Breast Reduction
(Reduction Mammoplasty)
Definition
Breast reduction is a common surgical procedure. It is done to decrease the size of 1 or both breasts. While more common in women, this procedure can also be done in men.
Reasons for Procedure
The procedure may be done to correct:
-
Overly large breasts, resulting in any of the following symptoms:
- Poor self image
- Back, neck, or shoulder pain
- Posture problems
- Grooving and/or abrasions from bra straps
- Rash under the lower portion of the breasts
- Breast asymmetry—may be due to previous surgery to one breast, such as in the case of mastectomy or lumpectomy
- Large male breasts, known as gynecomastia—can be related to hormonal changes, medications, or other health conditions
After the surgery, your breasts will be smaller and more symmetrical in appearance. They should reflect the size, shape, and symmetry you desired.
Possible Complications
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
- Infection
- Bleeding and bruising
- Possible loss of sensation to the breast, nipple, and/or areola
- Possible loss of ability to breastfeed
- Asymmetry between breasts
- Limited arm and/or shoulder movement
- Delayed wound healing
- Scarring
- Fluid or blood-filled cysts in the healing breast tissue
- Loss of nipple, areola, skin, or breast tissue due to change in blood supply
Some factors that may increase the risk of complications include:
- Obesity
- Smoking, alcohol use disorder, or illegal drug use
- Diabetes
- Prior radiation therapy to the breast area
- Poor nutrition
What to Expect
Prior to Procedure
You may be asked to look through an album of breast sizes and shapes. This will help the doctor understand the outcome you desire. Computer software may also be used to help you determine your desired result.
Your doctor will likely do the following:
- Physical exam, including a breast exam
- Blood tests
- Mammogram
- Photos for comparison after surgery
In the days leading up to your procedure:
- Talk to your doctor about your medications. You may be asked to stop taking some medications or herbal supplements up to 1 week before the procedure.
- Arrange for a ride to and from the procedure. Also arrange for help at home after the procedure.
- The night before, eat a light meal. Do not eat or drink anything after midnight.
- You may be asked to shower before your procedure. You may be given special antibacterial soap to use.
Anesthesia
You may be given:
- General anesthesia—You will be asleep during the procedure.
- Local anesthesia—The area will be numbed.
Description of the Procedure
The area around the nipple and areola will be cut. Skin, fat, and breast tissue will be removed in a specific pattern. Depending on how much breast tissue is removed, the nipple and areola may need to be repositioned higher up on the breast tissue. Liposuction, a vacuum procedure used to remove excess fat, may also be used. The amount of scarring will depend on the amount that the breast is reduced and the amount of repositioning needed to reposition the nipple and areola. The scarring can occur around the areola, down to the breast crease, and along the breast crease.
Depending on the extent of operating required, a small flexible tube may be placed in 1 or both breasts to drain any fluid from the early phases of healing. These drains may need to stay in place for several days. They can be removed in the doctor's office. You will not need a second surgery to remove them.
The cuts in the breast skin will be closed with tiny stitches.
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Immediately After Procedure
You will be tightly bandaged around your chest, or you will have a special surgical bra. These will provide pressure and support.
How Long Will It Take?
2 to 4 hours
How Much Will It Hurt?
Anesthesia prevents pain during the surgery. You will have tenderness, swelling, and bruising of the breasts for several weeks after surgery. The pain can be controlled with medications.
Average Hospital Stay
The hospital stay may be up to 4 days. It may be possible to leave the hospital or surgery center on the same day of the procedure. Talk to your doctor to see if this is an option for you.
Post-procedure Care
At the Hospital
Right after the procedure, you will be in a recovery room where your blood pressure, pulse, and breathing will be monitored. Recovery may also include:
- Medication to control nausea
- Gradually returning to your normal diet
- Using an incentive spirometer to help you breathe deeply
During your stay, the hospital staff will take steps to reduce your chance of infection, such as:
- Washing their hands
- Wearing gloves or masks
- Keeping your incisions covered
There are also steps you can take to reduce your chances of infection, such as:
- Washing your hands often and reminding visitors and healthcare providers to do the same
- Reminding your healthcare providers to wear gloves or masks
- Not allowing others to touch your incisions
At Home
When you return home:
- You will gradually return to your normal activities.
- Your doctor may advise you to avoid heavy lifting, straining, or difficult exercise for the first week or 2 after surgery.
- Wear a special surgical bra that applies pressure. This will properly shape your breast(s) after the operation.
Call Your Doctor
It is important for you to monitor your recovery after you leave the hospital. Alert your doctor to any problems right away. If any of the following occur, call your doctor:
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
- Pain that you cannot control with the medications you were given
- Persistent nausea or vomiting
- Cough, shortness of breath, or chest pain
- Pain or swelling in your calves, legs, or feet
- You have concerns about the size and/or shape of your breasts
- Fluid or blood collecting in either breast
- Any pain or stiffness when moving your arm
If you think you have an emergency, call for emergency medical services right away.
RESOURCES:
American Society of Plastic Surgeons
https://www.plasticsurgery.org
The American Society for Aesthetic Plastic Surgery
https://www.surgery.org
CANADIAN RESOURCES:
Canadian Society of Plastic Surgeons
http://plasticsurgery.ca
A Guide to Breast Augmentation in Canada
http://www.canadaba.ca
REFERENCES:
Breast reduction. American Society of Plastic Surgeons website. Available at: https://www.plasticsurgery.org/reconstructive-procedures/breast-reduction. Accessed September 5, 2019.
Breast reduction. Brigham and Women's Hospital website. Available at: http://www.brighamandwomens.org/Departments_and_Services/surgery/services/PlasticSurg/cosmetic-procedures/breast/breast-reduction.aspx. Accessed September 5, 2019.
Breast reduction. Smart Beauty Guide—The American Society for Aesthetic Plastic Surgery website. Available at: http://www.smartbeautyguide.com/procedures/breast/breast-reduction. Accessed September 5, 2019.
Last reviewed September 2019 by EBSCO Medical Review Board Donald W. Buck II, MD Last Updated: 10/16/2020