Answers to Common Breast Reduction Questions

Jeffrey Horowitz, MD

Article by
Bel Air Plastic Surgeon

It is well-known that the some of the happiest patients in any Plastic Surgery practice are those that have had breast reduction surgery.  This is because not only do they look better, but the symptoms related to their large breasts, such as bra strap grooving and back pain, have been relieved.  Fewer operations are so effective at improving self esteem and quality of life. 

I have noticed that a lot of patients in my own practice and on RealSelf.com ask many of the same questions about the surgery so I thought it would be helpful to list the answers here.

1. Will you have to graft the nipples back on? – It is very unusual to have to do this. Breast reductions are accomplished by creating a “pedicle” or a pyramid-shaped flap of breast tissue, at the top of which the nipple stays attached. Only with extremely large breasts would the nipples be removed and grafted back on.

2. Will I lose the ability to breast feed? –Studies have shown that 70% of women are able to breast feed after reduction surgery, but only 30% do. These are the same percentages for women who have not had breast surgery.

3. Will I lose sensation to my nipples? – This is an unusual complication. In fact, at times, the sensation in large breasts can actually improve after reduction surgery. This is because the nerve that supplies sensation is less stretched than it was preoperatively and it can actually work better.

4. What are the scars like? – In a typical breast reduction, the scar has an “anchor” shape. This means that the scar goes around the areola, then straight down from the 6 o’clock position of the areola to the fold under the breast, and then along the fold under the breast.

Increasingly, I am performing breast reductions using a “vertical” technique, meaning the scar along the fold beneath the breast is eliminated. This creates what is sometimes called a “lollipop scar”. This represents the most modern thinking in breast reduction surgery. Not only is there less scarring, but the breast gland itself is sutured to create a longer lasting result.

5. What if I want my breasts to be smaller and lifted? – This is a common misconception. All breast reductions accomplish the following: breasts are made smaller, more shapely and higher up on your chest. The areola are typically reduced in diameter and raised so that they are centered over the breast mound. In other words, any breast reduction includes a lift.

A breast lift alone does the same things, with the exception that the breasts are not made any smaller.

6. When can I go back to work? – This depends on what kind of work you do. You cannot lift anything heavier than 5 pounds, nor do vigorous exercise for two weeks after your operation. If your work does not require you to do this, you can go back when your pain allows, which is usually in one week.