Is there a limit to how much can be removed in a Breast Reduction?

Hello, thank you for your question. That is correct as you want to only remove a certain amount to safely preform the procedure due to lack of blood supply. It will be more difficult with you since this is your second surgery. It is always okay to get a second and third opinion but they are correct about the blood supply being an issue.

Hello, I understand there might be some consternation with understanding how much breast tissue can be removed if you've had a previous breast reduction. We (plastic surgeons) worry about the circulation to the nipples and it largely depends on what style/pedicle of breast reduction you had in the past. With an inferior pedicle breast reduction the main blood supply comes from the lower half of the breast which carries blood circulation. There is a higher risk of poor venous blood return and congestion of the nipple that makes plastic surgeons very nervous of taking out too much breast tissue for fear of disrupting the circulation to the nipple which then causes a partial or full nipple necrosis. Your plastic surgeon who is likely skilled in breast reduction surgery has already made the assessment that removing too much will risk the blood supply. Hope that helps!

Blood supply to the nipple is paramount. You'll need to be careful if too much tissue is removed. Given your information you should be able to achieve a full C cup with a breast reduction.

There a variety of breast reduction techniques used. One is liposuction if the breasts have high fat content. However, it is possible to injury the blood supply if too much breast tissue is removed. Unfortunately, you have not provided photographs and we don't know what technique was used in your prior surgery. It may be possible to reduce the breasts by 50% depending on your current size and previous procedure. The breast reduction technique I recommend is The Bellesoma Method. This will reduce and reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. The weight of the breast is transferred to the underlying pectoralis major muscle resulting in pain relief without excessive reduction. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained if not injured during your previous surgery.

Best Wishes,

Gary Horndeski, M.D.

It is frustrating when you go through a surgery and do not get the results you had been looking for. The amount of breast tissue that can be removed at one time has no limit, it simply depends on the technique used to maintain circulation to the nipple. I have removed over 3000g from each side, and would remove more if appropriate. Seek a new opinion.

Having a second reduction always comes with an increased risk of issues with blood supply to the nipple but it can definitely be done. According to some of the existing research that risk reduces significantly once you are more than 5 years out from your initial reduction. Nevertheless the risk is never zero. More than 250 grams can be removed in a secondary breast reduction however your surgeon should have a frank discussion with you about the risk of nipple necrosis ( nipple death) and get your consent for a possible nipple graft ( nipple is removed and then sutured back in place) if there is any concern about blood flow to the nipple during the surgery.

The amount that can be removed in a breast reduction depends on various factors such as your overall health, body proportions, and the surgeon’s judgment. However, there are generally accepted guidelines to ensure a safe and proportionate outcome. It’s crucial to discuss your goals and concerns with a skilled plastic surgeon who can provide recommendations based on your specific situation.

Hello and thank you for your question! It is always best to be examined in person by a board-certified plastic surgeon. Individual planning for breast reduction patients is very important and the amount of breast tissue removed is patient specific. This amount will vary based on a person's body habitus, breast size, and desired bra cup size. However, there is a limit to how much can be removed during a surgery to help preserve the form of the breast and protect the blood supplies to the nipples.
Some patients have very large and heavy breasts and the risk of loss of the nipple is high enough to plan for a "free nipple graft" procedure. This procedure allows for a greater reduction of breast tissue because the nipple no longer relies on the underlying pedicle blood supply. However, there are significant disadvantages of this procedure permanent lack of nipple sensation, no ability to lactate, and lack of nipple projection. Typically this procedure would be reserved for very large breasts requiring large reductions.

There is a limit to how much the breast tissue can be reduced in order to maintain blood supply to the nipple/areola. If you are unsure with the recommendation of your surgeon, you can visit with a few other board certified plastic surgeons near you to listen to varying opinions. I've included a video on the procedure that I hope you find helpful.

You can reduce your breasts as much as you want or even remove them altogether if you are willing to have your areolae with nipples removed and grafted back on to the skin. Otherwise, enough tissue must be left to support the blood supply to the areolae.