Breast Reduction Surgery
Important information:
Breast reduction, also called reduction mammoplasty, is a surgery done to decrease breast size by removal of breast tissue, fat and skin. The nipple and areola (the colored skin around the nipple) may also be repositioned. Patients chose to undergo breast reduction for several reasons. Breasts that are excessively large can cause pain, pulling, neck and back discomfort, rashes and many other physical symptoms. Most patients have significant improvements in these symptoms after breast reduction surgery.
Patients may also have emotional distress related to their large breasts causing them to avoid participating in sports or other physical activities, limiting the type of clothing they feel comfortable wearing and negatively impacting their self-esteem. Even though it may not be something that many teenagers and young adults feel comfortable talking about with their friends, it is important to know that you are not alone. Breast surgery is one of the most common plastic surgery procedures for teenagers and young adults!
About the surgery
Breast reduction surgery is done as an outpatient procedure, this means you do not need to spend the night at the hospital and will go home the same day as surgery. You will have general anesthesia during the procedure which will keep you from having any pain.
The most common breast reduction surgery places scars around the areola, underneath the crease of the breast and one from the nipple down to the crease. All your incisions will be closed with sutures that slowly dissolve over time. These scars will fade with time but are permanent and will always be visible. The scars should be easily hidden with clothing and almost all types of bathing suits.
This surgery leaves the breasts smaller, higher on the chest (less droopy) and with a smaller areola size.
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| This picture shows one method of breast reduction surgery. Talk to your surgeon about how your own surgery will be done. Image used with permission from The StayWell Company, LLC |
As with any surgery there are risks and problems can occur. These include:
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Bleeding
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Infection
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Abnormal scar formation
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Unusual or unexpected reactions to drugs or medications
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Changes in nipple sensation (temporary or permanent)
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Nipple loss (in rare cases)
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Inability to breast feed
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Uneven breasts
Insurance
Some health insurances will cover breast reduction surgery if you meet the criteria they require to determine “medical necessity.” Our team can help you with any questions related to your specific insurance policy requirements.
Frequently Asked Questions
Why are my breasts so large?
The major factor is genetics, however your weight, age and medications you take can also influence your breast size. Breasts are made up of breast fat, glandular tissue (the tissue that produces milk for breast feeding) and skin. The amount of each type of tissue is different in each person. If your breasts contain a lot of fatty tissue you will see changes with large amount of weight gain or loss. If your breasts are mostly glandular tissue, then you may not see much change when your overall body weight changes. Hormone fluctuations, such as during pregnancy or menstruation change breast size. Medications that impact hormone levels in your body can also change your breast size.
Why are my breasts droopy?
The weight of heavy breasts pulls the tissue down and causes drooping. The nipple often gets pulled down to an abnormally low position. This is normal and happens to almost everyone with large natural breasts. During breast reduction surgery we can also correct the position of your nipples and the size of your areolas.
Will I be able to breastfeed after breast reduction?
Usually. Most of the breast reduction surgeries we perform keep the nipple attached to the milk ducts and glandular system of the breast, this means that breastfeeding should be possible after surgery. It is important to discuss with your surgeon the possible impact on future breastfeeding based on the type of surgery you will be having.
Will my breasts grow back?
It is very unlikely. The tissue removed during your surgery is gone permanently. However, significant weight gain could cause the fatty component of your breasts to increase. Your breasts could also change with pregnancy and breast feeding. It is unlikely that these changes would make your breasts as large as they were before surgery. We can avoid most problems with breast regrowth by waiting until your breasts have stopped growing. This happens at the end of puberty. Once your breasts have been the same size for a year, we can be more confident that the glandular portion of your breasts will not regrow, but it is normal for the shape of your breasts to change throughout your life.
Patient instructions:
Before surgery
Do not give your child medicines that contain aspirin or ibuprofen (Advil®, Nuprin®, Motrin®) for two weeks before surgery. They may cause the body not to form the appropriate clots needed for healing.
Recovery
It is important to schedule surgery at a time when you can take time off from school or work to focus on healing. Most patients take 1-2 weeks off from school or work after surgery. You will need to be out of sports and other activities for longer. You should expect to feel tired, sore and swollen after surgery. We will give you medicine to manage your pain, but it is not possible to take all the pain away completely.
After surgery you will go home in a surgical bra that opens in the front. You should avoid wearing any bras with underwire after surgery, the wire can rub on the incision underneath the breast. After surgery you can wear any soft cup bra without underwires that opens in the front.
Drainage tubes are sometimes used after surgery to remove extra blood and fluid near the incisions. These drainage tubes may be removed the next day, or you may be sent home with these drains. If you are discharged with drains, we will teach you how to care for them. You will need to measure the amount of fluid in the drains each day. This will help us to decide when the drains can be removed. The drains are removed in the office.
It could take a few weeks or even months for the swelling to go down after surgery. Since the size and shape of your breasts will continue to change you should not buy new bras until three months after surgery.
Post – operative sports bra
You will go home in a sports bra, but you will want to have another one or two at home. There are many options, you do not need an expensive one. Although it is not required to have one that opens in the front, it can be easier if you have dressings top apply.
Please review your After Visit Summary (AVS) for specific recovery instructions from your surgeon.
Care at home
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You may still have pain at home. We will give you a prescription for pain medicine. Use it as needed and follow the directions. Take pain medicine half an hour before showering, changing the dressing, or going to bed. Prescription pain medication can cause some dizziness, nausea, or constipation. Over-the-counter medicine (such as Tylenol®) will have fewer side effects and may provide relief. Replace the prescription pain medicine with over-the-counter medicine as soon as possible.
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It is normal to feel tired after general anesthesia and surgery.
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You can shower and wash your hair after the drains are out. No baths or swimming for four weeks after surgery. If there is paper tape along the incisions, leave it in place and let the soap and water run over them. Do not scrub them.
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No heavy lifting, vacuuming, high reaching or intense exercise is allowed for 4 weeks after surgery. Do what is comfortable without any excess strain. For support, wear a bra (no underwire) both day and night for 3 weeks after surgery. Place a dry gauze dressing in the bra over the incisions for comfort.
Follow-up appointment
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Usually, the stitches in your child’s breasts will dissolve. Some children will have stitches that need to be removed in the office. If your child has stitches that need to be removed, this will take place in the office about two weeks after surgery.
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A follow-up appointment is required 2-3 weeks after surgery. Please call 215 590-2208 to make the appointment.
Contact your surgical team with questions, concerns or if your child has:
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Fever over 100.5°F (38°C)
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Worsening redness near incision
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Sudden swelling or deflation of the breast
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Any drainage from incision
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Sudden behavior change (irritable, nausea, vomiting, decrease in appetite)
Monday through Friday, 8 AM -5 PM
215-590-2208
Evenings, weekends, and holiday, call 215-590-1000 and ask to speak with the plastic surgery resident or fellow on call
Reviewed December 2023 by Kelsey Reilly, CRNP