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Breast reduction

Key points

  • Breast reduction is an operation to remove tissue and skin from your breasts to make them smaller and to reshape them.
  • Before you decide to go ahead with the procedure, talk to your surgeon about the results you are hoping for, and the risks and benefits of the procedure.
  • You will have scars afterwards but they will fade over the following months.

Breast reduction surgery involves reducing the size of your breasts and reshaping them.

You will meet the surgeon carrying out your procedure to discuss your care. It may differ from what is described here as it will be designed to meet your individual needs.

About breast reduction

Breast reduction is an operation to remove some tissue and skin from your breasts. Your breasts are then reshaped and your nipples repositioned. Breast reduction can also be used to make your breasts more equal in size if one is much larger than the other.

Breast reduction surgery can relieve the discomfort you may have if you have large breasts, which can include:

  • back, neck and shoulder pain
  • grooves in your shoulder from bra straps
  • sweating, rashes and skin infections under your breasts

Many women find it easier to join in with sport and exercise, and feel happier and less self-conscious after a breast reduction.

Breast reduction surgery can also be carried out in men who feel self-conscious about enlarged breasts, a condition called gynaecomastia. This is a different procedure to breast reduction in women.

Illustration showing the structures of the breast

Getting advice about breast reduction

It's important not to rush into the decision to have cosmetic surgery. Talk through your options with your GP, who may be able to recommend a surgeon or help you choose which hospital to go to.

Before you decide to have a breast reduction, think about the results you are hoping for and what will fit with your body shape. You may want a radical reduction in size, but this could affect your body proportions. Sometimes a more moderate reduction may give a better overall body shape.

Because breast size alters with body weight, your weight needs to be stable before surgery. If you're overweight, your surgeon will advise you to lose weight before your operation. Your breasts won't grow back after surgery, but they may get bigger if you put on weight or become pregnant.

Preparing for breast reduction

Your surgeon will explain how to prepare for your operation. For example, if you smoke, you will be asked to stop. Smoking increases your risk of getting a chest or wound infection, which can slow your recovery.

Breast reduction surgery is usually done under a general anaesthetic. This means you will be asleep during the procedure. You will be asked to follow fasting instructions. This means not eating or drinking, typically for about six hours beforehand. However, it's important to follow your surgeon's advice.

You will need a well-fitting bra to wear after your operation. Your surgeon will advise you about the most suitable type and size of bra beforehand.

At the hospital, your nurse may check your heart rate and blood pressure, and test your urine.

Your surgeon will discuss with you what will happen before, during and after your procedure, and any pain you might have. This is your opportunity to understand what will happen. You can help yourself by preparing questions to ask about the risks, benefits and any alternatives to the procedure. This will help you to be informed, so you can give your consent for the procedure to go ahead. You may be asked to do by signing a consent form.

Your surgeon will mark your breasts with a pen to show the planned size and shape of the cuts for your operation. He or she may also photograph your breasts for confidential 'before and after' images.

Your nurse will prepare you for your operation. You may be asked to wear compression stockings to help prevent blood clots forming in the veins in your legs. Also, you may need to have an injection of an anticlotting medicine called heparin as well as, or instead of, wearing compression stockings.

What happens during breast reduction

There are various ways to carry out the operation. Your surgeon will discuss which is the most appropriate for you and explain how your breasts are likely to look afterwards. The operation usually takes one and a half to three hours.

Typically, your surgeon will remove excess breast tissue through cuts in the lower part of your breasts. Your nipples will be moved to fit the new shape. He or she will reshape your breasts and close the cuts with stitches, which may be dissolvable. Your surgeon may wrap your breasts in a special supportive dressing or support bra.

Fine plastic tubes may be left in each breast afterwards, which will be taken out before you go home. These drain blood and fluids into a bag.

Sometimes, breast liposuction may be an option. Your surgeon will remove fat from your breasts through a plastic tube. Talk to your surgeon for more information about breast liposuction.

What to expect afterwards

You will usually need to stay in hospital for one or two days after your operation.

You may need pain relief to help with any discomfort as the anaesthetic wears off. Your surgeon or anaesthetist may also prescribe painkillers and antibiotics for the first few days after your operation.

Before you go home, your nurse will advise you about caring for surgical wounds and arrange a date for a follow-up visit. You may have several follow-ups to check on your progress.

Your surgeon will cover the stitches with a light dressing, which will be changed after around two days. He or she may fit a supportive, elastic dressing, or you may wear a supportive bra straight after the operation. When the surgical dressings have been removed, you will need to keep wearing a support bra. This helps to prevent the weight of your breasts pulling on your wound. You may have to wear the bra day and night at first.

Removable stitches will be taken out after ten to 14 days. The amount of time dissolvable stitches will take to disappear depends on the type of stitches you have. Your surgeon will advise you about this.

Recovering from breast reduction surgery

Full recovery from breast reduction varies between individuals, so it's important to follow your surgeon's advice. Usually you will be back to your normal activities, including exercise, within six weeks.

If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice.

At your initial appointment, your surgeon should give advice about when you will be able to return to your usual activities. You may need two to four weeks off work, depending on your job, and you shouldn’t do any heavy lifting for around six weeks afterwards.

What are the risks?

As with every procedure, there are some risks associated with breast reduction surgery. We have not included the chance of these happening as they are specific to you and differ for every person. Ask your surgeon to explain how these risks apply to you.

Side-effects

Side-effects are the unwanted but mostly temporary effects you may get after having the procedure.

Your breasts will be sore for a few days after your operation and may feel tender and lumpy for some time. You will have scars, which will be red and slightly raised to start with, but should fade over the following months.

Your nipples may be less sensitive than before. This is more likely if your nipples have been moved during surgery. Depending on the type of breast reduction surgery, you may be unable to breastfeed after the operation.

You may be left with small folds of skin at the end of the scar, both between and at the sides of your breasts. You may need to have a second operation under local anaesthetic to remove these.

Complications

Complications are when problems occur during or after the operation. The possible complications of any operation include an unexpected reaction to the anaesthetic, excessive bleeding or developing a blood clot. This is usually in a vein in the leg (deep vein thrombosis).

Specific complications of breast reduction include those listed below.

  • Infection. This may need to be treated with antibiotics and sometimes further surgery.
  • Haematoma. This is when bleeding occurs inside your breast making it swollen and painful. You may need further surgery to stop the bleeding.
  • Your wound can be slow to heal. The skin may form a scab that can fall off, leaving a wide scar.
  • Rarely, alterations in the blood supply to your breast may result in the loss of part, or even all, of your nipple.
  • It's possible that your breasts may not be exactly the same shape and size as each other or that your nipples may not be level after surgery.


Reviewed by Jane McQueen, Bupa Health Information Team, March 2014.

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  • This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.

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