Need a second reduction. What are the risks for a second one?

The risks of healing problems and loss of tissue is slightly greater with a secondary procedure, but most surgeons believe the risks are still low, making this safe to consider. This is particularly true in your case, as you have had 12 years for your breasts to recover and revascularize. If you can obtain a copy of your original operative report, this would be helpful to the surgeon planning your procedure.

A second breast reduction, or "re-reduction," can be a viable option, but it comes with some specific risks. One of the primary concerns is preserving the blood supply to the nipple and areola. If the blood supply is compromised, it could lead to nipple necrosis, though this is rare with careful planning. Altered nipple sensation or loss of sensation is also a potential risk. An experienced surgeon will understand the implications of your previous surgeries and have experience with revision procedures.
Factors like hormonal fluctuations or weight changes could contribute to breast regrowth, making the need for a second reduction more likely. To minimize risks, it's essential to consult with an experienced plastic surgeon who specializes in revision procedures. They can assess your previous surgery and create a tailored plan to ensure the best outcome while addressing the unique challenges of a second breast reduction.
Krishna Vyas, MD, PhD, MHSHarvard, Hopkins, & Mayo Clinic Trained Aesthetic Plastic SurgeonNew York, New York

Dear Cinnabon5264, thank you for your question!

It’s understandable that you’d want to revisit a second breast reduction, especially given the changes you’ve experienced over the years. Breast size can fluctuate due to hormonal shifts, pregnancy, weight changes, or even long-term effects of medications like birth control. These factors likely contributed to the increase in your breast size since your initial reduction.

A second breast reduction is indeed possible, but revision surgeries come with unique challenges. Scar tissue from your first procedure can make the surgery more complex, and preserving the blood supply to the nipple becomes even more critical. Additionally, there’s a higher likelihood of changes in nipple sensation or even loss of sensitivity. Healing may also be slower due to changes in skin and tissue elasticity, and risks like infection or bleeding remain standard surgical considerations.

I recommend consulting a board-certified plastic surgeon experienced in revision breast surgeries. They’ll carefully assess your current breast tissue and anatomy, ensuring a tailored plan to help you achieve your desired results while minimizing risks. With the right approach, a second procedure can help restore your comfort and confidence. Wishing you the very best on this journey!

Hello, my name is Dr Igor Burko and I am a plastic surgeon at SY Aesthetics in NYC.
Yes, it is possible to have a breast reduction procedure even after having one in the past.
Ideally, you can obtain your operative records from the first surgery to give during your consultation so that the surgeon is aware of the technique you had performed previously.
If you do not have the operative report, you are still a candidate for a breast reduction.
The risks are that the blood supply to your nipple and areola can be compromised by performing a second reduction. However, I recommend you consult with a trained plastic surgeon to discuss your options.

Hello Cinnabon5264.
The most common cause of breast growth after pregnancy if weight gain.
So if you have gained weight, loosing it again will help but sometimes the breasts don't reduce to the previous size.
Having a 2nd reduction gas the same risks, we just have to make sure the blood supply to the nipple and areola is preserved. The size of the reduction and the mivilization of the nipple and areola are the most important factors.
If you would like more information let me know

Thanks

Dear Cinnabon5264,
it is hard to tell for sure without an examination. Generally speaking, revision surgery has a higher risk of complications. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

- Having a second breast reduction is termed a "re-reduction," and this is a procedure I have performed numerous times.
- The key with this operation is blood supply to the nipple areolar complex
- I perform all of my primary breast reductions with a superior-medial pedicle. "Pedicle" is the medical term for the tissue that has a nerve and blood supply in it. In this case the pedicle supplies the nipple and areola.
-When performing a breast re-reduction, the concern is making sure that the blood supply to the nipple and areola are not compromised.
-If you have an operative report showing that a superior or superior-medial pedicle was performed when you had your first breast reduction, then you could show that to your plastic surgeon so he/she will know more about blood supply issues that could affect your nipple/areola, BUT it is unlikely that you have that operative report, AND that's just fine!
-When I perform breast re-reductions, I just assume that the old fashioned, or more popular, way of performing breast reductions in the past was likely used, whereby an inferior pedicle was used. The issue here is: that is exactly in the area of your breast where tissue needs to be removed.
-Of course removing that tissue also removes the dominant blood supply to your nipple and areola.
-Therefore, for patients like you, I remove all of that excess inferior (lower) breast tissue and skin, and de-epithelialize (remove the top layer of skin) around the areola, and allow the nipple and areola to be nourished by a random pattern blood supply. The key here is not moving the nipple and areola too much higher, but it can certainly be raised several centimeters very safely.
-The other option would be to try to re-create the old inferior pedicle, but that is purely guesswork as the old pedicle can not be readily identified, and it can take a long turn to the side under the skin before reaching the nipple and areola, so I never try that technique.
-Lastly, a free nipple graft is an option, but loss of sensation and some loss of pigment accompanies that method. And healing time takes longer.
-The above is very technical, but important! The key is this: meet with a board certified plastic surgeon (ASPS Member) who has a lot of experience with breast re-reductions!
-Best of luck to you, and thanks for sharing!

Hi Cinnabon,
It sounds like you could benefit from a second breast reduction, especially if you're again experiencing the symptoms you had in the first place- back, neck, shoulder pain, bra strap grooving, rashing and sweating in the inframammary folds....I see a lot of this in my practice and also see a lot of patients in need of revisionary procedures. To answer your question, yes, there is a rare condition that exists where breast tissue grows abnormally and in excess. Sometimes bodies simply inexplicably change .Technically there is an increased risk of nipple necrosis due to already compromised blood supply to the nipple areolar complex, but if you are young and healthy (and have no toxic habits), that risk is quite low. When you consult with your board certified plastic surgeon, he or she will evaluate any other risk factors you may have to determine if you're a good candidate.
I wish you the best in your search for treatment!
-Dr. Nik

Thanks for your question! Hormonal changes or weight gain are usually to blame for an increase in breast tissue. Rest assured that risks are relatively low for a second breast reduction. Especially since your first one was about 12 years ago. Please be sure to seek out an in-person consultation with a qualified plastic surgeon. Good luck!

I have often performed secondary breast reduction. You are at a higher risk for complication of nipple necrosis because the 2nd lift/reduction may cut some of the blood supply. It also depends on what technique was used during your 1st surgery. However, the 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.