Breast Reduction Guide



A breast reduction removes excess fat, skin, and tissue to create smaller, perkier breasts. The procedure usually results in lifting the nipple and areola to a higher position, and it may help eliminate back, shoulder, neck, and head pain.

If you’re considering breast reduction, you probably have a lot of questions. We’ve drawn on the expertise of our doctors and the RealSelf community to give you answers to those most commonly asked on our site.


What Is Breast Reduction Surgery?
Breast reduction surgery is in an invasive procedure that removes fat, skin, and tissue while lifting the breasts. The result is a more streamlined, younger-looking bust.

The most common method of reducing breast volume requires three incisions: one around the areola (a periareolar incision), another running vertically from the bottom of the areola to the crease underneath the breast, and a third following the natural line of the breast crease.

The surgeon removes the excess tissue and fat through these incisions before lifting the nipple and areola to a higher position. The size of the areola may also be reduced, and liposuction might be used to adjust the contour. 


Is Breast Reduction Right for Me?
If one or more of the following apply to you, you may be a good candidate for breast reduction:

Your breasts are overly large in proportion to your body frame
You have heavy, pendulous breasts with downward-pointing nipples and areolas
You have one breast that’s much larger than the other
You experience back, neck, shoulder, or head pain caused by the weight of your breasts
You have skin irritation under your breasts
You experience a restriction of physical activity due to your breasts’ size and weight
You’re self-consciousness about the largeness of your breasts
Breast reduction can be performed at any age, but plastic surgeons usually recommend waiting until breast development has stopped after puberty. You will need to be in good overall health.


How Should I Prepare for Breast Reduction?
If you have a family history of breast cancer, your doctor may recommend a pre-op mammogram, followed by another mammogram following surgery. (Some doctors recommend this occur a few months post-op while others may wait a year.) This will help detect any changes in your breast tissue. Breast reduction surgery does not increase your risk of developing breast cancer.

If you smoke, plan to stop well in advance of your surgery date. You will also be advised to stop taking aspirin and certain anti-inflammatory drugs that may increase bleeding.

Your doctor may advise you to exercise or change your diet before surgery. “I recommend to all of my patients to get in the best possible shape they can prior to their surgery,” says Munster, Indiana plastic surgeon Dr. David A. Robinson. “This includes losing weight, if they are overweight, stopping smoking, and exercising.” The more you can do before surgery, the better your results and healing.

Be sure to follow your surgeon’s specific pre-op instructions. One essential tip for the day of the surgery: wear a shirt that buttons up the front. It will be easier to get into when it comes time to leave the hospital,


What Happens During a Breast Reduction Procedure?
Breast reduction surgery typically takes between two and three hours. You’ll be put under using general anesthesia. Your surgeon will likely make three different incisions per breast to remove excess tissue, fat, and skin. The skin located above the nipple will be used to reshape the breast, and liposuction may be used to contour the new shape.

Typically, the nipples and areolas remain attached to underlying tissue. This means you should retain sensation and the ability to breastfeed following surgery.

Breast reduction may be an inpatient or outpatient procedure. If the former, you will likely spend one night at the hospital or surgical facility. If the latter, you will need someone to drive you home and monitor your recovery for the first one to two days post-op. 


What Should I Expect During Recovery?
Recovery from breast reduction surgery varies person to person, but you can expect to be sore in the first few days after surgery. “Most patients feel like they are wearing a tight bra,” says Dr. Burgess of post-op pain. “Fortunately, there is no bone or muscle surgery with a breast reduction, so I think it’s a little less painful with a quicker recovery.

Make sure you have friends or family on hand to care for you the day of surgery and, if possible, one to two days post-op. They can help administer medications and deal with drains, dressings, showers, and brief walks to stay active.

If your surgeon has placed any drains, Dr. Burgess recommends buying clean feminine hygiene pads or other padded dressings. “They can be helpful to have on hand to capture drainage,” she says. Expect your drains to be removed after a couple of days.

You’ll also likely wear a support bra for the next few weeks, as the swelling and discoloration of your breasts decreases (a process doctors say may not be fully resolved for six to eight months).

You may be instructed to sleep on your back to avoid putting pressure on your breasts, and you might notice reduced sensation in the nipples and areolas. This is usually temporary, but sensation may not fully return for weeks, months, or sometimes years.

Following surgery, most doctors recommend one to two weeks off work with no strenuous exercise (lifting above 10 pounds) for four to six weeks. You should also abstain from any sexual activity for at least one week; your doctor may advise you to wait longer. Your breasts must be handled extremely gently for at least six weeks following the procedure. Mild, periodic discomfort during this time is normal, but report any severe or lasting pain to your doctor.


What Results Can I Expect From Breast Reduction?
Your breast reduction results should remain fairly consistent barring two situations: gaining or losing a significant amount of weight, or becoming pregnant. While neither situation will “undo” the breast reduction, they will change the appearance of your breasts and may alter your results.

Expect the incisions from your breast reduction to be red and/or pink immediately following surgery. These incisions will heal and fade over time, but they will never fully disappear.

“There is no way to get around having scars. Science has yet to find a way to truly do ‘scarless’ surgery,” says Missoula, Montana, plastic surgeon Dr. Michelle A. Spring. “That being said, most patients are very happy to trade off having scars for an improved breast shape, fewer aches and pains associated with large, droopy breasts, and looking better in clothing, swimsuits, bras, and maybe even feeling comfortable going braless for the first time.”

Women who have a breast reduction may seek a breast lift if they grow dissatisfied with the appearance of their breasts following the wear and tear of gravity and aging over the course of years. This procedure will aim to restore a youthful contour to the bust.

As you continue to heal, prepare to have a whole new figure and one that will likely change in the year following surgery. “The last phase is where the breast externally looks healed, but the breasts soften and drop a little,” says Dr. Burgess. “This can take six to 12 months.”


Will My Nipples Be Removed During Surgery?

It’s a common question, says Dr. Burgess, but no, in most cases the nipples aren’t removed during surgery unless the patient is very, very large-breasted.


What If I Get Pregnant After My Breast Reduction?

Your breasts will change with pregnancy, but it won’t necessarily “ruin” the results. “Maintaining a stable weight under the guidance of your OB/GYN will be helpful in minimizing breast changes.


Can I Breastfeed After a Breast Reduction?

You should be able to breastfeed, but breast reduction surgery goes across the milk ducts. Doctors differ on how much of an impact this has on breastfeeding: some say their patients have been able to breastfeed, some say it decreases a woman’s ability to do so. So be sure to discuss all possible outcomes with your doctor. He or she may recommend waiting for surgery until after your family is complete.

Publish Date: 2016 Nov 13

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