Breast reduction (reduction mammaplasty) is a surgical procedure aimed at removing excess breast fat, glandular tissue, and skin to achieve a more proportionate breast size with your body and alleviate discomfort caused by overly large breasts (macromastia).
Disproportionately large breasts can cause both physical and emotional distress for patients. Those with macromastia may experience physical discomfort due to the weight of their breasts. In addition to physical discomforts of macromastia, some patients may also experience emotional distress or mental health issues as a result of having large breasts.
While breast reduction surgery is often performed to address medical issues, patients who are not experiencing symptoms of macromastia but are unhappy with the size of their breasts can also undergo breast reduction as an aesthetic procedure. Patients opting for breast reduction for cosmetic reasons may cite various factors, including social stigma and wardrobe concerns.
There are three commonly used techniques for breast reduction surgery: the graft technique, vertical (lollipop) breast reduction, and inverted T (anchor) breast reduction. The best way to determine which technique is right for you is to consult with a board-certified plastic surgeon face-to-face. Understanding each technique is crucial preparation for a consultation.
Lejour (Lollipop Watch Breast Reduction)
Reverse T Watch Breast Reduction
Breast Reduction with Graft Technique
Before Breast Reduction Surgery
It is important to follow your surgeon's instructions regarding vitamins you can take before and after surgery. Similarly, eating balanced meals is crucial. Nicotine (cigarettes and other tobacco products) impedes healing, so it's necessary to quit using tobacco products for a period both before and after surgery to ensure proper recovery. If you are considering breast reduction surgery, you should discuss your current medical condition with your doctor. This discussion includes:
- Your physical health, including your medical history such as illnesses, conditions, surgeries, vaccinations, and your current physical condition including diet and exercise regimen. This is a good time for the doctor to check your blood pressure, temperature, heart rate/rhythm, oxygen saturation, and respiratory rate.
- Medications, vitamins, and supplements you are currently taking.
- Past reactions to medications.
- Any allergies you have.
Your surgeon will measure your breasts and may take photographs. During this time, they will discuss how much breast tissue needs to be removed to achieve the desired results. You will also learn how to prepare for the surgery and plan your recovery. Additionally, your surgeon can prepare you for the procedure by performing a mammogram and breast examination. As a result of this consultation, your doctor will evaluate the risks and potential complications of the surgery for you. They can also advise you on the preparations needed to ensure as smooth a recovery as possible after the surgery.
After Breast Reduction Surgery
Surgery Day:
The day of your breast reduction surgery can be considered your first day of recovery at home, barring extremely rare complications that might require a few additional hours of observation. You will remain in the hospital for one or two hours immediately after surgery, during which our staff can ensure a smooth post-operative recovery process despite occasional discomfort. During this time, you should inform the staff of any pain or nausea you may experience.
1-3 Days After Surgery:
After returning home from surgery, you will wear sterile dressings and a surgical bra to protect your incisions and stitches. Swelling post-surgery will be most pronounced during this time and in the following few days, causing some discomfort. Expect to feel tired and sleepy due to general anesthesia and the overall effects of surgery. You can shower 48 hours after surgery. Ensure you follow post-operative instructions diligently during this period. You will receive instructions on prescribed painkillers, antibiotics, and how to care for your incisions.
1-2 Weeks Post-Surgery:
Between 5-14 days after surgery, especially if using narcotic painkillers, you may still feel fatigued. Allow yourself to rest as needed but ensure you continue to walk short distances frequently. During this time, you will notice swelling decreasing despite lingering bruising. Start silicone sheeting or gel treatments to help your wounds heal as thinly as possible. Be mindful of your movements and avoid lifting heavy objects.
2-4 Weeks After Surgery:
Between two to four weeks, some movements may cause minor discomfort, but you will resume normal activities. It's not unusual to experience itching as your incisions heal. Swelling should be significantly reduced. Continue wearing a soft, wireless bra. You'll be able to engage in most of your normal daily activities during this time but continue to avoid strenuous activities involving your chest area.
4-6 Weeks After Surgery:
After a full month of recovery, you'll feel your energy returning and be comfortable resuming all typical daily activities. Any dissolvable stitches will likely have dissolved by now. Your doctor may allow you to start exercising or bathing. By six weeks, you'll feel comfortable sleeping on your stomach or side and have increased confidence in the strength and mobility of your chest.
Frequently Asked Questions
If you want to change your appearance or if you have large breasts that contribute to or cause the following issues, you may consider breast reduction surgery:
- Neck tension
- Headaches
- Shoulder pain
- Back pain
- Chronic skin infections under the breast fold
Breast reduction surgery can help alleviate these discomforts or reshape your breasts for a more pleasant appearance.
Possible risks of breast reduction surgery include:
- Allergic reactions to tapes, suture materials, adhesives, blood products, topical preparations, or injectable agents
- Anesthesia risks.
- Bleeding (hematoma).
- Blood clots.
- Breast asymmetry.
- Changes in breast contour and shape.
- Temporary or permanent changes in nipple or breast sensation.
- Damage to deeper structures such as nerves, blood vessels, muscles, and lungs, which can be temporary or permanent.
- Deep vein thrombosis, cardiac, and pulmonary complications.
- Excessive firmness of the breast.
- Fat necrosis in the deeper layers of the skin (fat tissue death).
- Fluid accumulation.
- Infection.
- Persistent pain.
- Poor wound healing.
- Possibility of revision surgery.
- Potential inadequacy in breastfeeding.
- Potential loss of skin/breast tissue at the junction where incisions meet.
- Potential partial or complete loss of nipple and areola.
- Changes in skin color, permanent changes in pigmentation, swelling, and bruising.
- Unfavorable scarring
All incisions will cause scarring; however, skilled plastic surgeons use meticulous technique to minimize the visibility and appearance of post-operative scarring. Most scars will be fine and will fade over time. Some risk factors for scarring cannot be controlled, such as your genetics, age, or the color of your skin.
Incision pain is normal immediately after breast reduction surgery, but most patients looking to reduce back or neck pain will feel immediate relief when the weight is fully lifted off their breasts. Understand the side effects of anesthesia and your pain medications. It's normal to experience some nausea for the first few days as you recover. Prevent your pain by taking medication at the earliest moment the pain begins, not when the pain reaches its peak. Most people can reduce or stop their pain medications three to seven days after surgery.
Breast reduction surgery has no risk of causing cancer. One of the benefits of this plastic surgery is reducing the risk of cancer. The tissues that will cause breast cancer are reduced with this surgery. The risk of cancer does not increase, on the contrary, it decreases.
There is no upper age limit for breast reduction surgery, but the decision should be made by evaluating the general health condition of the patient. The lower age limit is the completion of puberty.
You can travel after 1 week, provided that you do not miss the necessary checks. It is recommended not to drive for approximately 2 weeks due to the risk of post-operative complications.
There may be temporary loss of sensation after breast reduction surgery. Permanent loss of sensation may also occur in very large and sagging breasts, but this is not common. A few months after the surgery, the nipples regain their former sensitivity.
After your breast reduction surgery, you will need to wear a surgical bra or compression garment for about six weeks. The bra can be removed during the shower, but should be worn for the rest of the day and night. Once this six-week period is over, you can wear regular bras again, as long as they are not underwired. Underwire bras can be worn after about three months.
Most patients with an office-based job take 10-14 days off work to recover from the effects of surgery. This gives them enough time to focus on relaxing, managing any discomfort, and reducing post-operative swelling. You can return to your simple daily activities a few days after breast reduction surgery.
Scarless Breast Reduction Operation
In rare cases, in patients whose breast tissue is not excessively large and whose sagging is low or moderate, the breasts can be slightly reduced with liposuction. This can be especially applied in patients whose side chest area is full of armpit area. It should not be forgotten that there is a possibility of sagging of the breast when extensive liposuction is applied to the entire breast.