planning to lose a lot of weight, you should wait until your weight has stabilized for at least 6 months. Also, if you are in your child-bearing years and are planning to have children soon, it is best if you wait to have a breast reduction if you can. Your breasts will change during pregnancy and that may result in permanent changes to your breasts.

Will I be able to breastfeed after breast reduction surgery?

There is a risk that you will not be able to breastfeed after surgery. If you require a large reduction that needs nipple grafts, you will not be able to breastfeed.

What is the difference between a plastic surgeon and a cosmetic surgeon?

A plastic surgeon is a surgeon that has gone through accredited surgical training. Dr. Shah and Dr. Farber are both board-certified in plastic surgery by the American Board of Plastic Surgery. This means they have completed accredited plastic surgery training and have undergone rigorous quality and safety evaluation including written and oral exams. The American Board of Medical Specialties (ABMS) recognizes the American Board of Plastic Surgery as an approved medical specialty board.

Cosmetic surgeons may or may not have official surgical training and are not trained in an accredited plastic surgery program. The ABMS does not recognize any boards with “cosmetic surgery” in its name. While there may be cosmetic surgeons that are able to produce consistent and safe results, there is no board-certification standard that can assure that a cosmetic surgeon is competent in the procedure performed.

What other procedures can be done with a breast reduction?

Other procedures like a Mommy Makeover that already include a procedures like a Tummy Tuck and liposuction.

Are you ready for a happier, more comfortable life? Meet with us!

Are you interested in learning more about this procedure? To schedule a consultation, please contact us. Hill Country Plastic Surgery is the premier plastic surgery center in the San Antonio and Austin area, and our friendly team members are here to help you and will reach out promptly.

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