Like any surgery, breast reduction procedures carry some risks, such as scarring and loss of nipple sensation.
Breast reduction surgery — known medically as a reduction mammoplasty — is a common procedure done either for medical or aesthetic purposes to reduce the size of a person’s breasts, chest, or nipples.
Generally speaking, the benefits outweigh the risks, and the risks themselves are both minimal and rare.
Still, it’s important to know what’s possible before undergoing any major procedure. Here are 10 common concerns after breast reduction surgery.
Even if surgery is medically necessary, the breast reduction procedure itself is a type of trauma.
In fact, even after uncomplicated surgeries, it’s common for people to experience postoperative fatigue.
Postoperative fatigue may be caused by a combination of the following:
- an inability to increase your heart rate via exercise
- nutritional changes
- hormonal imbalance
- the energy it takes the body to heal
You can help manage fatigue by:
- increasing your water intake
- eating nutrient-dense food
- limiting or avoiding caffeine
- avoiding alcohol and substance use
It is common to experience some tenderness and soreness at the surgical site.
You may also experience some swelling, which may last for around 3 months.
You can expect some scarring around the nipples. Any procedure that involves surgical incisions will lead to some degree of permanent scar tissue.
The scar’s location and overall visibility depend on the type of breast reduction surgery you have, your body chemistry, and how well you take care of the area.
According to Constance M. Chen, MD, a plastic surgeon and breast reconstruction specialist in New York, you can generally expect scarring around the nipple-areola complex and a vertical scar at the bottom of your breast.
“If you’re curious how your scars will heal, you should look at the other scars on your body,” explains Sean Satey, MD, a plastic surgeon based in Beverly Hills, California..
If you typically have minimal scarring, you’ll likely experience the same after breast reduction surgery. If, however, you typically have keloid scarring, you likely will have keloid scars at the incision site.
To minimize scarring, Satey recommends:
- working with a surgeon who specializes in breast reduction surgery
- keeping the wound clean to prevent infection
- an aggressive postoperative scar management protocol
- waiting the recommended amount of time before lifting weights
How to care for your chest to prevent scarring
Surgeons typically recommend the following to prevent scar formation:
- Avoid the sun.
- Apply anti-scar medication.
- Use silicone bandages.
- Regularly redress the wound.
“The scars can be treated with silicone scar therapy, laser therapy, or microneedle with platelet-rich plasma,” said Alexander Zuriarrain, a quadruple board certified plastic surgeon at Zuri Plastic Surgery in Miami.
You can expect some differences between sides when fully healed.
“Breasts are sisters, not twins, so they may not be perfectly symmetrical, just as many breasts are not perfectly symmetrical before surgery,” said Chen.
Keep in mind, she adds, that it will also take months for the final shape and size to develop as the tissue settles after surgery.
About 10% of all people experience some sensation loss, says Satey.
According to holistic plastic surgeon Shirley Madhère, founder of Jet Set Beauty Rx, sensation loss may be more likely if:
- a high volume of breast tissue is removed
- a larger portion of the nipple is removed
- you have a history of smoking cigarettes or vaping nicotine
- you have an underlying condition that affects your blood circulation, nervous system, or your ability to heal
“Sometimes the sensation loss is lasting and full; other times it is temporary or partial,” said Madhère.
It is unclear whether a person will be able to nurse after breast reduction surgery. It can depend on how large the breast reduction is.
So, if breastfeeding or chestfeeding is important to you, talk with your surgeon about which technique will give you the aesthetic you want and preserve your ability to produce milk in the future.
You can expect healing to take at least a few weeks, according to Chen.
Typically, people experience swelling and tenderness for a few weeks while the wounds heal, she says. “And it takes a few months for the swelling to go down and for the breasts to settle into their new size.”
Still, for some people, the wounds take extra long to heal.
“Delayed wound healing can usually be treated with standard wound care and dressing changes,” said Chen.
If you’re worried about how long your body is taking to recover from surgery, consult with your surgeon.
A hematoma is a
However, hematomas can become a cause for concern when they continue to enlarge, notes Chen.
“Be on the lookout for an expanding hematoma, which is when a blood vessel starts bleeding after surgery,” she explained. “It can cause the breast affected to become tight, bulging, and painful.”
If you have a hematoma or suspect you have one, seek medical advice as soon as possible.
“It may require a trip back to the operating room to evacuate the blood and stop any bleeding if it hasn’t already stopped on its own,” she said.
Nipple necrosis, also known as necrosis of the nipple-areolar complex, is a
Put simply, it’s the death of a nipple.
It happens when the blood supply to the nipple was not successfully maintained after the breast tissue was removed and reshaped during surgery.
Without nutrient- and oxygen-rich blood being pumped to the sensitive tissue, it’s unable to heal properly and subsequently dies.
This can also happen if there isn’t enough blood leaving the nipple, as it can cause blood to get trapped in the tissue.
The main sign of nipple necrosis is an unexpected color change.
If your nipple is paler than expected, there may not be enough blood flow into the nipple. If your nipple is purple or darker than expected, there may not be enough blood flow out of the nipple.
If you do have nipple necrosis, and it is recognized early, your surgeon can go back and remove the nipple as a free nipple graft. This involves detaching the nipple from the underlying breast tissue and reattaching it as a graft. As it heals, it may temporarily lose some pigment, and it will be permanently numb.
Your surgeon can also try to refer you for hyperbaric oxygen, which can improve the blood flow to the tissue and improve healing.
If recognized too late, it may be necessary to remove your nipple and any other dead tissue. Your surgeon can potentially reconstruct a nipple in the future to create a new bump. This, however, will still be numb, and you may choose to get a tattoo in the future to create pigment matching your areola color.
“The incidence of infection after breast reduction surgery is low and generally only appears in 1% to 2% of patients,” said Madhère.
“If an infection does occur, it usually occurs within 5 to 7 days after,” she said.
Common signs of infection include:
- redness or discoloration
- skin that feels hot to the touch around the incision
- intense pain or discomfort around the incision
- foul-smelling discharge from the wound
- fever
- chills
- nausea
How to reduce the risk of infection
“Infection prevention begins before the actual operation,” said Satey.
Some steps to help reduce the risk of infection include the following:
- A few days before the surgery: People are typically advised to cleanse the chest with an antiseptic solution to help eradicate the natural bacteria that live on the skin, Satey explains.
- The day of surgery: Your skin will be prepped with an antiseptic solution, the procedure will be performed with a sterile approach, and the wound dressings will be placed in a sterile fashion.
- After surgery: A member of your surgical team will teach you how to properly care for your wounds to minimize the risk of infection.
Breast reduction surgery is a relatively safe procedure for reducing the size of an individual’s breast or chest tissue. But as with most medical procedures, there are some potential risks and side effects.
Possible side effects include infection, swelling, pain, tenderness, fatigue, asymmetry, loss of nipple sensation, and delayed wound healing.
If you think you’re a good candidate for the procedure, consult with a surgeon to manage expectations and develop an appropriate postsurgery care plan.
Gabrielle Kassel (she/her) is a queer sex educator and wellness journalist who is committed to helping people feel the best they can in their bodies. In addition to Healthline, her work has appeared in publications such as Shape, Cosmopolitan, Well+Good, Health, Self, Women’s Health, Greatist, and more! In her free time, Gabrielle can be found coaching CrossFit, reviewing pleasure products, hiking with her border collie, or recording episodes of the podcast she co-hosts called Bad In Bed. Follow her on Instagram @Gabriellekassel.