A breast reduction operation, also known as mammoplasty, reduces the size and changes the shape and firmness of a woman’s breasts. You may choose to have a breast reduction operation for several reasons:

  • Comfort: Large, heavy breasts can cause neck, shoulder or back pain, posture problems, and skin irritation from bra straps.

  • Physical capability: Many large-breasted women find that enjoying sport or other physical activity is difficult as large breasts makes moving awkward.

  • Self-image: Women with excessively large breasts often feel self-conscious if their breasts are out of proportion with the rest of their body. It is also often difficult to find clothes that fit properly.

This article on breast reduction surgery is by Kathryn Senior, a freelance journalist who writes health, medical, biological, and pharmaceutical articles for national and international journals, newsletters and web sites.

Are you suitable for a breast reduction operation?

Generally, you are a good candidate for a breast reduction operation if your breast size causes you physical and emotional discomfort. Although it’s technically possible to have a breast reduction operation at any age, it’s generally advisable to wait until you’re at least 20 years old, when your breasts are likely to have stopped growing.

If you have breast reduction surgery while you’re pregnant or breastfeeding, changes to your breast tissue may mean that surgery results are inconsistent. It also may be difficult or painful to breastfeed after the surgery is performed. If you are considering breast reduction surgery and plan to breastfeed in future, you should discuss this with your doctor.

How is it performed?

A breast reduction operation is usually done using general anaesthesia, and takes around two to five hours.

Although different surgery techniques exist, the most common method of carrying out a breast reduction operation involves the surgeon making three incisions on each breast: one around the nipple, one vertically down from the nipple to the crease under the breast, and one that follows the curve of the breast crease. After the incisions are made, the surgeon will remove the excess tissue and then shift the nipple and areola to a higher position on the breast. In most cases, the areola and nipple are not removed from the underlying nerve tissue and blood vessels in order to preserve sensation and to allow for future breastfeeding. In some cases however, usually when the breasts are very large, the surgeon may remove them before reattaching them.

After the tissue has been removed and the areola and nipples are in the right position, the surgeon will stitch up the incisions and the breast reduction operation is complete.

What are the risks?

Breast reduction operations are performed on thousands of women each year, and severe complications are rare. Still, if you are considering the procedure, you should be aware of the risks that do exist:

  • A bad reaction to anaesthesia
  • Bleeding and infection
  • Blood clots
  • Breasts not being symmetrical in terms of size, shape, contour, nipple height, and areola size and shape
  • Permanent loss of nipple or breast sensation after the breast reduction operation: usually this is only temporary, but there is a risk of it being permanent
  • Scarring: the severity of the scars and how long they take to fade varies between individuals and depends on the type of incision that has been used
  • A breast reduction operation may make it impossible to breastfeed if you get pregnant later.

What happens after the operation?

For several weeks after breast reduction surgery, your breasts will probably be swollen and bruised and may feel tender or painful. Initially, they will be covered with gauze dressing or elastic bandages, and tubes may be placed under each arm to help drain excess blood and fluid. After the dressings are removed, you’ll be advised to wear a bra with extra support until the swelling reduces.

You’ll usually be able to move around comfortably by this time, though you should avoid heavy lifting or strenuous exercise for around a month afterwards. Your doctor may also advise that you sleep on your back to avoid putting pressure on your breasts.

Stitches are usually removed within one to two weeks after the breast reduction operation. Your doctor will usually prescribe medication for the pain and nausea, as well as antibiotics to reduce the risk of infection.

You may lose sensation in the nipple or areola area, but this will usually be temporary. For some women, sensation returns within weeks of their breast reduction operation, while in others, it may be months or even years for this to happen. The same goes for the shape and colour of the breasts immediately after surgery – these may take a while to return to normal.

You’ll usually be able to return to work within a couple of weeks of the surgery, although you may still experience mild discomfort. If you still have severe pain several weeks after the operation, you should consult your doctor.

The emotional impact

Besides physical healing, a breast reduction yields big changes in the way you look, and it may take a while for you to adjust to your new body image. Thankfully, most women find this adjustment easy, and the level of patient satisfaction after a breast reduction operation is one of the highest out of any cosmetic surgery procedure.

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Should I have a breast reduction operation?