Breast Reduction (Reduction Mammoplasty)
Women with excessively large and sagging breasts may experience back and neck pain, skeletal deformities, breathing difficulties, and many other medical problems caused by the excess weight of the breasts. Bra straps may leave deep marks on the shoulders, and overly large breasts often lead to loss of self-confidence in women and young girls. Breast reduction surgery, known as reduction mammoplasty, is designed specifically for such patients. In this procedure, excess fat, glandular tissue, and skin are removed, resulting in smaller, lighter, and more aesthetically shaped breasts. The areola (nipple area) can also be reduced in size. The goal is to create smaller, well-shaped breasts that are proportionate to the patient’s body.
Breast reduction is generally performed not only for cosmetic improvement but primarily to provide physical relief. Many women with large, sagging breasts report limitations in daily activities and significant physical discomfort. Breast reduction should not be performed before full breast development and is only recommended when large breasts cause significant physical or emotional problems. The best candidates for breast reduction surgery are those who are mature enough to fully understand the procedure and have realistic expectations. Breast reduction is not recommended for women who are breastfeeding or planning to breastfeed soon.
Breast reduction is not a simple surgery, but when performed by a well-trained plastic surgeon, it is considered safe. However, as with any surgical procedure, complications such as bleeding, infection, and reactions to anesthesia may occur.
Additional Risks and Considerations
Smoking can significantly impair wound healing, leading to more noticeable scarring and potential complications. Because a considerable amount of breast tissue is removed, breastfeeding may not be possible after surgery. Some patients may experience changes in nipple sensation. Rarely, the blood supply to the nipple–areola complex may be compromised, leading to tissue loss. In such cases, the nipple and areola can be reconstructed using a skin graft taken from another area of the body.
Before surgery, a mammogram and breast ultrasound should be performed to evaluate the breast tissue for any signs of cancer. Whether or not the patient smokes is an important factor affecting surgical outcomes.
Surgical Procedure
Breast reduction is performed under general anesthesia in a hospital setting. The surgery lasts approximately 2–4 hours. A hospital stay of 2–3 days may be required.
There are several surgical techniques, but the most commonly used method involves an inverted-T or anchor-shaped incision, which includes a circular incision around the areola, a vertical incision downwards, and a horizontal incision along the breast crease. Excess breast tissue, fat, and skin are removed, and the nipple is repositioned to a higher location. The remaining skin is reshaped around the areola to create a new breast contour. The incision lines are then closed with sutures.
Postoperative Care and Recovery
After surgery, elastic bandages or a surgical bra are applied around the breasts. Mild pain may be experienced during movement and coughing in the days following surgery, and general discomfort may persist for several weeks. Bandages are removed two days after surgery, and a supportive bra is placed. Dissolvable sutures are used, so there is no need for stitch removal.
Your first menstrual period after surgery may cause temporary swelling and tenderness in the breasts. Sensation changes in the surgical area typically lessen within six weeks, but in some cases, this process may take 1–2 years or become permanent.
Although most patients can stand and walk within 1–2 days, breast pain may persist for several weeks. Heavy lifting should be avoided for 3–4 weeks. Most patients can return to work and normal daily activities within about two weeks, though full energy levels may take several more weeks to fully return. A supportive athletic bra is recommended during recovery to protect the results.
