Post Breast Reduction: Not Happy with Size, What Are my Options?

Hi i am 29 and had a breast reduction 2 years ago. I was only reduced by one size and I am a size D (not much of a reduction for someone who is 135lb. My breasts have bottomed out and have lost its overall shape particularly towards the sides. As a result it is difficult finding bras which fit. I would like to know what options that i may have in fixing this problem. The nipples are still in upright position.

Doctor Answers 6

Repeat Breast Reduction?

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Thank you for the question.

Based on your description  in may be necessary to undergo breast reduction revisionary/redo  surgery.  This operation can serve to reduce the breast size further as well as improve the shape of the breasts.

Like every other procedure performed  this procedure carries its own potential risks. The main concern is related to blood flow to the remaining breast tissue;  is important to perform the operation in such a fashion that the blood flow to the nipple/areola/breast tissue is not compromised.   The  part of the tissue that is left in place  after breast reduction surgery is called the “pedicle"; this segment of tissue is responsible for delivering the blood supply to the nipple/areola/ breast tissue. If the pedicle (that was used during the previous breast reduction procedure)  is cut  then the blood flow to tissues may be compromised leading to serious competitions such as tissue necrosis etc.

If you choose to have another surgeon perform your breast surgery it will be helpful for you to find the previous surgeon's  operative report  prior to the redo surgery.

I hope this helps.

Breast Reduction - I Had a Reduction but I'm Not As Small As I Wanted To Be - What Can Be Done?

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Hi Baby2222,

In the range of problems, it's better to have too much tissue remaining than too little.  So that's the good news.

On the other hand, in order to address this issue you will need to undergo another procedure.  What that procedure is depends on what you look like now and what you're willing to have done.  If the nipples/areolas are in the correct position on your chest and the only problem is that you're fuller than you'd like to be, then liposuction alone may be an adequate treatment.

If, however, the nipples/areolas need to be elevated (raised) and you have some excess skin, etc., then you may need to undergo a more formal revision.  And if the nipples are too high, you may need to have a horizontal ellipse of tissue removed along the inframammary crease.

These are just suggestions; what you'll really need to do is see one or more plastic surgeons to get their assessment of what would be best for you.  Once they've done that, you'll be in a position to decide what you want to do.

I hope that this helps, and good luck,

Dr. E

Post Breast Reduction: Not Happy with Size, What Are my Options?

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Unfortunately you need a revision operation. seek boarded PS in your area to discuss with you in person. 

Breast reduction size

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Hi. Dissatisfaction with size after breast reduction is more likely to be because the breasts are too large rather than too small.  I think that's because we surgeons are cautious and also because the procedures have limitations. However, it is possible to have the procedure done a second time. Sometimes it can even be performed by liposuction, a very safe aproach to reducing a breast a second time.

Hugh McLean, MD
Mississauga Plastic Surgeon

Breast Reduction and long term shape

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Hello Baby2222,

The description of the appearance of your breasts details all the classic features seen in the appearance of many well-healed, long term breast reductions.  You have described a 'bottoming out' of your breasts, especially along the outer sides, with maintenance in the position of the nipples.

Surgeons who specialize in breast surgery see this all the time, and it is always correctable.   To understand how we can correct these issues, one needs to understand 'what happened'.  Its not that something was done wrong, it's just that breast reduction surgery can be done better in the first place.  If the breasts remain large and heavy after breast reduction, the weight and mass expands the lower pole of the breast, stretches the skin, which allows dropout of the internal breast tissue, deprives the upper pole of  fullness, and flattens the breast mound.

Correction centers on adequate excision of breast tissue as well as skin reduction in both the vertical and horizontal directions.  The key to success is removing enough tissue so that it no longer creates the downward force on the new and smaller skin envelope.   In certain individuals who want to maintain more breast size or would like more upper pole fullness, breast implants can be placed in the same operation achieving those goals.

Revision breast reduction surgery should be performed by surgeons who have a reputation and specialize in complex revision breast surgery, especially with the incorporation of breast implants.  They should be certified by the American Board of Plastic Surgery, and be members of the American Society for Aesthetic Plastic Surgery.

Best of luck!

Not happy with size after breast reduction

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Let me start by saying that further correction might be  possible. It will depend on many factors, including the current nipple position, as it nay not be possible to lift it further. During the original consultation, you should have had the opportunity to discuss your goals with the plastic surgeon. You should return to the doctor and review those goals with him and discuss whether he can improve your current dissatisfation.  If further surgery is undertaken, it will be important to know what technique was used , and if there were any problems encountered. Although additional surgery is safe, there are concerns about  the ciculation to the nipple and areola. An alternative to redoing the reduction might include  performing liposuction on the breast to reduce it further. This is not always a good option in younger women as the breast my be very dense. Somtimes, it is possible to remove additional tissue from the sides without redoing the entire operation.  Other issues that you may want to consider are furture pregnancies and nursing, as these may have an impact on your appearence.  These are questions that  should be addressed during any subsequent consultations.  Good Luck.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.