Breast reduction, also known as reduction mammaplasty, is a procedure to remove excess breast fat, glandular tissue and skin to achieve a breast size more in proportion with your body and to alleviate the discomfort associated with excessively large breasts (macromastia).
Disproportionately large breasts can cause both physical and emotional distress for patients. Patients with macromastia may experience physical discomfort resulting from the weight of their breasts. The resulting pain can make it challenging for some patients to perform common physical activities. Along with the physical ailments of macromastia, some patients may suffer from emotional distress or more significant mental health problems as a result of their large breasts.
Although breast reduction is often performed to address medical issues, patients who do not have the symptoms of macromastia but are unhappy with the size of their breasts can still pursue breast reduction as an aesthetic procedure. Patients choosing to undergo breast reduction surgery for cosmetic reasons may cite any number of factors, including social stigmas and wardrobe concerns.
Who is a good candidate for breast reduction surgery?
Overly large breasts can cause health and emotional problems. In addition to self-image issues, you may also experience physical pain and discomfort. The weight of excess breast tissue can impair your ability to lead an active life. The emotional discomfort and self-consciousness often associated with having large pendulous breasts can be as important an issue as the physical discomfort and pain.
You may be a candidate for breast reduction surgery if:
- You are physically healthy
- You have realistic expectations
- You don’t smoke
- You are bothered by feeling that your breasts are too large
- You have breasts that limit your physical activity
- You experience back, neck and shoulder pain caused by the weight of your breasts
- You have shoulder indentations from bra straps
- You have skin irritation beneath the breast crease
What should I expect during a consultation for breast reduction surgery?
The success and safety of your breast reduction procedure highly depends on your complete candidness during your consultation. You’ll be asked a number of questions about your health, desires and lifestyle.
During your breast reduction consultation be prepared to discuss:
- Why you want the surgery, your expectations and desired outcome
- Medical conditions, drug allergies and medical treatments
- Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs
- Previous surgeries
- Family history of breast cancer and results of any mammograms or previous biopsies
Your plastic surgeon will also:
- Evaluate your general health status and any pre-existing health conditions or risk factors
- Examine your breasts, and may take detailed measurements of their size and shape, skin quality, placement of your nipples and areolas
- Take photographs for your medical record
- Discuss your options and recommend a course of treatment
- Discuss likely outcomes of your breast reduction procedure and any risks or potential complications
- Discuss the use of anesthesia during your procedure for breast reduction
The consultation is the time to ask your plastic surgeon questions. To help, we have prepared a checklist of questions to ask your breast reduction surgeon that you can take with you to your consultation.
What are the risks of breast reduction surgery?
The decision to have breast reduction surgery is extremely personal. You will have to decide if the benefits will achieve your goals and if the risks of breast reduction surgery and potential complications are acceptable.
Your plastic surgeon and/or plastic surgery staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks or potential complications.
- Possible breast reduction surgery risks include:
- Allergies to tape, suture materials and glues, blood products, topical preparations or injectable agents
- Anesthesia risks
- Bleeding (hematoma)
- Blood clots
- Breast asymmetry
- Breast contour and shape irregularities
- Changes in nipple or breast sensation, which may be temporary or permanent
- Damage to deeper structures – such as nerves, blood vessels, muscles and lungs – can occur and may be temporary or permanent
- Deep vein thrombosis, cardiac and pulmonary complications
- Excessive firmness of the breast
- Fatty tissue deep in the skin could die (fat necrosis)
- Fluid accumulation
- Pain, which may persist
- Poor wound healing
- Possibility of revisional surgery
- Potential inability to breastfeed
- Potential loss of skin/tissue of breast where incisions meet each other
- Potential, partial or total loss of nipple and areola
- Skin discoloration, permanent pigmentation changes, swelling and bruising
- Unfavorable scarring
You should know that:
- Breast reduction surgery can interfere with certain diagnostic procedures
- Breast and nipple piercing can cause an infection
- Your ability to breastfeed following reduction mammaplasty may be limited; talk to your doctor if you are planning to nurse a baby
- The breast reduction procedure can be performed at any age, but is best done when your breasts are fully developed
- Changes in the breasts during pregnancy can alter the outcomes of previous breast reduction surgery, as can significant weight fluctuations
The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single breast reduction procedure and another surgery may be necessary.
What results should I expect after breast reduction surgery?
The results of breast reduction surgery will be long-lasting. Your new breast size should help relieve you from the pain and physical limitations experienced prior to breast reduction.
Your better-proportioned figure will likely enhance your self-image and boost your self-confidence.
However, over time your breasts can change due to aging, weight fluctuations, hormonal factors and gravity.
What is breast reduction surgery like?
The weight of a set of large droopy breasts can often lead to a rather flat upper part of the chest, with a good portion of your breasts sitting towards the centre to lower part of the chest wall. A breast reduction operation usually requires re-arrangement of your breast tissue, which will result in an auto-augmentation type effect – leading to a more lifted shape after surgery. Most patients are pleasantly pleased by this effect and feel great about themselves.
Is breast reduction surgery risky? Is it painful?
Provided you are fit healthy and well, and of an appropriate weight, breast reduction surgery is very safe. There are always risks and complications associated with every surgical procedure (as above) which will be discussed with you at the time of your personalised consultation.
Most patients don’t find they suffer from any significant debilitating pain after the operation, and are fairly comfortable on a regular dose of simple pain relief such as panadol and/or ibuprofen. Most stay overnight to ensure they are able to care for themselves prior to being discharged home the next day.
What should I do after a breast reduction surgery?
Rest and recover. You will have swelling after the operation so you will need to wear a soft supportive bra for 6-8 weeks to assist the healing process which will also reduce the amount of pain and discomfort. Make sure the bra doesn’t have an underwire because it will otherwise be quite uncomfortable and press on the wounds at the breast crease.
What is the right age for breast reduction?
Frequently, girls can become quite debilitated in their late teens with overly large breasts that cause back and shoulder pain, and cause embarrassment and restrictions during physical activity and sports. It is not recommended that these girls undergo breast reduction surgery until they have finished puberty and reached full development.