Breast Reduction

You may be unhappy with the size of your breasts for aesthetic reasons, functional reasons or both. Reducing the size of breasts can lead to a boost in self-esteem and also a greater ease in responding to the challenges of everyday life. Some candidates for breast reduction report difficulty exercising and finding clothing, as well as issues like back and shoulder pain.

Breast reduction surgery, also known as reduction mammaplasty, can be performed on individuals of various ages. However, it’s crucial to understand that if the procedure is done on a younger woman, there’s a possibility that a second surgery might be necessary later in life. This is because breasts undergo natural changes in size and shape due to factors such as aging, fluctuations in body weight, hormonal shifts (including those caused by pregnancy and menopause), and other physiological processes. If you’re planning to breastfeed or lose weight, this might not be the right time for the procedure.

Breast reduction is generally a safe operation with high patient satisfaction. However, like any other surgery, it has some potential risks. These include difficulty with breastfeeding, scarring and losing sensation in the nipples.

Benefits include relief from chronic back, neck, and shoulder pain, prevention of deep grooves from bra straps digging into the skin, reduction of skin irritations and rashes beneath the breast fold, and improved ability to engage in physical activities without restrictions or discomfort. By reducing the excessive weight and strain on the body, breast reduction surgery can significantly enhance an individual’s overall quality of life, both physically and psychologically.

Depending on your baseline health and desired outcomes, breast reduction surgery may be combined with other procedures such as tummy tuck (abdominoplasty) or liposuction. However, combining these procedures can lengthen time of surgery and recovery, as well as increase the overall risk of complications, especially if your health is not optimized.

Be sure to discuss all your options, as well as the attendant benefits and risks, with your plastic surgeon. Pre-operative clearance by your primary doctor or specialist is essential.

In a breast reduction, your surgeon typically makes an incision around the nipple-areola complex and down each breast. The nipple-areola complex refers to the area where the darker patch of skin around the nipple meets the surrounding breast skin.

The surgical approach to breast reduction involves making precise incisions to remove excess breast tissue and skin, while reshaping and repositioning the remaining tissue for a more proportionate and lifted appearance. There are two common incision patterns that may be employed by your surgeon.

The first is the anchor or inverted-T incision, which involves three separate incisions: one encircling the areola, one vertical line extending from the bottom of the areola to the breast crease (known as the inframammary fold), and one horizontal incision along the natural curve of the breast crease.

The second technique is the vertical or lollipop incision, consisting of two incisions: one around the areola and one vertical line from the areola’s bottom edge to the breast crease, without the additional horizontal incision.

Both methods allow for precise tissue removal and reshaping. The difference is that the anchor incision provides greater access for more extensive reductions, while the lollipop incision may result in less visible scarring for smaller reductions.

There are other surgeries that can alter the shape of your breasts, such as a breast lift (mastopexy). That procedure, which can improve the size, shape and projection of the breasts, may be done at the same time as a reduction. Be sure to discuss all the available options, along with attendant benefits and risks, during a consultation with your surgeon.

Before you go

Before considering a breast reduction, your surgeon will review your prior procedures, medical history, and your medications. They might also require blood work or other testing to make sure you are a good candidate for surgery.

After the medical evaluation has been completed, be sure to have an open and honest discussion about your goals, concerns and expectations. Visual aids, like before-and-after photos, are always helpful. Discussing these examples will help ensure that you are on the same page and that the surgeon can tailor the procedure to your specific needs.

Your surgeon will provide you with specific instructions to follow before the surgery, such as stopping certain medications (blood thinners, aspirin, supplements, ibuprofen, etc.), quitting smoking, or adjusting your diet. Adhering to these instructions is crucial for a smooth recovery and minimizing the risk of complications.

During the procedure

Breast reduction is performed under general anesthesia, so you will be pain-free during the procedure. Your vital signs will be closely monitored throughout the operation to ensure your safety and well-being.

During the surgery, which typically lasts several hours, your physician will skillfully make predetermined incisions and meticulously remove excess breast tissue, fat, and skin. The remaining breast tissue will be reshaped and repositioned to achieve a more proportionate and lifted appearance. When the surgery is complete, the incisions will be closed with sutures or surgical adhesives, and you will be taken to a recovery area with attendant medical staff.

Breast Reduction Aftercare 

It is imperative to thoroughly review and understand all the post-surgery instructions provided by your surgeon. These will include crucial guidelines for your recovery process, such as wound care, necessary medications, activity limitations, and any potential issues to watch for. Following these will help ensure a smooth and successful recovery, minimizing the risk of complications and promoting optimal healing.

Your surgeon will likely advise you to have a designated caretaker during the initial recovery period. Ensure that both you and your caretaker clearly understand and meticulously follow these post-operative instructions.

After surgery, you will usually not need drains, unless a very large volume of breast tissue has been excised. If you do have drains, these will remain until your first clinic visit a week or two after surgery.

There will be dressings over your incision and you will be wearing a supportive bra. It’s not uncommon to notice mild bruising. Pain is usually managed with over-the-counter and prescription pain medications, as needed.

In most cases, you should be able to go home the same day as the surgery. You will be able to resume everyday activities at around two to three weeks after surgery and exercise at around six to eight weeks after surgery.