L.A. Breast Reduction
Avosant Surgical Associates
LA Breast Reduction Experts


The only medically-proven way to permanently relieve most of the physical symptoms of having large, heavy breasts is with a breast reduction, also known as a reduction mammaplasty. The main goals of this surgical procedure are:
  • To improve symptoms including back, neck and shoulder pains, skin irritations, headaches and poor posture
  • To remove excess breast skin, fat and glandular tissue to decrease the weight and volume of the breasts while providing adequate blood and nerve supply to the breast and its nipple to preserve breast feeding functions and sensation
  • To properly place the nipple in its new elevated position in relation to the remaining breast’s shape and tissue
  • To create an improved breast shape and size that is natural looking, lighter and more proportionate to a woman’s figure


With more than 12 years of breast reduction surgical experience, Dr. Daniel Golshani and the Avosant Surgical Associates have acquired much experience and have further refined their surgical techniques. The main objectives of the surgery are to remove breast tissue, fat and excess skin as well as correct ptosis (droopy breasts) by moving the nipples up to a higher position on the chest. The surgery can be performed unilaterally (on one breast) or bilaterally (on both breasts). Because everyone’s overall breast shape and size is unique, Dr. Golshani is careful in choosing the best incision technique for you.

Our goal is to minimize scarring and maximize results with different incision patterns including an upside-down "T" (anchor-shaped pattern), an upside-down “L” pattern (both made in the middle of the breast as a circular pattern around your areola) as well as a keyhole pattern where the incision is made around the areola and vertically down to the crease of the breast only.

During the incision, the nipple is left attached to its tissue and the breast in order for it to survive. This breast tissue attachment is called the nipple pedicle. After the breast incisions are made and the nipple pedicle is separated, it is time to reduce your breasts and reposition your nipples. Breast tissue, excess skin and fat are removed and weighed to sculpt the breasts while the nipple-areola complex is moved into its new, higher position. Dr. Golshani uses several techniques to shape the breasts. Generally, the Inferior Pedicle Technique, or a combination of the inferior and central pedicle techniques, are used to preserve the blood supply, sensation and ductal network to the nipple – areola complex to insure healthy breasts with normal sensation and capacity for breast-feeding. To help shape the breasts and close the incisions, sutures are used to create, support and anchor the remaining breast tissue to each other and to the deep chest tissue while closing the surgical incisions.

For more detailed information about breast reduction surgery and its techniques including free-nipple grafting, incision techniques, and the Inferior Pedicle technique, please refer to the day of surgery section of our website.


In some cases, the sagging, or ptosis, of the breasts rather than the breast weight is the issue. For instance, a large-breasted woman may have less fat tissue than a woman with small breasts. That is not to say that there are not viable reasons why a particular woman may develop overly large breasts, also medically known as Macromastia or Mammary Hypertrophy.

Genetics, hormones including both natural ones found in the body and those taken as medications, pregnancy, diet, early puberty and skin tone and laxity can all be possible reasons. Obesity may also be a reason but its relationship with breast enlargement is still unclear and most heavy women say that even with weight loss, their breast size does not decrease. Overtime, women’s breasts often lose their youthful shape and firmness as a result of pregnancy, breast-feeding, weight fluctuations, aging, and gravity. Thus, the nipple position falls at or below the crease.

A breast lift, also called mastopexy, can reverse these effects. Through different incisions and patterns similar to those used in a breast reduction, this surgical procedure removes very little breast volume or weight and can raise and firm the breasts by removing excess skin and tightening the surrounding tissue to reshape and support the new breast contour. Several options are available as techniques utilized for breast lift including vertical mammoplasty, which reduces the number of incisions, and totem mastopexy, which gives longevity to the results of the breast lift.

Most women who seek a breast lift do not have many symptoms relate to large breasts and are motivated by cosmetic reasons. Some women even choose to combine their breast lift with breast augmentation. Because this surgical procedure is considered cosmetic, it is generally not covered by insurance.


In other cases, women are not bothered by the loss of volume and firmness in their breasts, but rather concerned with the heavy weight of their breasts or large, uneven breasts. The best option in this situation may be liposuction, or suction lipectomy, which gently removes extra fat from the breasts to reduce the size of large breasts or even them out. For breast liposuction surgery, the traditional large cuts are not needed and patients are usually left relatively “scar-free.” It is an excellent option for patients with certain medical conditions who cannot tolerate a more traditional, larger breast surgical procedure and who meet certain criteria such as minimal ptosis and good skin tone. Occasionally, during the breast reduction procedure, liposuction is used as an additional procedure to help contour the breasts.


Many women seeking a breast reduction wish there were other ways to reduce their breast size besides surgery. Unfortunately, there is no other alternative to permanently and predictably relieve the symptoms of having large, heavy breasts than breast reduction surgery. However, there are several ways to temporarily relieve these symptoms.

For more information, please visit our alternatives to surgery section.

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