What's the number one thing you should do before choosing breast reduction surgery? Research. Step one should be consulting with your health care provider, and step two should be finding a physician who's board-certified in plastic surgery.

";Board certified" means after that rigorous education and training, including three years doing general surgery, and two years actively practicing plastic surgery, the physician passed a comprehensive written and oral certification exam given by the American Board of Plastic Surgery.

Many women (and more men) are opting for breast reduction surgery after spending years suffering with chronic back, neck, and shoulder pain due to very large, pendulous breasts. Large breasts can limit physical activity, lower self-esteem (this is a big problem with very young women), make finding properly fitting bras and clothing difficult, cause chronic rashes under the breast (a common problem in hot weather), and contribute to poor posture.

Before breast reduction (also known as reduction mammaplasty), the physician will determine if the patient is an appropriate candidate by doing a complete medical history. Patients should be in good health, physically and mentally. It's recommended a patient be accompanied by a friend or family member, particularly if she's returning home afterward and not spending the night in the hospital. Eat healthy, don't smoke, and tell your doctor of any medications you're taking.

According to the American Society of Plastic Surgeons (ASPS), the surgeon will usually remove excess fat, glandular tissue and skin during breast reduction mammaplasty. However, if the size of the breast is mainly due to excess fat, liposuction of the area through a tiny opening (the micro-incision technique) may be all that is needed. Whatever the incision technique used, after all of the necessary tissue removal, the breast is reshaped to a higher, natural appearance. With the exception of very large, pendulous breasts, the nipple and areola do not have to be removed, and their original blood supply and nerves can be left intact.

Unfortunately, weight loss often won't correct many of the problems associated with very large breasts, such as low hanging breasts, and skin and ligaments that have usually been stretched past the point of recovery. Remember, too, that as common as breast reductions is, it is still major surgery and carries the usual risks such as bleeding, infection, and wound healing problems. With this surgery, lost or reduced nipple sensation is also a risk.

While breast reduction is a popular procedure, according to 2009 data from the ASPS breast augmentation is still the most common form of plastic surgery, and its prevalence has risen 36% since 2000. (Women comprise 91% of plastic surgery consumers, with those aged 40 to 54 years old making up the largest segment. Teens, 13 to 19 years old, make up the smallest segment of plastic surgery patients.)

During consultation with your surgeon, she will determine emotional readiness and discuss any physical ailments patients usually experience. Patient and doctor should jointly agree on the optimum amount of breast tissue to remove to give the desired result.

The surgery typically takes two to five hours, and usually the patient is left with more "youthful" breasts — specifically, breasts that are sized in better proportion to their body with an upward lift. Procedures can cost from $5,000 to $7,000, and since reduction mammaplasty is typically done for health reasons as opposed to cosmetic ones, it's often covered by insurance.

For more information, talk to your doctor or visit the website of the American Society of Aesthetic Plastic Surgery to see if you're a good candidate for breast reduction.