Breast reduction is a cosmetic surgery procedure that reduces the size and weight of large, heavy breasts, helping to create a more aesthetically pleasing breast contour that is better proportioned to a patient’s body. By removing excess breast tissue, fat, and sagging, stretched skin, a cosmetic surgeon can make the breasts smaller, lighter, and firmer and improve breast symmetry and eliminate sagging.
Although breast reduction and lift surgery are often performed to address medical issues, patients who do not have the symptoms of macromastia but are unhappy with the size of their breasts can still pursue breast reduction as an aesthetic procedure. Patients choosing to undergo for cosmetic reasons may cite any number of factors, including social stigmas and wardrobe concerns.
While many patients choose breast reduction to alleviate physical symptoms such as back, neck, or shoulder pain, shoulder grooves, or discomfort while exercising, you should not overlook the cosmetic benefits of breast reduction:
- Your breast will be lifted and firmer, helping you look youthful
- Bras will fit more comfortably and attractively
- With better-proportioned breasts, your overall silhouette will be more balanced and attractive
- Stretched areolas and large nipples can be reduced during the same procedure, helping you look better in and out of clothing.
- Swimsuits, sports bras, and form-fitting clothes will look and feel better, helping boost your confidence during activity.
Who is a Good Candidate for Breast Reduction Surgery?
Overly large breasts can cause health and emotional problems. In addition to self-image issues, you may also experience physical pain and discomfort. The weight of excess breast tissue can impair your ability to lead an active life. The emotional discomfort and self-consciousness often associated with having large, pendulous breasts can be as crucial as physical discomfort and pain.
You may be a candidate if:
- You are physically healthy
- You have realistic expectations
- You don’t smoke
- You are bothered by feeling that your breasts are too large
- You have breasts that limit your physical activity
- You experience back, neck, and shoulder pain caused by the weight of your breasts
- You have shoulder indentations from bra straps
- You have skin irritation beneath the breast crease
What Should I Expect During a Consultation?
The success and safety of your breast reduction procedure highly depend on your complete candidness during your consultation. You’ll be asked several questions about your health, desires, and lifestyle.
During your breast reduction consultation, be prepared to discuss:
- Why do you want the surgery, expectations, and desired outcome?
- Medical conditions, drug allergies, and medical treatments
- Use of current medications, vitamins, herbal supplements, alcohol, tobacco, and drugs
- Previous surgeries
- Family history of breast cancer and results of any mammograms or previous biopsies
Your cosmetic surgeon will also:
- Evaluate your general health status and any pre-existing health conditions or risk factors
- Examine your breasts, and may take detailed measurements of their size and shape, skin quality, placement of your nipples and areolas
- Take photographs for your medical record.
- Discuss your options and recommend a course of treatment
- Discuss outcomes of your breast reduction procedure and any risks or potential complications
- Discuss the use of anesthesia during your procedure for breast reduction
What are the Risks of Breast Reduction Surgery?
The decision to have breast reduction surgery is highly personal. You will have to decide if the benefits will achieve your goals and if the risks of breast reduction surgery and potential complications are acceptable. Your cosmetic surgeon and cosmetic surgery staff will explain the risks associated with surgery. You will be asked to sign consent forms to fully understand the procedure you will undergo and any risks or potential complications.
Breast reduction surgery risks include:
- Unfavorable scarring
- Changes in nipple or breast sensation, which may be temporary or permanent
- Anesthesia risks
- Bleeding (hematoma)
- Blood clots
- Poor wound healing
- Breast contour and shape irregularities
- Skin discoloration, permanent pigmentation changes, swelling and bruising
- Damage to deeper structures—such as nerves, blood vessels, muscles, and lungs—can occur and may be temporary or permanent
- Breast asymmetry
- Fluid accumulation
- Excessive firmness of the breast
- Potential inability to breastfeed
- The potential loss of skin/tissue of the breast where incisions meet each other
- Potential, partial, or total loss of nipple and areola
- Deep vein thrombosis, cardiac and pulmonary complications
- Pain that may persist
- Allergies to tape, suture materials, and glues, blood products, topical preparations, or injectable agents
- Fatty tissue deep in the skin could die (fat necrosis)
- Possibility of revisional surgery
You should know that:
- Breast reduction surgery can interfere with specific diagnostic procedures
- Breast and nipple piercing can cause an infection that may limit your ability to breastfeed following reduction mammaplasty; talk to your doctor if you plan to nurse a baby.
- The breast reduction procedure can be performed at any age but is best done when your breasts are fully developed.
- Breast changes can alter previous breast reduction surgery outcomes during pregnancy, as can significantly weight fluctuations.
The practice of medicine and surgery is not an exact science. Although satisfactory results are expected, there is no guarantee. A single breast reduction procedure may not achieve optimal results, and another surgery may be necessary for some situations.
Where is Be Will Surgery Performed?
I may perform breast reduction procedures in the MSI office-based surgical facility, an ambulatory surgical facility, or a hospital. Your cosmetic surgeon and the assisting staff will fully attend to your comfort and safety.
When Do You Go Home Surgery?
If you experience shortness of breath, chest pains, or unusual heartbeats, seek medical attention immediately. Should any breast reduction complications occur, you may require hospitalization and additional treatment. The practice of medicine and surgery is not an exact science. Although satisfactory results are expected, there is no guarantee. It may not be possible to achieve optimal results with a single surgical procedure, and another surgery may be necessary for some situations.
Following your physician’s instructions is key to the success of your surgery. During healing, surgical incisions mustn’t be subjected to excessive force, abrasion, or motion. Your doctor will give you specific instructions on caring for yourself and minimizing breast reduction surgery risks. Be sure to ask questions: It’s crucial to address your questions directly to your cosmetic surgeon. It is natural to feel anxiety, whether excitement for the anticipated outcome or preoperative stress. Discuss these feelings with your cosmetic surgeon.
How should I Prepare for Surgery?
After researching the basics of breast reduction, many patients want to know what to expect before surgery. Before breast reduction surgery, you may be asked to:
- Get lab testing or a medical evaluation
- Take certain medications or adjust your current medications
- Get a baseline mammogram before surgery and another one after surgery to help detect any future changes in your breast tissue
- Stop smoking well in advance of breast reduction surgery
- Avoid taking aspirin, anti-inflammatory drugs, and herbal supplements as they can increase bleeding
The special instructions you receive will cover:
- What to do on the day of surgery
- Post-operative care and follow-up
Your cosmetic surgeon will also discuss where your procedure will be performed. Breast reduction surgery may be performed in an accredited office-based surgical center, outpatient/ambulatory surgical center, or a hospital. If your breast reduction procedure is performed outpatient, arrange for someone to drive you to and from surgery and stay with you the following night.
What are my Options for Breast Reduction Surgery?
Cosmetic surgeons can use one of several different surgical techniques when performing breast reduction. A surgeon’s technique for any given patient depends on the patient’s existing breast anatomy, the type and amount of tissue to be removed, and the patient’s desired outcome.
Liposuction for Breast Reduction
In some instances, breast reduction can be performed using liposuction alone. The advantages of liposuction for breast reduction are a shorter, less invasive procedure, virtually undetectable scars on the breast, and lasting results. However, this technique will only achieve optimal results in certain patients.
The best candidates are those who need or desire a slight to moderate reduction in breast size, have good skin elasticity and little to no sagging to correct, and whose excess breast size is due to excess fatty tissue. If you must sag, have asymmetrical breasts, stretched skin, or a more significant amount of tissue to remove, one of the following breast reduction techniques will probably benefit you the most.
Vertical or “Lollipop” Breast Reduction
Patients who need a moderate reduction in breast size and have more noticeable sagging are often good candidates for a vertical breast reduction. This involves two incision sites: one is around the edge of the areola, and a second incision runs vertically from the areola’s bottom to the inframammary fold or the crease beneath the breast.
This incision pattern allows a cosmetic surgeon to remove excess fat, skin, and breast tissue, reshape the new smaller breast internally, and lift the breast into a more youthful position. While a vertical breast reduction leaves some scarring on the breast, it is limited to the area below the nipple and, therefore, can be easily hidden beneath a bra or bikini top.
Inverted-T or “Anchor” Breast Reduction
The inverted-T breast reduction involves three incisions: one around the edge of the areola, one vertically from the areola to the breast crease, and one made along the crease underneath the breast. Because this technique allows for the maximum degree of tissue removal and reshaping, cosmetic surgeons will typically use this approach if a patient needs a more significant breast size reduction and has considerable sagging or asymmetry to correct.
The inverted-T or anchor breast reduction scars are like those from a vertical reduction, with one additional, thin scar running along the crease beneath the breast. With proper care, scars typically fade over the first year after surgery and are easily concealed by clothing, even a bikini top.
What are the Steps of Breast Reduction Surgery?
Breast reduction surgery is usually performed through incisions on your breasts with surgical removal of the excess fat, glandular tissue, and skin. The technique used to reduce the size of your breasts will be determined by your condition, breast composition, amount of reduction desired, your personal preferences, and the surgeon’s advice. If breast size is due to fatty tissue and excess skin is not a factor, liposuction alone may be used in breast reduction. In some cases, I may remove excess fat through liposuction in conjunction with the excision techniques described below.
Step 1 – Anesthesia
Medications are administered for your comfort during breast reduction surgery. Your doctor will recommend the best choice for you. The choices include intravenous sedation and general anesthesia.
Step 2 – The incision
The incision lines remain visible and permanent scars, although usually well concealed beneath a swimsuit or bra. Inclusions might be
- A circular pattern around the areola
- A keyhole or racquet-shaped pattern with an incision around the areola and vertically down to the breast crease
- An inverted T or anchor-shaped incision pattern
Step 3 – Removing tissue and repositioning.
After the incision is made, the nipple (tethered to its original blood and nerve supply) is repositioned. The areola is reduced by excising skin at the perimeter, if necessary. Underlying breast tissue is reduced, lifted, and shaped. Occasionally, the nipple and areola may need to be removed and transplanted to a higher position on the breast (free nipple graft).
Step 4 – Closing the incisions.
The incisions are brought together to reshape the now smaller breast. Sutures are layered deep within the breast tissue to create and support the newly shaped breasts; sutures, skin adhesives, and surgical tape close the skin. Incision lines are permanent, but they will fade and significantly improve over time in most cases.
What Should I Expect During Breast Reduction Surgery Recovery?
Many patients have questions about recovery from breast reduction surgery. When your breast reduction procedure is complete, dressings or bandages will be applied to the incisions. You may wear an elastic bandage or support bra to minimize swelling and support the breasts as they heal. A small, thin tube may be temporarily placed under the skin to drain any excess blood or fluid that may collect.
You will be given specific instructions for breast reduction recovery that may include:
- How to care for your breasts following breast reduction surgery
- Medications to apply or take orally to aid healing and reduce the risk of infection
- Specific concerns to look for at the surgical site or in your general health
- When to follow up with your cosmetic surgeon
Be sure to ask your cosmetic surgeon specific questions about what you can expect during your recovery.
- Where will I be taken after my surgery is complete?
- What medication will I be given or prescribed after surgery?
- Will I have dressings/bandages after surgery? When will they be removed?
- Are stitches removed? When?
- When can I resume regular activity and exercise?
- When do I return for follow-up care?
What Results Should I Expect in Breast Reduction Surgery?
The results of breast reduction surgery will be long-lasting. Your new breast size should help relieve you from the pain and physical limitations experienced before breast reduction. Your better-proportioned figure will enhance your self-image and boost your self-confidence. However, your breasts can change over time due to aging, weight fluctuations, hormonal factors, and gravity.
Will the Results of Breast Reduction Surgery Last?
After breast reduction, you can expect to enjoy smaller, lighter breasts for a lifetime, so long as you maintain a stable weight and do not have any more children. However, nothing can stop the normal aging process. Eventually, your breasts will begin to sag once again, although not as severely as they might have before breast reduction.
Also, future pregnancies are likely to change the shape, size, and appearance of your breasts, reversing some of the positive changes made during breast reduction. If you plan to have more children, talk to your cosmetic surgeon. They can help you weigh the pros and cons of having surgery or wait until you have finished having children.
Life After Breast Reduction Surgery
After about 2-3 months, your results will be in place, and you can shop for new bras with confidence. However, you may notice subtle changes for the first 6 to 12 months.