Breast reduction is a common surgical procedure. It is done to decrease the size of one 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.
Complications are rare, but no procedure is completely free of risk. If you are planning to have a breast reduction, your doctor will review a list of possible complications, which may include:
- 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
- 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:
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
- 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 one 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.
You may be given:
- General anesthesia —You will be asleep.
- 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 one 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.
Breast Reduction Procedure
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 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 four 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.
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
When you return home, follow these steps:
- 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 two after surgery.
- Wear a special surgical bra that applies pressure. This will properly shape your breast(s) after the operation.
- Be sure to follow your doctor’s instructions.
Call Your Doctor
After you leave the hospital, contact your doctor if any of the following occur:
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
- Nausea and/or vomiting that you cannot control with the medications you were given after surgery, or which last for more than two days after you leave the hospital
- Pain that you cannot control with the medications you have been given
- 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
In case of an emergency, call for emergency medical services right away.
American Society for Aesthetic Plastic Surgery
American Society of Plastic Surgeons
Canadian Society of Plastic Surgeons
A Guide to Breast Augmentation in Canada
Breast reduction. The American Society for Aesthetic Plastic Surgery website. Available at: http://www.surgery.org/consumers/procedures/breast/breast-reduction. Accessed September 8, 2014.
Breast reduction. American Society of Plastic Surgeons website. Available at: http://www.plasticsurgery.org/Reconstructive-Procedures/Breast-Reduction.html. Accessed September 8, 2014.
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. Updated July 24, 2014. Accessed September 8, 2014.
Last reviewed August 2014 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.