Contact Dr. Alexandre Charão: +55 21 99474-9160 (WhatsApp) or

Rio de Janeiro – Brazil

Reduction Mammoplasty Surgery (aka Breast-Reduction Surgery)

Women with very large breasts usually present serious difficulties to show their bodies. It’s a limitation that may bother the patient when going to the beach or the pool, being naked or wearing tight clothes; and sometimes it may even hinder the person’s self-esteem.

Besides, there may be a physical compromise of the spine and shoulder, being common for the patient to feel pain in these regions since the breasts are excessively apart from the gravity axis of the body, leading to compensatory kyphosis (slouching of the spine) that tends to compress the vertebrae. 

Another problem that may appear is a strong skin irritation below the breasts, where the skin meets the breast skin, as well as in the sulcus created by the bra strap. 

Our objective will always be the same: reestablish the dignity and sensuality that every woman desires.

To explain the different types of breast-reduction surgeries, we divided them into three very easy-to-understand groups. Of course each person is unique and will always need a customized solution, but the understanding of how the surgery is done will certainly help you decide which one to pick.

Reduction Mammoplasty with Silicone Implants

This is the surgery indicated for average reductions of up to 500 g of breast-tissue removal. There are a few advantages to inserting a silicone implant on the same day, even after having lost a lot of weight. 

The first advantage is making the upper pole of the breasts more pronounced. The second advantage is the stability of the shape of the implant throughout the years, since the implant does not age. To maintain implant stability, we prefer placing it in the sub-muscular plane, using the internal bra and muscular sling to avoid the sagging or lateral sagging of the implants.

One must not confuse reduction mammoplasty with mastopexy, since they are very different from each other. In reduction mammoplasty, the main objective is to reduce the weight of the breast, and that’s why it’s common for us to use small implants. In mastopexy, the main objective is to lift the entire breast, correcting the nipples that may have sagged with time. 

Mastopexy patients usually prefer larger volumes, since they don’t have the trauma of having lived with large breasts for decades. If you wish to know more about mastopexy, we suggest you read the material we have prepared for you in another post.

Reduction Mammoplasty without Implants

This is the technique that grants more lightness to the breasts, since we don’t use implants in the surgery. It’s great if you have a narrower chest, since it is possible to create more proportional breasts. If you have an average or wide chest, this modality can also be done without the use of the implant, but will probably show less cleavage.

In all cases we can use the fat graft to better define the upper pole. Fat is not like the implant, since part of it will be absorbed and the fat is liquid. We will talk about all the options we have to solve your large-breast problem in your appointment.

A frequent question at our office is about the length of the scar. It is important to clarify that the size of the scar is proportional to the size of the breasts, how it has sagged, and the size of the base of the breasts. 

This change from large breasts to small breasts with a scar is usual very beneficial, since most of our patients heal very well and are happy to have lighter breasts without too much volume.

If you prefer a greater breast volume and don’t like the idea of using silicone implants, we have prepared a third option where we use part of the mammary gland to simulate an implant and grant a better-defined upper pole.

Reduction Mammoplasty with the Inferior Pedicle

In this technique, we don’t use implants, but a part of the mammary gland folded over itself to simulate an implant. The result will not be the same as with the implant, since we’re using live tissue. On the other hand, you won’t run the low risks inherent to using implants, such as rejection or infection. 

This technique is probably the most chosen modality at my clinic because it allows for the removal of a large part of the breast tissue, relieving the weight of the breasts a lot and maintaining a good projection of the upper pole. This is important for women that want to wear a low neckline, more open clothes or that want a curtain effect, with the blouse draping over the breasts and falling freely without touching the abdomen.

How Is the Reduction-Mammoplasty Scar?

For reduction Mammoplasty, there will always be a larger or smaller inverted “T” effect, according to the degree of breast flaccidity. Wearing bikinis will be possible after this surgery because now the breasts will fit in the bikini cup.

In all cases we try reducing the size of the scar as much as possible, but it isn’t always possible. We also use differentiated suture techniques to increase the chances of having a very thin, faint scar, and we are usually successful.

In some cases, we are usually able to use a well-differentiated technique to reduce the scar even further, but be advised that we will only know if this technique is possible during the reduction-mammoplasty surgery. 

If you are interested in this technique, read the paragraphs below and write down your own questions so I can answer them during the appointment.

Reduction Mammoplasty – Short Scar

This is when we do a large removal of tissue through the vertical incision, emptying the breast through this access. Since most of the gland is removed through this incision, it is unnecessary to extend the horizontal scar that much. This technique works well for dense and heavy breasts with firm skin and a narrow base and will not work well in very wide breasts, with a lot of skin flaccidity or many stretch marks.

L-Shaped Scar-Reduction Mammoplasty

It may be considered an evolution of the short scar. For decades, several surgeons tried to develop a technique that didn’t have the center part of the scar, thus avoiding the incision in the middle. 

Only recently has Medicine evolved to the point of achieving, in selected cases, a large weight reduction with a small, short, non-extended scar that before tended to escape the bikini. In other words, there is an inverted-T scar in traditional mammoplasty, a mini inverted-T in the short scar, and in the cases in which it is possible to apply this new technique, the scar will have an L shape that extends to the sides, being easier to hide.

Important details of reduction mammoplasty: 

I always draw these techniques on the day of the appointment to help the patient understand the differences. There are a few minor details to be careful with during mammoplasty, such as the size of the areola (or nipple) for example, which must always be between 4 and 5 cm in diameter. I always take into account the height and width of the patient’s shoulders to calculate the final size, the adequate projection of the upper pole and breast width for every patient I see.

I’m also careful to perform liposuction on the sides of the breasts, since some patients have some fat build up there, hindering the final outcome. The idea is to actually sculpt the breasts to reach the shape you desire.

Lastly, I use absorbable sutures as much as possible, so the patient does not feel the discomfort of removing the stitches. We like using surgical glue in all patients and apply the physical-therapy Kinesio Taping the next day. Then, we start using the silicone tape for 2 months to guide the healing process so the scar is very thin,

 In sum:

Large breasts cause physical and psychological discomfort. Breast excess may hinder your posture and strain your spine. In my office, I frequently receive patients that wear a DD bras and want to reduce them to a B, for example. There will certainly be a scar, but it will be hidden and will not cause embarrassment, as opposed to large breasts, which are difficult to hide.

The outcome reported by my patients after breast-reduction surgery is of great improvement in self-esteem, self-confidence to expose their bodies, and a sense of relief and freedom to wear whatever they want.

How to Have a Procedure Done In Brazil?

Brazilian Plastic Surgery is very well-known around the globe. This started to happen with the work done by Dr. Ivo Pitanguy, which raised the bar for modern plastic surgery worldwide.

At Dr. Alexandre Charão’s clinic, we have developed several protocols to improve our post-op outcomes and comfort. We were able to summarize years of experience in this site text.

Our patients come from many different countries around the world and all of them have reported the following advantages of undergoing the procedure in Brazil:

  1. High technical capacity
  2. Lower cost
  3. Friendlier experience in comparison to other countries
  4. Complete team to facilitate a quick recovery
  5. Safety in all steps

The next step for you to get rid of whatever is bothering you is to schedule an appointment
with Dr. Alexandre Charão.

This can be done in two ways:

After you get in touch, we will send you a link for the payment of the appointment, which
will be scheduled soon after.