I want to have a breast reduction what are my options in us vs abroad?

Insurance coverage. Breast reduction is often covered by insurance so this is recommended for most patients. Surgery abroad would not be covered by us health insurance and follow up may be difficult.
Medical tourism. While medical tourism may sound very attractive unless you have done your research and can freely travel back and forth for follow up, i would discourage this.
Stay close. Breast reduction is one of the most common operations plastic surgeons perform in the United States that is covered by insurance. The safest bet is to stay local, close to where you live to be able to have the necessary close follow up required. In terms of details about the surgery is something you have to discuss with your surgeon.
Stay in US. I recommend having your procedure performed in the US by a Plastic Surgeon certified by the American Board of Plastic Surgery. The path to becoming board certified by ABPS is rigorous and will insure that your surgeon practices with the most up-to-date techniques, in the safest manner possible. Good luck!
Follow up better. Obviously, there are good surgeons around the world; however, if there is a complication or need for close follow-up after the surgery it would be difficult to fly back to the surgeon.
US surgery preferred. For any procedure, i would recommend against having surgery abroad. If problems arise after surgery then you might have problems with contacting your surgeon and/or getting evaluation and treatment. Furthermore, stateside treatment of complications may not be covered for procedures done in other countries. Seek a local plastic surgeon with a good breast surgery practice.
Stay Close... If at all possible, best to have your procedure done close to home by a well experienced board-certified plastic surgeon who can demonstrate significant experience achieving the types of outcomes you will be please with. Doing so, will allow for close follow-up and management of any complications that may arise. Best wishes.
USA. Breast reduction is one of the most common plastic surgery procedures and while there may be variations in technique most any plastic surgeon should be able to help you with this. Insurance companies often cover this so go to a board certified plastic surgeon and let them write you carrier for determination of benefit. I would see very little reason to go abroad for this procedure.
Problems. There are many fine surgeons around the world. Their fees should be similar to our fees. There are a lot of very inexpensive options also, why is it so cheap? Are the safety procedures and standards the same as ours. If you have complications will you travel back to get treated? The native bacteria is very different from ours if you can't drink the water do you want surgery?