Breast Reduction Considerations and Risks

By Jerome Edelstein, MD

FINDING THE RIGHT SIZE

Though the majority of women wish to achieve a B or C cup, the natural size and shape of a woman’s body will help to inform the most aesthetically pleasing goal. Most patients want to reduce their breasts to a “normal” or average size while other women, such as those who are very physically active, may seek greater reduction. Women who desire substantial cleavage may also opt for a larger post-operative breast size. Dr. Edelstein can accomplish nearly any size alteration, but, as a general rule of thumb, the possibility of experiencing surgical complications can rise alongside the amount of breast tissue removed during surgery.

POST-OPERATIVE BREASTFEEDING

The breast reduction procedure involves removing a significant amount of tissue and ducts from the breasts. This means that there is a risk of being unable to breastfeed after surgery. It’s also important to note that post-operative pregnancy and breastfeeding cause the breasts to increase in size again, possibly negating the benefits of the reduction.

POST-OPERATIVE MAMMOGRAMS

It’s extremely important for every woman to receive regular mammograms, especially as they advance in age. The temporary destabilization of tissue caused by surgery may cause changes in the breast tissue pattern monitored by mammogram x-rays for the first two years following treatment. For this reason, patients should schedule a baseline x-ray immediately after the breast tissue has stabilized. The results of this baseline can be used in mammogram comparisons in the years to come, helping physicians to differentiate between regular and abnormal changes to the breast.

SCARRING

Dr. Edelstein talks about how he reduces scarring

Every surgical procedure leads to scars and breast reduction is no different. While not a complication, normal scarring will always result as a side effect of surgery. These scars will fade and soften over one to two years, but will never completely disappear. We are aware of the importance of hiding scarring that can easily be concealed by clothing. The majority of patients will be able to continue wearing items as revealing as halter tops and evening gowns without worrying about scar visibility. When unclothed, the breast scars may remain visible, however.

Your surgeon exercises caution when suturing wounds. Patients who properly adhere to the post-operative wound care regimen provided to them will help to promote healing and minimize scarring. Every woman is different, though, and natural healing tendencies may play a large role in scar development.

Abnormal healing can lead to raised, red, itchy or tender marks known as hypertrophic scars. These develop in 25% of breast reduction patients.

COMPLICATIONS AND RISKS

Despite the safety of breast reduction surgery, there are still other risks inherent to the treatment and the administration of general anaesthesia. Some bleeding may occur during recovery, but is usually pre-empted by the placement of drains that reduce any blood accumulation beneath the skin. Healing complications like wound reopening, infection or delayed recovery are rare, but can require antibiotics. If the incisions open during healing, they may prolong the recovery period and create significant scars. Some patients may notice a decrease in nipple sensation. This is often a temporary issue that resolves on its own, but can also be permanent.

After a reduction the size and shape of the breasts may be asymmetrical due tissue movement and scar formation. Women with large, asymmetric breasts prior to surgery are more likely to experience this complication. It’s possible for the nipple/areola to become inverted or fail to form a perfect circle after healing as well.

The diversion of blood vessels that takes place during surgical breast tissue alteration can lead to poor circulation and in severe cases, some breast tissue or portions of the nipple/areola may be lost as a side effect.