When it comes to breast reduction and uplifting, who better to speak to than Brazilian plastic surgeon Dr. Vipul Nanda? Based in India, he has been performing this potentially life-changing surgery for more than three decades.

When we met and fell in love, I had recently quit smoking and put on about six kilograms – at least one of them located on my chest. So, imagine his crushing disappointment a few months later, when I dieted and joyfully shed the excess fat. I suspect that he never fully recovered from the loss.

The point is that – despite all this – I remain happy with my modest 36C bra size. It’s enough to fill out a T-shirt, yet not so much that I can’t wear spaghetti straps. Not too big, and not too small, but just right for my fairly slender frame. A Goldilocks situation, one might say.

Almost invariably, women who opt for aesthetic surgery do so for themselves, not for their partners or anyone else. And that’s how it should be.

An empowering choice

Changing your appearance through surgery doesn’t have to mean conforming to unrealistic social stereotypes of beauty. In fact, a May 2022 research paper published in HealthYatra.com found that undergoing plastic surgery can be an empowering and liberating act that allows women to align their physical bodies more closely to their perceived identity.

It’s a fact that breast augmentation is the most popular plastic surgery procedure. But a significant number of women would prefer to have smaller breasts, not larger ones. Of the approximately eight breast surgeries that Dr. Nanda performs each month, around five are augmentations and the other three are for reduction and lifting.

I don’t find this surprising. For those who feel over-endowed with large, heavy or disproportionate breasts, there are several possible advantages of downsizing. The advantages of uplifting go without saying, of course.

6 reasons to go smaller

• Excess weight on the chest can make it difficult to maintain good posture, leading to chronic headaches, back, shoulder and neck pain

• Other health issues such as restricted blood circulation or breathing problems

• Sleeping difficulties – and we know how vital it is to achieve properly restorative sleep

• Limited clothing options – it can be hard enough to dress for your body shape, even without the handicap of inconveniently heavy breasts

• Psychological issues such as self-consciousness, a negative body image, or simply wishing that people would look you in the eye!

• Unsightly and uncomfortable bra-strap grooves

• Exercise discomfort – it’s probably a Greek myth that Amazonians cut off one breast to facilitate archery, but over-generous boobs are not a sportswoman’s friend.

What is breast reduction, or reduction mammoplasty?

A surgical procedure for oversized breasts in which excess fat, glandular tissue and skin are removed.

What is a breast lift, or mastopexy? Surgery aimed at raising up and firming not only oversized breasts, but also breasts of normal size that are sagging. Excess skin is removed and the surrounding tissue is tightened to improve breast shape.

Which surgical techniques do you prefer for reduction and uplift?

• The inverted-T or anchor technique is ideal for very large or saggy breasts, where there is a lot of skin to be removed. The downside is a higher risk of scarring.

• In cases of only moderate sagging, the vertical technique involves removing a vertical ellipse of skin at the front of the breast, allowing the nipple to be repositioned while keeping blood vessels and milk ducts intact. Any scarring is less obvious and more easily hidden.

• Where sagging is slight or moderate and the skin has good elasticity, I will use the endoscopic lift. Minimally invasive, it requires only small incisions that are hidden in the infra-mammary folds.

You’re especially well known for your endoscopic procedure, aren’t you?

Well, I developed the research project to adapt video endoscopy for plastic surgery in the 1990s. I also designed the instruments and patented them internationally, before having the privilege of sharing my technique through workshops, seminars and surgical demonstrations all around the world. As a result, I was invited in 2000 to come and practise in India… and the rest is history!

Are you doing anything differently today?

Yes, we have started combining endoscopic breast lifting with fat grafting – so-called keyhole scarless natural breast lifting and augmentation, which is proving highly popular.

What is the satisfaction rate with breast reduction surgery and breast lift?

I find that my patients are very happy with the reduction in breast weight. Improved posture helps to alleviate back and neck pain, takes pressure off the shoulders and allows them to wear whatever they like.

Basically, breast lifting is a wonderfully rejuvenating procedure. Many patients tell me they feel younger and more self-confident afterwards. Some have even reported feeling cooler, cleaner and fresher without sweaty folds under the breast.

How common is a loss of nipple sensation? Is it something to be worried about?

Any loss of feeling in the nipple areola is usually temporary. It can take up to a year to restore between 80 and 100 percent of nipple sensation.

Does breast reduction affect the ability to breastfeed?

That depends on the extent of surgery. With very large breasts, where we need to remove a lot of tissue just behind the nipple areola, this can affect future breastfeeding. But if it’s just a lifting procedure with only a small reduction of tissue, breastfeeding will not be affected.

What’s your best advice to a woman who is considering breast reduction or uplift?

Choose the right surgeon – someone who has the necessary experience to deliver the beautiful result that you want and deserve. And if disproportionately large breasts are causing spinal, dermatological or other medical issues, don’t hesitate to find out more. The earlier you deal with the problem, the better. You may even be covered by medical insurance.