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Breast reduction surgery
By Mayo Clinic staffMayo Clinic Health Manager
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Definition
Breast reduction surgery, also known as reduction mammaplasty, is a procedure used to remove excess fat, glandular tissue and skin from the breasts. If you have large breasts, you may choose to have breast reduction surgery to alleviate discomfort or to achieve a breast size in proportion with your body. Breast reduction surgery may also help improve your self-image and self-confidence, as well as your ability to participate in physical activities.
If you're considering breast reduction surgery, consult a plastic surgeon. It's important to understand what breast reduction surgery entails — including possible risks and complications — as well as set realistic expectations.
Why it's done
Breast reduction surgery is meant for women who have large breasts and want to resolve issues such as:
- Low-hanging breasts and stretched skin
- Chronic back, neck and shoulder pain
- Chronic rash under the breasts
- Deep grooves in the shoulders from bra strap pressure
- Poor posture
- Restricted activity
- Low self-esteem
- Difficulty fitting into bras and clothing
You can have breast reduction surgery at any age — even as a teenager in some cases — but most doctors recommend waiting until you're at least age 18, when your breasts are fully developed.
If you haven't started a family or your family isn't yet complete, you might postpone breast reduction surgery until pregnancy isn't an issue. Changes to breast tissue during pregnancy could alter your surgical results. Also, breast-feeding may be difficult or impossible after breast reduction surgery.
Risks
Breast reduction surgery has the same risks as any other type of major surgery — bleeding, infection and an adverse reaction to the anesthesia. Other possible risks include:
- Loss of sensation in the nipples and areolae
- Loss of the nipples and areolae
- Scarring
- Inability to breast-feed
- Asymmetry in size, shape, position and contour of the nipples or breasts, which may lead to further surgery to improve appearance
After breast reduction surgery, it might also take time to get used to the change in your appearance. Understanding what's involved in breast reduction surgery and weighing the benefits and risks ahead of time can help you decide if breast reduction surgery is right for you.
How you prepare
Initially, you'll consult with a plastic surgeon about breast reduction surgery. During your first visit, your plastic surgeon will likely:
- Evaluate your medical history and overall health
- Discuss your expectations for breast size and appearance after the surgery
- Provide a detailed description of the procedure and its risks and benefits, including likely scarring and possible loss of sensation
- Examine and measure your breasts
- Take photographs of your breasts for your medical record
- Explain the type of anesthesia used during surgery
- Discuss cost and insurance considerations
Before breast reduction surgery, you may also be asked to:
- Complete various lab tests
- Get a baseline mammogram
- Stop smoking for a certain period of time
- Avoid taking aspirin, anti-inflammatory drugs and herbal supplements
Ask your surgeon whether you'll be able to go home the day of the surgery or whether you'll need to spend a night in the hospital. In either case, make plans for someone to drive you home after surgery and stay with you as you begin to recover.
What you can expect
Breast reduction surgery is usually done under general anesthesia, either in a hospital or outpatient surgical facility.
During the procedure
The specific technique used to reduce the size of your breasts may vary. With one common technique, the surgeon makes an anchor-shaped incision around the areola, down the breast and then horizontally in the crease under the breast. Excess breast tissue, fat and skin are then removed to reduce the size of each breast. If the amount of tissue to be removed is relatively small, your surgeon may not need to make the horizontal incision.
In most cases, the nipple and areola remain attached to the breast. If your breasts are very large and droopy, however, your nipple and areola may need to be removed and then reattached at a higher position on your breast as a skin graft. Detaching the nipple and areola from their blood vessels and nerves causes a permanent loss of sensation and can result in the inability to breast-feed.
After the procedure
After breast reduction surgery, your breasts will be covered with a gauze dressing or elastic bandages. A tube may be placed under each arm to drain any excess blood or fluid. Your surgeon may prescribe medication for pain and nausea as well as antibiotics to decrease your risk of infection. During the initial recovery period, your breasts will probably feel tender and sensitive. They may also be swollen and bruised. Scarring is permanent but may fade over time.
Talk to your surgeon about when your dressings or bandages will be removed, when — or if — your stitches will be removed, and when you can return to your regular activities.
Results
Successful breast reduction surgery can relieve pain in your upper back, neck and shoulders. It may also increase your ability to participate in physical activities and promote a more positive self-image.
If you're not happy with your results, talk to your surgeon. In some cases, another surgical procedure may be needed to help you achieve optimal results.
- Antoniuk PM. Breast augmentation and breast reduction. Obstetrics and Gynecology Clinics of North America. 2002;29:103.
- Chadbourne EB, et al. Clinical outcomes in reduction mammaplasty: A systematic review and meta-analysis of published studies. Mayo Clinic Proceedings. 2001:76:503.
- What is breast reduction? American Society for Plastic Surgery. http://www.plasticsurgery.org/Patients_and_Consumers/Procedures/Reconstructive_Procedures/Breast_Reduction.html. Accessed July 17, 2009.
- Cruz NI, et al. Lactational performances after breast reduction with different pedicles. Plastic and Reconstructive Surgery. 2007;120:35.
- Grassley JS. Breast reduction surgery: What every woman needs to know. Association of Women's Health, Obstetric and Neonatal Nurses Lifelines. 2002;6:44.
- Pruthi S (expert opinion). Mayo Clinic, Rochester, Minn. July 29, 2009.
- Walsh MF (expert opinion). Mayo Clinic, Rochester, Minn. Aug. 18, 2009.
