Breast reduction surgery

Originally Published: January 23, 2004 - Last Updated / Reviewed On: March 12, 2010
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Hey Alice,

I have a breast reduction coming up soon and I wanted to know if you could explain to me how and what is done so that I could understand it better?

Dear Reader,

Breast reduction surgery (also known as reduction mammoplasty) is usually done when a woman's large breasts are causing actual physical discomfort, (i.e., back pain, neck pain, skin problems, breathing difficulties). The goal of breast reduction is to remove some of the fat, glandular tissue, and skin in order to relieve these problems. Depending on the size of the areola (the pigmented area around the nipple), the areola may be surgically reduced in size in order to make the breast and areola appear in better proportion with each other.

Before your surgery, photographs are usually taken of your breasts, to aid the surgeon in planning for your operation. In many cases now, photos are drawn or recreated to show you what you will look like after surgery. You can use this time to ask your surgeon any questions you may have about the procedure. It is useful and important to ask what kind of preparation you will need before and after surgery, as well. For example, what the surgery will entail, where and how many the stitches will be, how long will you be in the hospital, who should bring you home, how much care will you need, what about physical therapy, how do you take care of your incisions, etc.

In the operating room, general anesthesia is given so that you are unconscious throughout the procedure. An incision is usually made around the nipple and areola, and then down underneath the breast, so that the scars are somewhat hidden by the breast's natural crease (the scars should be completely hidden by your bra or bikini top in the future). The surgeon usually tries to leave the areola and nipple attached throughout the surgery, if possible, although when large amounts of breast tissue are removed, the nipple and areola need to be detached and repositioned in a higher location on the remaining breast tissue. After surgery, small, flexible drainage tubes are usually left in place for a day or two to drain fluid that may accumulate.

Some of the expected side effects of this surgery include decreased or lost sensation in the breast skin and/or nipple and areola. If the surgery required removal of significant glandular tissue, a woman may not be able to breastfeed in the future. These may seem like reasonable trade-offs, however, for women who have back and neck pain and breathing problems due to their large breasts.

Your surgeon is your best resource in informing you about the procedure, addressing any of your concerns, and helping you to be prepared. Knowledge is power, and information about the procedure and beyond will empower you to take care of yourself physically and psychologically.

Alice