Breast Reduction Recovery

I want to have a breast reduction surgery, but after seeing pictures of patients whose operation went very wrong, I got worried and discouraged. Why do some patients who have breast reduction surgery end up with dead tissue and really awful wounds? How can you prevent that? Is it the doctor's fault? If the operation goes great and the patient follows the post operation treatment correctly, can still this happen? If the doctor I'm seeing is a member of the ISAPS, can I be assured that he won't do anything wrong? Please, I'm really really worried.

Doctor Answers 65

Breast reduction surgery complications

Breast reduction surgery removes a large amount of tissue: anywhere from 1-4+ lbs of tissue per side.  When the remaining tissue does not have adequate blood flow, healing problems can occur.  These might range from a small area that is slow to heal, all the way up to losing a nipple.  The major risk factors for healing problems are:
  1. Smoking
  2. Diabetes
  3. Very large breast size
If you have very large breasts, your surgeon may recommend a free nipple reduction, where the nipple is taken off the breast and put back on as a skin graft.  This ensures good blood flow to the nipple in its new position.  

I require my patients to quit smoking before reduction surgery to help minimize risks due to smoking.

Good management of diabetes can help decrease risks as well.  This is evaluated by looking at the hemoglobin A1c level.

In addition, ask your surgeon how many breast reductions he or she does a year, as well as his/her complication rate.  This should give you a better idea of your individual risk of complications after breast reduction surgery.

Cleveland Plastic Surgeon
4.8 out of 5 stars 10 reviews

Bad Results With Breast Reduction

First, most surgeons put their best pictures up on the internet and many patients put their worst disasters on the internet. The end result is that you see the best 10% and the worst 10% but not the middle 80%. Breast reduction surgery has an exceptionally high satisfaction rate, higher than any other procedure that plastic surgeons do.  The reason is that results are immediate, improvement fitting into clothes and comfort walking around is often better only a few days after surgery than it was before surgery, and most people go through surgery without any complications.  Take some time to find a good plastic surgeon who does multiple variations of a breast reduction and who can match the procedure to your body. Find someone you trust and an office you feel comfortable in. Stay away from those who pressure you into surgery and DO NOT SMOKE before your operation.
Dr. Pyle

Jeremy Pyle, MD
Raleigh-Durham Plastic Surgeon
4.9 out of 5 stars 107 reviews

Breast reduction complications

Breast reductions are more advanced level cases in the spectrum of cosmetic cases.  Besides the risk factors of diabetes, smoking, high blood pressure and cholesterol, some of the most important determinant of a necrosis complication is the technical aspect.  Making the nipple base to thin or dissecting underneath the pedicle (bridge) to the nipple can cause significant problems.  Adhering to good techniques and good patient selection gives consistently good results and if there is a complication it is usually small enough that can be handled easily.  Pick a doctor that does a lot of these operations routinely.  Dr. Michael Omidi

An in-person exam with a board-certified plastic surgeon is the best way to assess your needs and provide true medical advice. The response to the question does not constitute a doctor patient relationship or formal advice.  

Michael M. Omidi, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 90 reviews

Technique & Breast Reduction Recovery

I prefer to use a minimal incision surgery with a “#vertical” or “#LollipopBreastReduction #scar technique. The benefits of this technique include approximately fifty percent less scarring, a narrower breast, better forward projection and shape, longer lasting improvement, shorter surgery time and less complications.

The initial discomfort post procedure subsides daily and can be controlled with oral medication.
Most patients resume normal activity within two weeks. However full activity, lifting, sports, with no restrictions is safer after 6 weeks Some discomfort, swelling and discoloration of the #breasts are to be expected for several weeks. 

The scars at the incision lines typically become reddish and a few weeks after surgery are raised and firm. In a number of months they become pale and soft. After 8-12 months, the scars are relatively inconspicuous. The #nipples and some areas of the skin may be numb or sensitive after surgery. Sensation may return within a few weeks or months, but may be diminished or overly sensitive.

Your procedure should be performed by a #PlasticSurgeon who is board-certified and has a great deal of experience specializing in cosmetic #surgery. You will then greatly improve your chances of getting the result you desire, and, without the need for a revision surgery. It is suggested that you look at before and after photos of the surgeons actual patients, and read patient reviews. Gathering all of this information will help you make a well-informed decision.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 107 reviews

Breast Reduction Recovery and Complications

Thank you for your question.

Breast reduction surgery is safe and effective. Many of patients go home the same day, although most opt to stay in hospital overnight. All the sutures I use are dissolving and most patients are able to lightly shower over their dressings the following day. I ask my patients to wear a bra with no underwire day and night for the first two weeks. Most patients return to work after 2 - 3 weeks. I ask patients not to exercise for 3 - 4 weeks. Most patients feel well enough to drive after 1 - 2 weeks.

All surgery involves some risks - wound healing problems, bleeding, pain for example. Thankfully, the complication rate of breast reduction surgery is low. Make sure your plastic surgeon is a registered member of the Australian Society of Plastic Surgeons, or the Australian Society of Aesthetic Plastic Surgeons. This is your way of ensuring your surgery is being performed by a specialist who knows what they are doing. If complications occur, it is important that you are under the care of someone who knows how to treat them.

It important that you feel comfortable with and have confidence in your surgeon. I often meet with patients a few times before their procedure to go over everything and make sure that we're all on the same page. As I am sure you will read elsewhere on this forum, breast reduction surgery is a popular procedure which patients recover well from. In the main, breast reduction patients are overwhelmingly glad they went through with their surgery.

I hope this helps.

Damian Marucci, MBBS, PhD, FRACS
Sydney Plastic Surgeon
5.0 out of 5 stars 10 reviews

Breast reduction recovery

Most people who undergo breast reduction are very happy. After surgery, they literally feel like they have a huge weight off of their shoulders, and many women are able to stand up straight and look and feel more confident. That said, not everybody is a great candidate for breast reduction. For example, the top three risk factors that can lead to major wound healing problems are smoking, obesity (BMI > 30), and diabetes. Knowing this, many plastic surgeons will avoid operating on smokers (or at least require that the patient stop smoking completely of a couple of months before surgery), require that patients lose weight so that their BMI is less than 30, and keep their glucose (blood sugar) under control. If all of these factors are controlled, then it is still possible to have wound healing problems. For example, the surgeon must be careful to preserve the blood supply to the nipple. Sterile technique must be used in a certified operating room. If the operation goes well and the patient is compliant with postoperative treatment, it is still possible to have wound healing problems, but the risk is then minimized. If your doctor's only qualifications is that he is a member of the ISAPS, then that may be a red flag. You want to look for a board-certified plastic surgeon, meaning the surgeon has been certified by the American Board of Plastic Surgeons and is a member of the American Society of Plastic Surgeons. The ABPS has an extremely rigorous board certification process, and they are the only medical board in which breast reduction is part of the board certification process.

Board Certification Matters Most

As a board-certified plastic surgeon with extensive experience performing cosmetic breast surgery, I can say with confidence that women who undergo breast reduction are among the most satisfied patients I've treated. There is always the risk of complications with any surgical procedure, but if you select a plastic surgeon certified by the American Board of Plastic Surgery (who might also be a member of ASAPS or ASPS), your chances of experiencing the type of complications you may have seen are going to be significantly lower. I hope this helps ease your anxiety.

James N. Romanelli, MD, FACS
Long Island Plastic Surgeon
4.6 out of 5 stars 22 reviews

Complications following Breast reduction.

Delayed wound healing or dehiscence of suture line can rarely happen . These are treated  conservatively  with dressing and oral medication. The worst complication following breast reduction is loss of blood supply to the Nipple and Areola complex. This is rarely seen  in women who are diabetic or are smokers. If this happens ,then new nipple and areola have to be created after the wound heals completely.  This can rarely happen in any surgeons hand.

Jayanthy Ravindran, MS, DNB, MRCS
India Plastic Surgeon
4.8 out of 5 stars 6 reviews

Breast Reduction Surgery

Thank you for your inquiry. The first step is to set up a consultation with a board certified surgeon. Once you are in the consultation, see how you feel about your surgeon? Can you ask her questions easily? Does she tell you about the procedure in detail and possible complications? Ask her to show pictures of patients pre and post-operatively.  Complications happens to the best of surgeons, the question you want to ask is how your surgeon takes care of them. This is a very common procedure and many patients have very few complications. Good Luck!

Maria M. LoTempio, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 14 reviews

Breast Reduction Surgery and Complications

Breast reduction surgery has been one of the more rewarding aspects of my practice as my patients continually explain that their surgery has been life changing.  No surgery is without risks for complications.  Technique certainly can play a part in complications, such as nipple necrosis, which is why I would implore you to seek out a Plastic surgeon certified by the American Board of Plastic Surgery.  Sometimes, complications occur outside of the surgeons control or fault can lie with improper patient selection.  For instance, patients who have an elevated B.M.I., diabetes mellitus, or are smokers have a higher incidence of wound healing complications, infections, skin and nipple/areolar necrosis.  If you do not have these risk factors, and your are being treated by a board certified Plastic surgeon, your risk for complications is very low and will in all likelihood have a successful outcome.  

Joseph L. Hill Jr., MD
Lexington Plastic Surgeon
5.0 out of 5 stars 5 reviews

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.