Breast reduction involves surgery to remove excess skin and breast tissue. Breasts that are too large may be caused by an increase in the volume of the mammary gland, known as breast hypertrophy, or by an increase in the fatty tissues of the breasts, often occurring after menopause, following weight gain or hormonal problems. Breasts that are too heavy can cause chronic back and shoulder pain, headaches and posture problems. Physical exercise is often painful, and it becomes difficult to find appropriate clothing. With breast reduction, you can reduce the size of your breasts and raise their position to give them a more toned and firmer appearance.