Beautiful breasts that can be considered perfect are genuinely a very small percentage when looking at the general population. While extremely exceptional breasts widely displayed in the media are presented as examples, women today seek ways to get rid of sagging or very large breasts not only due to their appearance but also because of the functional side effects they impose.

Women with very large breasts experience medical problems such as neck and back pain, hunching, skin irritations, and deep tissue bruising caused by bras. Difficulties during sports are also among the primary complaints. However, the biggest problem is not so much the size of the breasts as their sagging.

If only breast size truly led to orthostatic complaints and postural deformities, then women who have enlarged their breasts beyond normal with silicone implants should experience the same complaints. The posture and gait of a woman with large but firm and upright breasts are very different from those of a woman with sagging breasts. It is possible to understand the form of a woman's breasts and the psychological balance they provide her from her body language (her posture, her movements). Sensitive women, feeling uncomfortable with the appearance of their breasts and disliking this situation, feel the need to hide them, causing them to pull their breasts inward or keep their shoulders forward. This further exacerbates existing back and shoulder pains.

The main goal to be achieved in breast reduction surgeries is not only to reduce breast volume but also to give the breast a good shape, minimize scarring, and ensure symmetry between the two breasts. Along with all these, attention should be paid to preserving sensation throughout the breast, especially the nipple, and the ability to breastfeed. As a rule, breast reduction surgery can be performed on any healthy woman of any age. However, ideal candidates for this surgery are women who do not plan to become pregnant again after the surgery. This is because pregnancy and breastfeeding can alter the breast shape achieved after surgery.

In medical literature, there are at least 30 surgical techniques that have been used or are currently in use, and at least 3-4 times that number of modifications consisting of small changes made by plastic surgeons. When we evaluate these techniques, which increase over the years, with their outcomes, it is clear that each new technique does not bring significant changes to the surgical results.

For years, plastic surgeons have been working to develop new techniques that leave the least scarring and provide the best shape. It is obvious that achieving the most beautiful breast shape with the least amount of scarring is not possible for large and very saggy breasts. In my opinion, whether the scar is aesthetically bothersome is more important than the amount of scarring. What is important in breast reduction surgery is to agree on what should be prioritized from the patient's perspective. The rule I have learned and try to apply in plastic surgery is: "the more beautiful and attractive the shape of the breast, the less attention is drawn to the scar," and this view also applies to breast reduction and lift surgeries. It should be noted that a surgeon capable of creating a very beautiful breast shape will demonstrate the same ability in scar formation.

The female breast is the most surgically treated organ in the science of plastic surgery due to many different problems.

It is important not to forget that the breast absolutely symbolizes a woman's femininity. A topic that we, as surgeons, often forget when performing breast surgeries is the reaction of the woman's partner to the results of the surgery we perform. Just as we consider it important for parents to approve the outcome when correcting congenital defects in children, such as aesthetic deformities, prominent ears, or drooping eyelids, it is important for the patient's partner to know what the breast shape and scars might look like before breast surgery to appreciate the surgical outcome.

As surgeons, due to our constant exposure to scars, they may not be bothersome to us. But for a non-surgeon, a scar can be repulsive, and sometimes the patient's partner may even hesitate to touch the breast.

The psychological impact of this has been investigated among the partners of patients who underwent breast surgery at Aachen University. The results of this research indicate that during the 3-6 month period until the breast regains its normal shape after surgery, the partners of the patients avoided the breast when engaging in sexual activity. It was also stated that for 20% of the partners, their desire to touch was inhibited by the appearance of the scars in later times.

Just like the changes that occur throughout the body over the years, sagging will eventually appear in the breast due to the quality of the connective tissue. Pregnancy, breastfeeding, and significant weight loss are factors that accelerate this process. The technique used in breast lift or breast augmentation surgery is very similar to breast reduction surgery. The only difference is that in breast reduction surgery, the excised breast tissue is preserved to provide projection. What is important is that the breast and connective tissues are correctly and well adapted in the desired position so that the breast can maintain its acquired shape for many years.