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Breast Reduction Surgery

Breast reduction surgery is also called reduction mammoplasty. Fat, tissue, and skin are removed from the breasts to make them smaller. The size of the areola (dark skin around the nipple) may be reduced. And the nipple may be moved higher on the breast. This sheet explains the procedure and what to expect.

Two images of female chest showing right breast: First figure shows incisions for vertical breast reduction surgery; second image shows result.

Preparing for Surgery

Prepare for the surgery as you have been told. In addition:

  • Tell your doctor about all medications you take. This includes herbs and other supplements. It also includes any blood thinners, such as Coumadin, Plavix, or daily aspirin. You may need to stop taking some or all of them before surgery.

  • Do not eat or drink during the 8 hours before your surgery, or as directed by your surgeon. This includes coffee, water, gum, and mints. (If you have been instructed to take medications, take them with a small sip of water.)

The Day of Surgery

The surgery takes about 3-6 hours. You may go home the same day. Or you may stay overnight.

Before the surgery begins:

  • An IV line is put into a vein in your arm or hand. This line delivers fluids and medications.

  • You will be given medication to keep you pain free during surgery. This may be general anesthesia, which puts you into a state like deep sleep. (A tube may be inserted into your throat to help you breathe.) Or you may have sedation, which makes you relaxed and sleepy. If you have sedation, local anesthesia will be injected to numb the area being worked on. The anesthesiologist will discuss your options with you.

During the surgery:

  • The doctor makes one or more incisions in your breast. Incisions are mostly made around the areola. You and your doctor will have discussed incision sites prior to the surgery.

  • The doctor removes fat, tissue, and skin from the breast. In some cases, fat is removed using liposuction. This involves inserting a cannula (hollow tube) into the breast. A special vacuum pulls fat through the cannula.

  • If needed, the areola and nipple are removed and positioned higher on the breast. To reduce the size of the areola, excess skin is removed. The areola is then stitched (sutured) into place.

  • The process is repeated on the other breast.

  • The incisions are closed with sutures (stitches), surgical glue, or both. A tube (drain) may be placed into the incisions before they are closed. This drains excess fluid as the wound begins to heal.

After the Surgery

You will be taken to a room to wake up from the anesthesia. You may feel sleepy and nauseated. If a breathing tube was used, your throat may be sore at first. You will be given medication to control pain. When you’re ready, you will be able to go home with an adult family member or friend. Or, you may be moved to a room to stay overnight.

Recovering at Home

Once home, follow any instructions you are given. Your doctor will tell you when you can return to your normal routine. During your recovery: 

  • Take any prescribed medications exactly as directed.

  • Wear the special bra or Ace bandage you were given before discharge as directed by your doctor.

  • Care for your incisions and the dressing (bandage) over them as instructed by your doctor.

  • Follow your doctor’s guidelines for showering. Avoid swimming, bathing, using a hot tub, and other activities that cause the incisions to be covered with water until your doctor says it’s okay.

  • When you shower, gently wash your incision sites. Then pat the incisions dry. Don’t apply lotions, oils, or creams to the incisions until after they are fully healed.

  • Don’t raise your arms above breast level for 10 days. And don’t lift, push, or pull anything heavier than 10 pounds for at least 7 days.

  • Don’t drive until you are no longer taking prescription pain medication and your doctor says it’s okay. When riding in a car, carefully position the seatbelt so that it doesn’t compress your breasts.

  • Be aware that breast swelling may last for 3-5 weeks. If advised by your doctor, use a cold pack wrapped in a thin towel to relieve discomfort and control swelling. It’s important not to leave the cold pack on for too long, or your skin could be damaged. Put the pack over your bandages for no more than 20 minutes at a time. Then, leave it off for at least 20 minutes. Repeat this as often as needed during waking hours until swelling starts to improve. Don’t fall asleep with the cold pack on. If you’re not sure how to safely use the cold pack, ask your doctor.

Call the Doctor If You Have Any of the Following:

Be sure you have a contact number for your doctor. After you get home, call the doctor if you have any of the following:

  • Extreme chest pain or trouble breathing (call 911 or other emergency service)

  • A fever of 100.4°F or higher (or as directed by your doctor)

  • Bleeding or drainage through the special bra or Ace bandage

  • Symptoms of infection at an incision site such as increased redness or swelling, warmth, worsening pain, or foul-smelling drainage

  • Pain that is not relieved by medication or pain that gets worse

  • Much more soreness, swelling, or bruising on one breast that the other

  • Breast that is very warm to the touch

Follow-Up

You will have follow-up visits so your doctor can see how well you’re healing. If needed, stitches or drains will be removed at one of these visits. If you have any questions or concerns about your recovery, let your doctor know.

Risks and Possible Complications Include:

  • Bleeding or infection

  • Blood clots

  • Excessive internal or external scarring

  • Breasts that are asymmetric (not the same shape and/or size)

  • Breasts that are too firm

  • Changes in breast or nipple sensation (temporary or permanent)

  • Damage to nerves, muscles, or blood vessels

  • Persistent pain

  • Death of fat cells deep in the skin (fat necrosis)

  • Inability to breastfeed

  • Not happy with cosmetic result

  • Risks of anesthesia (the anesthesiologist will discuss these with you)

 

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