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Breast reduction surgeryBy Mayo Clinic staff
Original Article: http://www.mayoclinic.com/health/breast-reduction-surgery/MY00778
Breast reduction surgery, also known as reduction mammaplasty, is a procedure used to remove excess fat, tissue and skin from the breasts. If you have large breasts, you might choose to have breast reduction surgery to alleviate discomfort or to achieve a breast size proportionate to your body. Breast reduction surgery might 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 or skin irritation under the breasts
- Deep grooves in the shoulders from bra strap pressure
- Poor posture
- Restricted activity
- Poor self-image related to large breasts
- Difficulty fitting into bras and clothing
You can have breast reduction surgery at any age — even as a teenager in some cases — but it's usually best to wait until 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 affect your surgical results. Also, breast-feeding might be challenging after breast reduction surgery — although some research suggests that breast-feeding difficulty after breast reduction surgery is related to a lack of support or coaching rather than the surgery itself.
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
- Difficulty breast-feeding
- Asymmetry in size, shape, position and contour of the nipples or breasts, which might lead to further surgery to improve appearance
- Allergic reaction to surgical tape or other materials used during or after the procedure
In addition, the risk of poor wound healing after breast reduction seems to be higher for women who have a higher body mass index.
After breast reduction surgery, it might 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 might 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
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|Breast reduction surgery|
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. Generally the surgeon makes an incision around the areola and down the breast. Excess breast tissue, fat and skin are then removed to reduce the size of each breast. 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 might need to be removed and then reattached at a higher position on your breast as a skin graft.
After the procedure
After breast reduction surgery, your breasts will be covered with a gauze dressing or bandages. A tube might be placed under each arm to drain any excess blood or fluid. Your surgeon will likely prescribe medication for pain as well as antibiotics to decrease your risk of infection. During the initial recovery period, your breasts will probably feel tender and sensitive. They might also be swollen and bruised. Be careful to avoid excessive force or movement while you're healing.
As your recovery progresses, be prepared for lingering pain in or around your breasts and numbness around your nipples. Some women also experience itchiness. Scarring is permanent but usually fades 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.
Successful breast reduction surgery can relieve pain in your upper back, neck and shoulders. It might also increase your ability to participate in physical activities and promote a more positive self-image.
Although you'll see results immediately, remember that it can take months for the swelling to completely subside and the surgical scars to fade. The final result is generally permanent — although breast shape and size can change due to factors such as aging and weight gain or loss.
If you're not happy with your results, talk to your surgeon. In some cases, another surgical procedure might be needed to help you achieve optimal results.
- Spector D, et al. Not what I expected: Informational needs of women undergoing breast surgery. Plastic Surgical Nursing. 2010;30:70.
- Sabino N, et al. Self-esteem and functional capacity outcomes following reduction mammaplasty. Aesthetic Surgery Journal. 2008;28:417.
- Breast reduction. American Society of Plastic Surgeons. http://www.plasticsurgery.org/reconstructive-procedures/breast-reduction.html. Accessed Aug. 16, 2011.
- Henry SL, et al. Risk factors and complications in reduction mammaplasty: Novel associations and preoperative assessment. Plastic and Reconstructive Surgery. 2009;124:1040.
- Spear ME, et al. The impact of reduction mammaplasty on breast sensation: An analysis of multiple surgical techniques. Annals of Plastic Surgery. In press. Accessed Sept. 26, 2011.
- Tenna S, et al. Postural variations after breast reduction: Introduction of a new technique to achieve an objective analysis. Annals of Plastic Surgery. In press. Accessed Sept. 26, 2011.
- Thibaudeau S, et al. The effects of breast reduction on successful breastfeeding: A systematic review. Journal of Plastic, Reconstructive & Aesthetic Surgery. 2010;63:1688.