Breast Reduction & Mastopexy


Large breasts, although desired by many, can lead to psychological and emotional distress, back pain, neck pain, shoulder pain, shoulder grooving, and rashes. If you are experiencing any of these or other issues related to your large breasts, you are probably a candidate for reduction surgery. Dr. Zelken has performed this operation on women as young as 17 years old and has performed more breast reductions than any other operation.

Macromastia, gigantomastia, and titanomastia are medical terms for large breasts. A genetic predilection to large breasts, childbirth, ethnic variations, and obesity can lead to overly large breasts in women of all ages. A breast reduction result in greater comfort and better proportions.

Breast Reduction Schedule a Consultation


Breast reduction, or reduction mammaplasty, is the art of making breasts smaller, repositioning the nipple and sculpting the remaining breast tissue to a beautiful shape. There are a number of ways to accomplish this, and the approach will differ according your unique goals, existing anatomy, physique, and sometimes, from breast to breast. Many of Z Plastic Surgery’s happiest patients are reduction patients; breast reduction is a great way to enhance your appearance and improve your quality of life. Breast reduction is designed for women who want to improve the shape and decrease the size of her breasts. If this describes you, call (949) 432-4730 to schedule your consultation today.


Breast reduction is anything but one-size-fits-all. Every woman needs to be examined very carefully, and accept the need to trade scars for improved shape. Depending on your anatomy, Dr. Zelken may opt for a breast lift that places a scar around the border of your areola (circumareolar), around the areola and down to the bottom of your breast (lollipop, vertical or circumvertical) or around the areola, a vertical scar, and a scar along the bottom fold (Wise pattern or anchor scar). While the anchor scar is the longest scar, it generates excellent results from the start and allows for optimal control of the width and height of the reduced breast. Dr. Zelken does not have a preference for one technique versus another, but most commonly uses the Wise pattern or anchor scar for his breast reductions. Scarless breast reduction using liposucton alone may be possible in certain cases, but may lead to an unsatisfactory breast shape.


Breast reduction surgery is a rewarding challenge because it requires artistic vision and a keen understanding of breast anatomy. A nipple and areola should not be simply cut off and sewn back on if an aesthetic result is desired. In some cases, a free nipple graft may be necessary, but preservation of the blood and nerve supply to the nipple is the ultimate goal of reduction surgery. In other words, the objective of reduction is to remove as much tissue as possible while avoiding important blood vessels and nerves that keep the nipple alive and sensate. Rather than blind faith alone, Dr. Zelken employs a sound understanding of breast anatomy to prevent injury to critical vessels and nerves. Dr. Zelken also may employ a tool called the Spy that allows him to visualize areas of blood flow disturbance in the operating room. This will facilitate intraoperative decision-making and lead to the best aesthetic result.

I found Dr Zelken through a friend who could not stop saying how beautiful his work is and that he is a true, genuine person that cares about each one of his patients. She was absolutely right!

– Carly M.



Dr. Zelken encourages you to very carefully pick your surgeon if you are seeking a breast reduction. Pick one who has extensive experience in breast reduction, mastopexy, and cancer reconstruction. More importantly, pick one who voices an obsession for symmetry and who seems to have an artistic touch. It is very easy to create asymmetries in areolar diameter and breast shape that may impact your final result and necessitate revision surgery. Worse, improperly performed reduction surgery can result in the loss of your nipple. Be picky when you choose your surgeon. To learn more, call (949) 432-4730 for a consultation today.


What other procedures can be done with a breast reduction?

A breast lift is often included in breast reduction to improve the overall size, shape and symmetry of the breast. Surgery time can vary from two to four hours depending on the severity of size, ptosis, asymmetry and patient goals.

What is the recovery like after a breast reduction?

Drains should be expected after reduction surgery, but seldom are left in place for more than a day, and may not be necessary at all for smaller reductions. As a rule of thumb, Dr. Zelken prefers to avoid drains whenever possible.

What are some risks associated with a breast reduction?

Women who are smokers, diabetic, or who have had prior breast surgery may be at greater risk of complications including partial or total nipple loss, sensory disturbances, wound breakdown, and skin loss. The ability to breastfeed can also be affected with this operation.

Does insurance cover a breast reduction procedure?

If you fail to improve with diet and exercise, anti-inflammatories, physical therapy, or specialized support bras, this procedure may be covered by insurance. Insurance coverage is determined on a case-by-case basis and can vary by insurance provider.

Explore the possibilities at the Zelken Institute