A breast reduction, or reduction mammoplasty, is a cosmetic surgery procedure designed to reduce the size of the breasts by removing excess fat, tissue and skin. Many women choose to undergo this procedure to seek relief of physical and emotional stress caused by overly large breasts, rather than for simple cosmetic reasons. If you are thinking about reduction mammoplasty, learn more about the steps to take before surgery, what the breast reduction procedure will entail, and what to expect after breast reduction surgery. Breast reduction surgery can also be performed on men suffering from gynecomastia, or ‘man boobs’. Have a look at some of our breast reduction photos for men and women.
Although many women are desperate to have bigger boobs, having overly large breasts can cause a lot of mental and physical stress. Women with very large breasts often suffer from back and neck pain, problems sleeping and breathing, sore shoulders from bra straps digging in and rubbing the skin under the weight of the breasts and even breathing problems. Many women feel very self-conscious about having large boobs and find that certain activities, such as running, are restricted because they can be very uncomfortable. In some cases, oversized breasts can cause hygiene problems because the breasts hang against the underlying skin, leading to irritation, rashes, and infections.
Breast reduction differs from other forms of breast surgery as it is not a purely cosmetic procedure. This means that in some cases it may be performed on teenagers where the emotional and physical stress caused by having large breasts is severe. In most cases it is advisable to wait until the breasts have finished developing.
Breast reduction surgery is not usually recommended for women who intend to breast feed, because the procedure removes many of the milk ducts that lead to the nipples. Also women who are extremely obese or who have heart, lung or kidney problems may not be good candidates.
Heavy smokers are also not ideal candidates for any type of surgery as they are at more risk when undergoing general anaesthetic. If you do smoke, you’ll be asked to stop at least two months before the procedure, as smoking can also delay the healing process.
Only a qualified cosmetic surgeon can determine whether a breast reduction is right for you, but providing you are fit and healthy and have realistic expectations of what can be achieved then surgery can be a great way of giving you more confidence in the way you look.
Undergoing any form of plastic surgery is a big step so make sure you have thought about it carefully and come to an informed decision. You should also never consider having surgery if you are being pressured into it by someone else.
Breast Reduction for Men
Men may undergo a breast reduction if they have abnormally large breasts, a medical condition referred to as gynecomastia. This occurs quite frequently, affecting one or both breasts in an estimated 40- 60%of men.
Ideal candidates for male breast reduction are those with elastic skin that can be easily reshaped, producing excellent breast reduction results. The surgery is not recommended for men who are overweight or obese. Doctors often encourage these patients to try traditional weight loss methods before undergoing breast reduction surgery.
Certain medical conditions and the use of drugs such as steroids have been linked to gynecomastia; however, the cause of the condition is not always known.
Men who have this condition often experience feelings of shame, emasculation, and embarrassment. It is therefore important that male patients choose a breast reduction surgeon they feel comfortable with. Men who drink alcohol in excess or smoke marijuana are generally discouraged from undergoing breast reduction surgery since both alcohol and marijuana have been linked to the condition.
Breast reduction surgery carries some of the biggest benefits of any cosmetic surgery procedure. Because it is not just a cosmetic procedure it has additional benefits to simply making your breasts look better. It can relive years of back and neck pain, problems sleeping and breathing and restriction of activity.
Having very large breasts can also dramatically affect your self-esteem so many women find a renewed sense of confidence after this surgery. It also enables you to wear a wider selection of clothes and more flattering underwear.
Breast reduction for men also known as gynecomastia is a surgical procedure which occurs quite frequently, affecting one or both breasts in an estimated 40- 60%of men. Men who have this condition often experience feelings of shame, emasculation, and embarrassment. After breast reduction surgery they feel physically and mentally more confident in their daily lives.
Results differ from person to person however, so you need to make sure you have reasonable expectations of what the surgery can do for you. To find out more about the benefits of breast reduction look at our other sections on what happens during breast reduction surgery, before and after photos and also how much a breast reduction costs.
Risks include swelling, bruising, infection, scarring, loss of nipple sensation, nerve damage, asymmetry, uneven nipple height, interference with breast-feeding and reaction to general anesthetic. The risk of these complications occurring can be minimized by carefully picking your surgeon, following the post-surgery recovery instructions and the type of implant you choose.
Swelling is very common following any breast surgery. It can take three to five weeks to go completely and wearing your recommended supportive surgical garments will help.
Bruising is fairly common after any surgery although not everyone will experience it. The amount of bruising you get will depend on how your surgery is performed and varies from person to person. While bruising is usually very minimal, if you have any large, firm, painful areas of bruising, contact your surgeon immediately as there is the possibility of developing a hematoma, which is a more serious type of bruise that will need treatment. However normal bruising should subside in one to two weeks.
Infection can occur with any type of surgery. It usually happens within one to six weeks of surgery. In the majority of cases an infection can just be treated with antibiotics. If you have also had implants and contract a serious infection, they may need to be removed. Symptoms of infection include fever as well as severe tenderness, redness, and swelling. To avoid getting an infection, make sure you keep the area around your stitches clean and avoid putting creams or deodorants near it. You should also not submerge yourself in a bath or swimming pool during the recovery period.
Scarring will occur with any kind of surgery. The locations of your scars will depend on the technique used by your surgeon. Your scars will be firm and pink for approximately six weeks and will fade over the next few months but never disappear completely. Various topical medications are available to help minimize the appearance of scars.
Loss of or increased nipple sensation is one of the most common side effects of breast reduction surgery and can be permanent, especially if the areola has been removed and then grafted. Although grafting the areola places the nipple in the correct position aesthetically, the detachment from the breast tissue may cause a loss of sensation in the nipples. It is important to discuss this risk with your surgeon when deciding which type of reduction technique is used. It is important to remember that temporary loss of feeling is very common as the nerves that bring sensation to the breast are severed during surgery. It may take several months for these nerves to regenerate and for sensation to return. There is a higher risk of permanent sensation loss when significant re-positioning of the nipple is necessary.
Asymmetry of the breast is another possible complication following surgery, although this is rare. Because everyone heals differently, some women will experience small differences in the size or shape of breasts after breast reduction surgery. Asymmetrical nipple placement may also be apparent after surgery. In most cases the asymmetry is minor however, if the asymmetry is extreme, it can be revised through an additional surgery. Although very uncommon there is the possibility of significantly asymmetrical breasts after surgery. It is important to note that most breasts are not completely symmetrical so you will not need to have additional surgery if the difference in size and shape is only slight.
Uneven nipple height is another possible complication. This is because in some breast reduction techniques, the nipple and areola will be removed and grafted back on the breast. In other instances, the nipple will remain intact, but the breast skin will be altered to fit the smaller sized breasts. In both methods of breast reduction, there are risks that the nipples and areolas will become uneven between breasts.
Interference with breastfeeding is another common side effect of breast reduction surgery so you are advised to wait, if possible, until after you have finished having children. The risk varies depending on the surgical technique used for your breast reduction. Traditional anchor breast reduction surgery increases risks affecting the ability to breastfeed. During this type of breast reduction, many of the milk ducts are removed during surgery, making it more difficult to breastfeed in the future. Women that have the vertical incision breast reductions have a greater chance to be able to breastfeed since at least a portion of the nipple will remain connected to milk ducts during this mammoplasty procedure. Breastfeeding breast reduction risks are often avoided if the patient has more fat tissue than glandular tissue and breast reduction through liposuction is utilised (known as the scar-less technique). This breast reduction technique leaves the glandular and connective tissue largely untouched.
There is also always a risk associated with undergoing general anesthetic. You can experience side effects from anesthesia, such as a sore throat, headache, dizziness, nausea, vomiting, shivering, or muscle pain but these are usually temporary. It is very important that you let your surgeon know if you have experienced any reactions to anesthesia in the past.
Serious side effects and complications with breast reduction surgery are very unusual, however it is important to remember that if you do suffer complications you may require additional surgery to repair the damage. Is a very safe procedure when performed by a qualified plastic surgeon, however, as with all surgeries, there are risks, which should be carefully considered before you make the decision whether or not to go ahead.
Before making the decision to undergo breast reduction surgery, you should find out as much information as possible about the procedure, the plastic surgeon and hospital you are being treated at.
Always discuss the procedure with your clinic or hospital and make sure you have a consultation of at least an hour with your cosmetic surgeon before going ahead. Do not be afraid to ask any questions and make sure all of your concerns are addressed before you sign on the dotted line. The most important thing is to make an informed decision that you feel confident about.
A thorough consultation should involve your plastic surgeon taking a full medical history to ensure that there are no reasons why you shouldn’t have the procedure done. You will also be asked to sign a consent form to say you have understood both the benefits of surgery and breast reduction complications. It is very important that you read this form carefully. Most plastic surgeons will also take before and after photographs to give you a comparison later.
During your consultation, your surgeon will examine you and measure your breasts. They will then discuss your options with you. They will also talk to you about the type of surgery you can have which will determine where your scars are and where your nipple and areola will be positioned. They will also discuss the factors that may affect the operation, such as your age, the size and shape of your breasts, and the condition of your skin.
To prepare for your breast reduction surgery you should:
- Avoid taking aspirin or anti-inflammatory drugs for a period of 10 days before your surgery, because they cause the blood to thin and make surgery more dangerous
- Give up smoking at least two months before the breast reduction procedure, as it increases the risks and can delay the healing process
- On the day of breast reduction surgery, you should wear loose-fitting clothes that can be removed and replaced easily
Your breast reduction will be performed at a hospital and usually doesn’t require an overnight stay. The operation takes a few hours but this will depend on each individual case and whether the breast reduction is combined with another procedure such as a breast lift known as a breast reduction with lift. You will be put under general anaesthetic during the procedure.
There are several different techniques that can be used including ‘anchor’ incision or traditional breast reduction, vertical incision breast reduction and scar-less breast reduction. Your surgeon will discuss these options with you so you can agree on the best technique for you.
Whichever option you and your plastic surgeon agree on, the operation will involve incisions being made on and around your breasts and excess fat and skin being removed. Your nipple will also be removed and re-positioned. The technique your surgeon utilizes will determine where your scars are.
As with any cosmetic surgery, breast reduction recovery takes time. You will most likely be drowsy and sore for a day or two so it is a good idea to have a friend or relative drive you home and help you for a couple of days until you feel a bit better. Although you should be up and around after about 48 hours, there may be some side effects which can last for a couple weeks to a month so you should follow your surgeon’s instructions closely during this healing period.
Breast Reduction Recovery
You can be quite swollen and bruised after breast reduction surgery and your breasts may also be quite sensitive and tender for a few weeks. You will be sent home with bandages and surgical bra, which will be removed after a couple of days. You may also have a drain (to drain excess fluid) as drainage of fluid and crusting is a normal side effect.
You will wear the surgical bra for the first few days after surgery. This bra is then replaced with a support bandage or sports bra, which is to be worn at all times for at least four weeks after surgery.
Discomfort, swelling, and bruising usually lasts from two to three weeks so you may be prescribed pain medication during your first week of recovery.
Your breasts may swell and become tender during your first period after surgery. You may also experience sporadic pains for a few months. Any contact with the breasts should be gentle for four to six weeks following breast reduction surgery. Altered sensations of the breast skin and nipple are common symptoms following surgery so it is advisable to refrain from sexual activity for a couple of weeks, as sexual arousal can cause inflammation around the incisions.
You should avoid bending over, exercising or performing any strenuous activities that put unnecessary pressure on the chest for at least four weeks, as this can slow the healing process and lead to excess swelling and bleeding. You should also avoid sleeping on your stomach for the first two weeks, and are advised to sponge bathe until the sutures are removed one to two weeks after your surgery.
Most women are able to return to work and normal activities two weeks after having a breast reduction, but for some people it may be longer. Don’t attempt to rush your recovery however as it may have the reverse effect and prolong things. If you need to take more time off work, do it.
It can take six months to a year to fully recover from your surgery and the final results can be seen. To ensure that your breasts are healing properly you should attend follow-up appointments for several months after surgery.
Numbness of the breast and nipple may be experienced by for up to a year following breast reduction surgery, while others may experience increased sensitivity. In some cases, this numbness can be permanent.
Your scars will be very noticeable for the first few months, often appearing red and lumpy. The scars will continue to fade into thin white lines over the next several months, but will never go away completely. Several treatment options are available to reduce the appearance of scars, including cortisone creams and silicone sheeting. Because of the benefits of breast reduction surgery, many women feel that scars are a fair trade-off. However, in some cases, abnormal scars can form, causing undesirable results.
The surgical technique used during your breast reduction surgery procedure will also influence the appearance of your scars. Your plastic surgeon can help you understand the typical scarring associated with the standard (anchor) breast reduction surgery, vertical incision breast reduction and scar-less breast reduction and determine which is appropriate for you.
To make sure your scars heal as well as possible, make sure you stick religiously to the recovery instructions given to you by your surgeon. If you have any concerns during your recovery discuss them with your surgeon.
Contact your breast reduction surgeon immediately if you notice any signs of infection or if you experience bleeding or a sudden increase in pain.
There are a number of different techniques used for breast reduction surgery. Which one you have will be determined by the size and shape of your breasts.
The three most common Breast Reduction Surgery techniques are:
- Traditional or ‘anchor’ incision breast reduction
- Vertical incision breast reduction surgery
- Scar-less breast reduction
Traditional or ‘anchor’ breast reduction
The anchor incision method is a standard breast reduction technique where, the surgeon begins the procedure by making an incision around the nipple, vertically down to the crease of the breast, and horizontally along the crease in an anchor shape.
The surgeon will remove skin, fat, and tissue from the lower breast area to reduce the mass of the breast. The nipple and areola will be moved to a higher location on the breast, but not removed from the breast mound itself. There are a small percentage of patients that may experience loss of sensation and feeling in the nipples. This still remains one of the most common breast reduction risks. With extremely large breasts, it may be necessary to entirely detach the nipple and areola from the breast, and graft it to the upper half of the breast. The only downside to this is that you will lose all feeling in the nipple area. After the nipple is moved to its new position, the skin above the nipple is brought down and around the swell of the breast, and then stitched back to close the original incision.
Vertical incision breast reduction surgery
The vertical incision breast reduction surgery is a new technique, which is less invasive and has the benefits of fewer scars, and results last for longer. However, many doctors don’t offer this incision technique yet. If you are interested in this procedure, be sure to choose a breast reduction surgeon with the experience and abilities to perform the technique. In a vertical incision breast reduction, your doctor will make a ‘lollipop incision’ around the areola and down the breast. After removing breast tissue and skin, the surgeon will then stitch up the incision by pleating the excess skin over itself on the breast. The nipple can still be moved up in a method similar to that of the standard procedure, but not more than a few millimetres. This incision technique is generally a good idea for women with moderately large breasts, but may not produce the best results for patients with extremely large bust lines.
Scar-less breast reduction
Scar-less breast reduction surgery, involves using liposuction to remove breast tissue through very small incisions. The resulting scars are only a few millimetres wide and are discreetly located in the crease of the breast or in the armpit.
If you have a large proportion of fat in your breasts compared to glandular tissue you could be suitable for scar-less breast reduction. The benefits if this technique are fewer scars, less trauma to breast tissue, and a reduced chance of possible breast reduction complications. Liposuction only removes fat tissue, not connective tissue, and is generally not considered for thinner women with large breasts. It is also not recommended for women with pendulous, or very large, dense breasts. Depending on your breast size and shape, and the surgical incision chosen, your surgery should produce positive breast reduction result.
Meet the experts featured
on our global TV Series
Dr. Dilip Madnani
Dr. Marina Peredo
Dr. Jayson Oates
Dr. Lauren Bramley
Dr. Catherine Stone
Dr. Nicole Yap
Dr. Sean Kelishadi
Dr. William Mooney
Dr. Dilip Madnani