Are breast reduction pills, the alleged quick-fix, actually safe?

There’s no denying that our relationship with what’s considered an “ideal” boob size depends largely on what’s happening in popular culture at the time. In the 1980s, the arrival of Pamela Anderson left everyone wanting bigger, fuller breasts, and unsurprisingly, there was an increase in breast augmentation surgeries throughout the 90s. Since the 2000s, larger-than-life boobs have fallen out of trend. In fact, a growing number of teenagers are opting for breast reduction surgery and celebrities such as Victoria Beckham have had their implants removed.

Along with a decrease in popularity, there’s a number of medical and personal reasons why a person might want to reduce their breast size. Gender transitioning, breast-induced back pain, concerns about male breast size, or assistance with weight loss are just a few. So, when a pill online promises to shrink breast size without the need for breast reduction surgery (false advertising?), it’s easy to see how people wanting a quick (or cheaper) fix would be motivated to click “buy now”. But what exactly are they buying? 

Brian Labow, the director of the Adolescent Breast Clinic at Boston Children’s Hospital, told The Atlantic that there’s an absence of data on the rise of teenage breast reduction surgeries “because the breast in this society is very sexualised.” There is also a lack of data surrounding breast reduction pills. As “targeted” fat burners, they sit within the supplement section online, meaning there’s no requirement for them to licenced or registered with the UK Government. Drug companies have been producing weight loss pills since the late 1800s, and many of the same ingredients are used in breast reduction pills like theobromine, chromium picolinate, and caffeine. 

We asked Dr Melanie Palm, board-certified medical dermatologist and cosmetic surgeon, to talk us through the ingredient list for Alexia Breast Reduction Pills, a popular and easily accessible brand sold on Amazon. These retail for $64.95 for one month’s supply and the product description asks us to “Imagine what it would be like to wake up with smaller, lighter, and firmer breasts tomorrow?” However, there’s no clear timeframe for how long to take the pills or for how long results are meant to last, and reviews are mixed. A fairly even split of the reviews on the purchase page claim that Alexia either doesn’t work at all or is a scam, then there are those that say they “saw results the first day”. 

Some of the most worrying potential side effects discussed came from the ingredients listed as guggulsterones, chromium picolinate, and “Proprietary Alexia Blend”. Guggulsterones, explains Dr Palm, in high doses can cause diarrhoea, itching, skin irritation, and “could possibly mimic estrogen in the body, and therefore could be potentially dangerous to women with estrogen-sensitive breast cancers, a history of blood clots, or other estrogen-responsive conditions.” 

Chromium picolinate is used by some in body conditioning, but clinical research has found chromium to be ineffective for increasing weight loss or lean body mass. “Chromium is safe in very low doses and has been shown to be safe in the short term use up to six months, but longer use safety is unknown,” says Dr Palm. “Chromium can have a myriad of side effects including skin irritation, mood changes, impaired thinking and judgement, nausea, coordination problems, and could cause blood disorders or liver or kidney damage.” Then there’s the “Proprietary Alexia Blend”, a trade-secret formula without the disclosure from the manufacturer. We reached out to Alexia Breast Reduction for comment but have had no response to date. 

“It’s very much buyer beware and I’m doubtful that this product delivers what it advertises to consumers. There seems to be no published clinical data relating to the effectiveness of these products on breast reduction or increasing breast firmness” – Dr Melanie Palm, medical dermatologist and cosmetic surgeon

The list goes on to include theobromine cacao, which in high doses, could cause severe headaches, sweating and trembling, and there are no published clinical studies demonstrating any health benefit of theobromine on breasts or breast size. It also contains caffeine, which Dr Palm notes as being an appetite suppressant and that a British Journal of Cancer 2008 study found that women consuming three or more cups of coffee daily had a modest decrease in breast size. Dr Palm advises those with heart conditions to consult a specialist before taking any caffeine supplementation. While many of the ingredients listed were “safer” than the others, including green tea extract and sclareolide, a plant-derived chemical compound, Dr Palm is sceptical that they would have any real impact on breast size. 

Even with the potential side effects and the risk of fake medication – a 2010 report on safe medicines in Europe found 62 per cent of medicines bought online were substandard or fake – it seems people are still willing to take the gamble. Rebecca, based in Essex, UK, was one of them. After ordering breast reduction pills online (available for $39.99 on Amazon) because of weight gain and back pain, they arrived in packaging that “looked like it was printed on someone’s home printer”. The pills themselves, which were in a packet of 60 capsules (one to be taken per day), she explains, “smelled terrible” and caused a myriad of symptoms after just a week of taking them. “I first felt incredibly bloated, then felt out of it and just strange so I went to my doctor. He took one look at the bottle and told me to stop taking them, and I didn’t even go down half a bra size.” 

Derrick, based in Los Angeles, USA, however, had a neutral experience when ordering Gynexin (available on Amazon for $87.87), in the hope of slightly reducing the size of his breast tissue because of the insecurities of having “man boobs”. After reading reviews such as “Literally, my moobs dropped off the second I took these pills”, he was hopeful that they’d help him to confirm to the masculine ideal of having a tight chest. “I only tried one bottle but I did feel tighter in my chest and saw the puffiness of my nipples go down,” he explains. “I did start on them the same time I started working out and eating more vegetables, so I don’t know if it worked or if I just lost weight.” Working out while taking the pills, scanning through many reviews online, seems to be a commonality in those who claim its effectiveness. 

Yet, ultimately, no matter what the brand claims or reviews state, Dr Palm reminds us that ordering supplements like these online misses a crucial step in making a health decision: consulting with a doctor. “Generally speaking, I don’t recommend any of my patients taking a prescription or non-prescription oral medication or supplement that could potentially alter any of their organ systems or tissues without reviewing it with their physician first,” she says. “Supplements are not regulated by the FDA in the same way a prescribed medication is. It is very much buyer beware and I’m doubtful that this product delivers what it advertises to consumers. There seems to be no published clinical data relating to the effectiveness of these products on breast reduction or increasing breast firmness.” The lack of research reflects our blasé approach to “wellness” fads and diets.  

In an era where laxative products like Skinny Me Tea are being sold to us through Khloe Kardashian’s Instagram account, “miracle” fat burning products have never been more accessible and we are all too eager to buy health products online without professional medical advice. Common insecurities can lead people towards the animosity of an online transaction, often after encouragement from social media, instead of to a doctors office. With that in mind, products targeting specific “embarrassing” areas of the body feel exploitative. It’s not hard to imagine a scenario where a young male bullied for his breast size, or a person looking to start transitioning, would look for an anonymous “solution” online. 

Instead of rolling the dice by ordering breast reduction pills (or any weight loss supplements) online, Dr Palm suggests those concerned with their breast size instead of having a discussion with a physician that specialises in the area of breast health. There, breast cancer, weight and hormonal changes can be considered during the evaluation. This makes breast reduction pills yet another reminder of a lesson taught to many of us by our parents: a “quick fix” is often an ineffective one, and potentially dangerous.