Breast Reduction

Breast reduction surgery, or mammaplasty, is usually performed for physical relief rather than cosmetic reasons. This procedure involves removal of excess breast tissue to reshape and lift the breasts. The results are smaller, lighter, better-shaped breasts that are in better proportion with the rest of the body.


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In general, the best candidates for breast reduction are women who are 18 years of age or older, in good physical health, psychologically stable, well-informed about the procedure, without medical conditions such as high blood pressure, circulatory problems, hypothyroidism or other thyroid related conditions and realistic about the outcome of the operation.


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In most cases, the nipples remain attached to their blood vessels and nerves. However, if the breasts are very large or pendulous, the nipples and areolas may have to be completely removed and grafted into a higher position, which will result in a loss of sensation in the nipple and areolar tissue.

If there is not a large excess of skin, the doughnut (or periareolar) reduction method may also be effective. However it tends to flatten the breasts shape a bit. The surgeon will discuss the different methods used for the breast reduction.

The operation usually takes one to three hours per breast and generally performed on an outpatient basis. However, if an extremely large amount of breast tissue will be removed, the doctor may want the patient to stay overnight in the hospital where medical personnel can monitor the initial recovery.

Breast reduction is most often performed under general anesthesia. In some cases, the patient may choose to be sedated instead. This alternative will make the patient sleepy and comfortable without being completely asleep.

Although the surgical incision is quite large, it is placed in areas of the breast that are not too sensitive. The pain after surgery is usually easily managed with medication prescribed by the surgeon. In the first couple of days after the operation there will be discomfort in walking, getting out of bed and any activity that causes the breasts to move.

After sugery the breasts will be wrapped with gauze bandage and a tighter bandage for protection and support. The patient may have small drainage tubes coming out of the incisions the help drain excess fluid.

The patient should make sure to arrange for someone to drive her home and to help out for a few days. The bandages will be removed after a day or two and the patient will continue wearing a surgical bra around the clock for several weeks. The stitches will be removed in one to three weeks.

The patient may be instructed to avoid sex for a week or more, since sexual arousal can cause the incisions to swell. Routine physical activity and exercising, especially lifting, pulling and pushing motions, should be avoided for at least six weeks. This will help the scars to heal.

Some women experience random, shooting pains for a few months, especially around the time of menstruation. Expect some loss of feeling in your nipples and breast skin, caused by swelling. This usually fades over the first few weeks, but occasionally lasts a year or more.

Breast reduction has immediate dramatic results. Some women find that they need time to adjust to their new body image. The patient should keep in mind that the scarring from this surgery is fairly extensive and permanent. The scars are long and remain pink or brown for several years. For some women the scars become wider, but for others they fade and become less noticeable. Poor healing and wider scar are more common in smokers. However, the surgeon will make the incisions as inconspicious as possible and will be places in areas that are usually not seen.

Future breast-feeding may not be possible, since the procedure removes many of the milk ducts leading to the nipples.

The breasts will remain smaller forever. But the patient should keep in mind that gravity continues to work and the breasts will sag again with time. The remaining breast tissue will continue to respond like any breast tissue: it will get bigger if you gain weight, take hormones or get pregnant.


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Some patients may experience a permanent loss of feeling in their nipples or breasts. Rarely, the nipple and areola may lose their blood supply and the tissue will die.

Cigarette smoking decreases blood flow to the skin and subcutaneous tissues, just under the skin, that carry blood flow and leads to an increased risk of the skin scabbing, and can lead to permanent scarring as well.

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Costs vary from one geographic location to another but will be around $5000. This fee does not include anesthesia, operating room facility or hospital stay.

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