The Risks of Having a Second Breast Reduction
It seems like you are already aware of the issue regarding what type of breast reduction surgery was originally performed. This has to do with your current surgeon knowing what blood supply was preserved the first time. In general, it's a good idea to have the original surgeon do the subsequent procedure, but understanding that that is not always possible, it helps to at least have the original operative report. If this procedure is more of a touch up, to improve areola shape for example, it's probably not a big deal. But if you need a significant amount of breast tissue removed again, the risks to blood supply and nerve supply are higher.
Breast reduction second time around
You are quite correct in that breast reduction the second time does have a greater risk of sensory loss in the nipple, or worse, nipple loss. The superior pedicle does make reduction a bit safer the second time and you are smart to stay with an experienced surgeon. Chances are you will do well but risk is greater.
Best of luck,
What are the Risks in Having a Second Breast Reduction?
Sounds like your PS has done a great informed consent for you. Secondary FULL reduction have higher risks and if you are aware of them you have done your homework.
A second breast reduction can have additional risks because of the blook supply to the nipple. Knowing the type of breast reduction that was performed is helpful in minimizing risks.
Risks of second breast reduction
As long as your plastic surgeon knows the exact technique used in the previous surgery, then he can take into account the altered blood supply to the nipple. So, for instance, you state that you had a previous superior pedicle technique. It is important that he use the same techniques to preserve the nipple blood supply . To just alter the shape of the areola is not very risky since it only involves removal of skin and resuturing. You might also want to ask him about liposuction to reduce the volume and then skin removal only to tighten the breast envelope. This will further increase your chances of not having any compromise of nipple blood supply.
D. Medalie, MD
Second Breast Reduction Risks
Secondary Breast Reduction Risks
An examination by a board certified plastic surgeon experienced in secondary surgeries would be required. Often, the location and type of scarring tells the surgeon the most likely surgical approach used previously. Your position is not unique and in most cases revisional surgery is possible without complications.
Here is an overview of complications that can occur with breast revisional surgery
The specific risks and suitability of this procedure for a given individual can be determined only at the time of consultation. All surgical procedures have some degree of risk. Minor complications that do not affect the outcome occur occasionally. Major complications are rare. In general there are comlications that apply to surgery just about anywhere such as : excessive bleeding, unsightly scars, pain, fluid collection (seroma) beneath the skin, wound separation, infection,etc.
Then there are complications specific to the breast reduction such as: nipple sensation change/loss, fat necrosis (hardening of breast tissue), breast asymmetry, all of which may require revisional surgery.
Thank you for the question.
It sounds like you are aware of the potential conflict of supply when a redo breast reduction is performed.
The 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.
It may be helpful for you to find the previous surgeon's operative report prior to the redo surgery.
I hope this helps.
Risks associated with a second breast reduction
The biggest risks from performing a second breast reduction is loss of the nipple-areola complex and or of a significant amount of breast tissue due to interruption of blood supply. Given that you already know which technique was employed, your risks for these will be decreased as long as your plastic surgeon is experienced and takes this into account when performing the reduction. It would not even be unreasonable to seek out the plastic surgeon who performed your original surgery.