Why do some patients who have breast reduction surgery end up with dead tissue and really awful wounds?

Your concerns are understandable. Although breast reduction is routinely performed by most Plastic surgeons , it still remains extensive surgery and carries a number of risks. The most common problem being wound healing complications. These can vary from minor oozing at the "T" junction, to more extensive wound breakdowns, tissue necrosis, and even nipple loss at the extreme. Having said that, breast reduction still remains the plastic surgery procedure with the highest satisfaction rate amongst patients and surgeons. The wound problems can be due to patient factors- smoking, diabetes, connective tissue disorders etc -, and /or due to inappropriate surgical technique. Plastics surgeons are trained very hard to understand and respect the tissue blood supply, and this is a key aspect for the success of almost every plastic surgery operation. For this reason, you should never cut corners when it comes to selecting your surgeon. Look for proper qualifications, training, memberships, and make sure they have an accessible aftercare service. However, even the most qualified and experienced surgeon may have problems. The difference is that they do recognise and deal with them early. Wound problems usually heal with conservative management and rarely affect the overall result. It is extremely important however, to have a good aftercare and be able to see your surgeon or a specialist nurse for regular checks. Don't forget that disaster cases make the news very easily. Still, most of those disasters could have been avoided, had they been diagnosed and treated at an early stage.

Hi. Thanks for asking those very real and relevant questions regarding the risks of breast reduction.
Your surgeon will be able to outline to your some of the risks, both common and uncommon, pertaining to breast reduction. Having a surgeon who is board certified does not guarantee a risk free procedure. It does however, ensure that your surgeon has undergone the necessary level and quality of training to carry out the procedure safely AND to be able to manage any complications that may arise.
Wound healing problems, poor scarring, and nipple necrosis are both all un-welcomed (and uncommon) complications in breast lift/reduction surgery. They are generally related to inadequate blood supply going to the tissue, although infection can also be a factor. 
Please remember that breast reduction surgery does give a very good outcome and high satisfaction in the majority of patients. Complication risks are involved in every kind of surgery, and all measures need to be taken to minimize them.You need to be confident in understanding the procedure and in the experience and skill of your surgeon. 
All the very best.
Dr Ray Goh

Thank you.
There are side effects and complications of any surgical procedures. Breast reduction is a common and safe procedure. Minor wound or delayed wound healing can occur but in the main most patients heal well and is back to their routine in about 4-6 weeks.
please check that your surgeon is a fully qualified specialist.
I hope this helps.