Breast reduction is a surgical procedure that aims to reduce breast size. It is often chosen by women facing health issues due to the size of their breasts, as well as by those seeking to regain comfort and self-confidence.
Ideal Candidates
- Women with excessively large breasts that interfere with daily activities, such as sports.
- Women experiencing back, neck, and shoulder pain.
- Deep grooves on shoulders from bra straps.
- Reduced quality of life due to breast size.
- Frequent skin irritation or rashes under the breasts.
Consultation
Proper preparation is essential before surgery. During the consultation, the plastic surgeon will discuss:
- Your medical history, current medications, and dietary supplements.
- Allergies.
- Previous surgeries.
- Family history of breast cancer.
- Assessment of breast size, shape, nipple position, and skin quality.
- Available surgical options and answers to any questions you may have.
Preoperative Preparation
- Blood work and basic pre-op tests such as ECG and chest X-ray. Additional tests may be needed depending on individual health.
- Pre- and post-operative mammograms are required to monitor any future changes in breast tissue.
- Avoid aspirin, anti-inflammatory medications (ibuprofen, diclofenac, etc.), or supplements that may increase bleeding risk.
- Smoking must be stopped well before and after the surgery.
Breast Reduction Techniques
Several modern reduction techniques are available, and the most appropriate one is chosen based on breast size, shape, skin quality, excess skin, and nipple position.
An important goal is to preserve nipple sensation and ensure the possibility of future breastfeeding.
One common technique is the inverted-T or anchor incision, which circles the areola, goes vertically down, and follows the natural fold of the breast.
Excess skin, fat, and glandular tissue are removed, and the nipple-areola complex is repositioned higher.
Other approaches include:
- Periareolar incision
- Periareolar with vertical incision
The Procedure
The operation begins with careful markings on the breast to guide the surgeon during surgery. This step is crucial for achieving a well-shaped result, as it defines what tissue will be removed and what will remain.
The procedure is performed under general anesthesia.
After the initial incisions, the areola is reduced in diameter and moved to its new, higher position. Excess skin, fat, and glandular tissue are removed.
The wounds are closed in layers, and the breast is dressed and supported to assist healing. Drains may be placed if necessary. The procedure usually lasts about 3 hours.
Postoperative Instructions
- Patients typically return home the day after surgery.
- Nipple numbness is common immediately after surgery but usually resolves within 1–2 months.
- Avoid pressure on the area for the first 2 weeks to minimize complications.
- Avoid strenuous activity, lifting, pushing, reaching overhead, and intense exercise for 3–4 weeks.
- If drains are placed, they are usually removed within a few days.
- You will need to wear a surgical bra or compression garment to reduce swelling and support the breasts during healing.
- Rest during the first week but avoid staying in bed all day. Gradually increase activity starting from the second week.
- Plan to take 2–4 weeks off from work or daily obligations.
Possible Complications
As with any surgery, complications may occur, including:
- Temporary or permanent nipple numbness (usually improves over time)
- Hypertrophic or thick scars (depends on individual healing)
- Infection requiring antibiotics
- Hematoma (blood collection)
- Breast asymmetry
- Reduced ability to breastfeed
- Fat necrosis
- Partial or total nipple loss
- General surgical risks: deep vein thrombosis, cardiac or pulmonary complications
Patients should understand that all surgical incisions heal with scarring, which is a normal and expected part of the healing process. Scars are initially red and prominent but fade significantly over time.
Several factors influence optimal healing: individual skin type, surgical technique, minimizing tension at closure, avoiding infection, and proper wound care.
References
- Liu D., et al. (2023). Risk Factors and Complications in Reduction Mammaplasty: A Meta-Analysis. Aesthetic Plastic Surgery.
https://pubmed.ncbi.nlm.nih.gov/37253843/ - Oliveira J.A., et al. (2025). The Risks Potentially Associated with Higher Total Resected Weight in Reduction Mammaplasty – Systematic Review and Meta-Analysis. Journal of Plastic, Reconstructive & Aesthetic Surgery.
https://www.jprasurg.com/article/S1748-6815(24)00702-2/fulltext - Benedict K.C., et al. (2023). Oncoplastic Breast Reduction: A Systematic Review of Postoperative Complications. Plastic and Reconstructive Surgery – Global Open.
https://journals.lww.com/prsgo/fulltext/2023/10000/oncoplastic_breast_reduction__a_systematic_review.35.aspx
