What is breast reduction?
Breast reduction (reduction mammaplasty) is a surgical procedure performed to reduce excess breast volume, sagging, and the related functional/aesthetic problems. During this operation, excess breast tissue, fat, and skin are removed; the breast is reshaped, and the nipple–areola complex is repositioned to a more appropriate location.
The goal is not only to make the breasts smaller, but also to achieve a breast shape that is lighter, more balanced, lifted, and proportionate to the body.
 

Who is a good candidate?
You may be a suitable candidate if you have one or more of the following:
- Neck, shoulder, and back pain related to heavy breasts
- Bra strap grooving / shoulder indentations
- Rash, irritation, or recurrent fungal problems under the breasts
- Limitations in daily activities and exercise
- Difficulty finding well-fitting clothing
- Aesthetic discomfort due to breast size and sagging
- Noticeable asymmetry between the breasts (asymmetry correction can be planned during reduction)
Suitability is determined based on your general health, breast volume, degree of sagging, skin quality, and expectations.
 

What is the difference between breast reduction and breast lift?
- Breast reduction: The goal is to reduce volume + correct sagging + improve shape.
- Breast lift (mastopexy): The main goal is to correct sagging and improve shape (without significant volume reduction, or with only limited tissue removal).
In practice, breast reduction surgery usually includes a lifting component as well.
 

What techniques are used?
Different techniques may be used in breast reduction surgery. The choice depends on breast volume, degree of sagging, skin quality, and the desired result. The most common scar patterns are:
- Vertical (lollipop)
- Inverted-T / anchor
Other techniques may be considered in selected patients. The most suitable approach for you is determined during consultation.
 

What happens to the nipple and areola?
In breast reduction surgery, the nipple–areola complex is usually moved to a higher, more aesthetically appropriate position. In suitable patients, the areolar diameter can also be reduced to create a more balanced appearance.
 

Where will the scars be?
Depending on the technique, scars are most commonly located:
- Around the areola
- In a vertical line from the areola downward
- If needed, in a horizontal line along the inframammary fold
Scars are more noticeable during the first months and generally fade over time. Scar quality depends on individual healing characteristics, skin type, smoking, and adherence to aftercare instructions.
 

Anesthesia and surgery time
Breast reduction is usually performed under general anesthesia. Depending on the extent of the procedure and asymmetry correction, surgery typically takes about 2.5–4.5 hours (varies by patient).
 

Pre-operative preparation
Common recommendations include:
- If you smoke: reduce/stop smoking to support circulation and wound healing
- Adjusting blood thinners and certain supplements as advised
- Required pre-operative tests and anesthesia evaluation
- Measurements, medical photography, and surgical planning
- Planning for a post-operative support bra
- Reviewing prior imaging (such as mammography/ultrasound), when appropriate based on age and risk factors
 

Recovery and return to daily activities
A general timeline (varies by patient):
- First 3–7 days: Swelling, tenderness, tightness, and mild pain are common.
- 1–2 weeks: Gradual return to daily activities; some patients can return to desk work.
- 2–4 weeks: Light activities are resumed; arm movements are gradually increased.
- 4–6 weeks: Progressive return to more intense exercise (especially upper-body activities, as clarified at follow-up visits).
- 3–6 months: Breast shape becomes more natural as swelling decreases; scars continue to mature.
- 6–12 months: Further settling of breast shape and scar maturation.
Wearing a support bra, attending regular follow-up visits, and following activity restrictions are important for recovery.
 

Safety, risks, and important considerations
Breast reduction surgery generally has high patient satisfaction, but like any surgical procedure, it carries risks. Commonly discussed risks include:
- Swelling, bruising, temporary asymmetry
- Bleeding, infection
- Wound-healing problems / wound separation along incision lines
- Prominent scarring (hypertrophic scar/keloid tendency)
- Changes in nipple or skin sensation (temporary, rarely permanent)
- Areolar shape/asymmetry issues
- Fat necrosis / firm areas (in some patients)
- Changes in breast shape over time
- Rarely, the need for revision surgery
 

Important notes:
- In very large breasts, severe ptosis, or patients with higher circulation risk, the surgical plan may need to be modified.
- Smoking may increase circulation-related and wound-healing risks.
- The same amount of reduction may not be safe or achievable in every patient; preserving tissue viability and circulation is a priority.

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Frequently Asked Questions (FAQ)

 

1) Will breast reduction leave scars?
Yes. Scars are unavoidable in breast reduction surgery, but the goal is to choose the most appropriate technique and help scars fade as much as possible over time. The scar-to-benefit balance is discussed during your consultation.
 

2) How small can I go?
This depends on your current breast volume, skin characteristics, chest dimensions, circulation safety, and your goals. Reaching an exact bra cup size may not be safe or possible for every patient.
 

3) Does breast reduction also lift the breasts?
Yes. Breast reduction surgery usually includes reshaping and lifting as part of the procedure.
 

4) Will my neck/back pain improve?
Many patients experience significant relief from neck, shoulder, and back discomfort related to heavy breasts. However, breast size may not be the only cause of pain in every patient.
 

5) Does it affect breastfeeding?
Many patients may still be able to breastfeed, but this cannot be guaranteed in every case. Surgical technique, the amount of tissue removed, and individual factors all play a role.
 

6) Will I lose nipple sensation?
Temporary changes in sensation can occur after surgery. In most patients, sensation improves over time; rarely, changes may be permanent.
 

7) Will my breasts be perfectly symmetrical after surgery?
Natural asymmetry is common in the human body. The goal is to reduce noticeable differences and achieve the best possible balance, but perfect symmetry cannot be guaranteed.
 

8) When can I return to work?
For desk-based work, some patients return within 1–2 weeks. Physically demanding jobs may require more time.
 

9) When can I exercise?
Walking is usually allowed early. For upper-body exercise and intense sports, 4–6 weeks is often safer for most patients; the exact timeline is determined during follow-up visits.
 

10) Will I see the result immediately?
In the first weeks, the breasts may appear higher, firmer, or different due to swelling. The shape becomes more natural over weeks to months.
 

11) Can the breasts enlarge again or sag over time?
Weight changes, hormonal factors, pregnancy/breastfeeding, and aging can affect breast shape over time. Results are often long-lasting, but natural changes continue throughout life.
 

12) Is pathology evaluation performed on removed tissue?
In many centers, removed tissue may be routinely sent for pathology evaluation. This may vary depending on the institution and surgeon’s approach.
 

13) Will I need revision surgery?
Most patients do not. However, revision may occasionally be needed for scars, asymmetry, areolar shape, or contour concerns.
 

14) Should I lose weight before surgery?
In general, planning surgery when you are close to your target weight and your weight is stable provides more predictable and longer-lasting results. However, every patient is evaluated individually.

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The content on this page is for general informational purposes only; it does not replace diagnosis and treatment. The appropriate surgical method and implant selection are determined through face-to-face examination and medical evaluation.

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