Mae West was not talking about breasts when she said, "Too much of a good thing is wonderful." Over-endowed women have just as much trouble as under-endowed women, or more, because there may be physical problems in addition to the psychological ones.
There is an operation for every degree of breast sagging and size. It is possible to reduce the breast size slightly by taking out a small amount of breast tissue with the skin, or dramatically reduce breast size (at which point it is called a breast reduction), by removing skin and a lot of breast tissue. Insurance companies often use 500 grams as their benchmark for deciding when a breast lift amounts to a breast reduction. They don't want to pay for breast lifts, which they consider cosmetic. Interestingly, our study found that women with less than 300 grams of tissue removed also report significantly less symptoms of neck, shoulder, and back pain after surgery.
Mastopexies (the medical term for breast lifts) that just remove skin and do not remove breast tissue from the lower pole, the so-called "skin-only breast lifts," are ineffective. The shape remains bottomed-out. A better strategy is to remove extra breast tissue from the lower pole, where it is not needed, and add to the upper pole, where it is welcome.