Breast Reduction Surgery

Risks & Complications

Just like any other surgical procedure, breast reduction has risks and complications. It is essential that you are aware of all these breast reduction risks before you commit to having surgery.

Your surgeon will discuss all relevant breast reduction risks and complications with you before you agree to have the procedure. The information below should be considered a short overview of possible breast reduction risks and complications. Contact your surgeon or Medbelle Patient Care Adviser if you have specific questions or want to learn more about any breast reduction risk,

The breast reduction surgery risks and complications include:

Infection

An infection develops when bacteria grows in a wound, provoking an immune response. Infection is a breast reduction risk as it is with any surgery.

Symptoms of an infection can develop within one to two weeks after breast reduction surgery.

It is essential you contact your GP or surgeon as soon as you notice any of these symptoms of a low-grade infection:

  • Increased pain that is not eased with painkillers
  • Swelling
  • Warmth or redness that starts at the incision site and grows in size
  • Red streaks around the incision site
  • Any foul-smelling liquid or pus leaking from the incision
  • A fever over 38° C

Signs of infection should never be ignored. Infection does not have to be a concerning breast reduction risk as they can usually be easily treated with antibiotics if caught and diagnosed quickly. This is why it is so important to contact your surgeon if you recognise any of these infection symptoms.

If an infection is allowed to progress, it can severely and negatively impact the look of final results from breast reduction and lead to serious health problems like sepsis.

Blood clots

Patients of breast reduction risk blood clots because of their limited mobility in the days and weeks following surgery.

Clots after surgery usually develop in the so-called deep veins in the legs, arms, and torso but are most common in the legs. When a clot develops in a deep vein, it is called deep vein thrombosis or DVT for short.

If your surgeon believes you are at higher risk of a blood clot after breast reduction surgery, they may prescribe you wear compression stockings until you are able to go about your normal activities again. Compression stockings aid blood flow to the legs and help prevent clotting just like the compression bra worn while healing from breast reduction surgery.

Though a blood clot is unlikely to form after breast reduction surgery, it is important you are aware of the risk and understand the symptoms.

Symptoms of DVT can present in the leg, arm or torso depending on where the clot has developed. They are usually confined to the area of the body where the clot has formed.

The symptoms of DVT include:

  • Throbbing pain
  • Cramping
  • Swelling, warmth and redness
  • Soreness or skin sensitivity
  • Very red or darkened skin

If you develop any of these symptoms in the weeks after your surgery, contact your GP or surgeon immediately.

Tissue necrosis

If the blood supply to areas of the skin, fat, breast tissue or the nipple is lost during breast reduction surgery, the tissue may die. This results in the breast reduction risk called necrosis.

Tissue necrosis is much more likely to develop in smokers than non-smokers. This is one reason it is so important you refrain from smoking or using nicotine products before and after surgery. Learn more about why you should stop smoking before surgery in this article on the Medbelle blog.

Areas of necrosis in the breast may feel lumpy, uneven and hard. Occasionally, this may interfere with the interpretations of breast scans such as mammograms.

If tissue necrosis does occur after your breast reduction, you may need further surgery to remove any dead tissue and repair your breast or breasts.

Bruising & bleeding

Bruising and bleeding are a natural part of the healing process after breast reduction surgery. Some light bleeding and bruising may happen in a week or two following surgery.

Abnormal bleeding or bruising may be a sign that you have a bleeding complication like a haematoma.

A haematoma is similar to a bruise but more severe and deeper in the body. It is a large amount of swelling that is red in colour and very painful. Contact your surgeon or healthcare professional immediately if you see these symptoms form on or near your breasts after breast reduction.

Excessive or keloid scarring

Scarring is a natural part of the healing process after surgery. Scars will naturally form wherever the surgeon makes incisions on the body.

For some patients considering breast reduction, the risk of scarring is a major deciding factor. It is important to know that choosing a skilled surgeon is the best way to ensure you are happy with your breast reduction results.

Also, a highly experienced surgeon who is a member of BAAPS/BAPRAS will have up-to-date training on the best methods to reduce the look of scarring after breast reduction surgery.

Depending on your skin quality and predisposition to scarring, you may have fairly obvious scarring on your breasts after breast reduction surgery. Your surgeon may recommend silicone patches and massage once your incisions completely heal.

Keep in mind that the look of scaring can improve for years after surgery as the colour lightens and they blend into the skin.

Keloid Scarring

Very thick, raised scars called keloid scars are a breast reduction risk and can form on any patient. If you have ever developed a keloid scar from an incision or injury, you are more likely to develop them again. You can see an example of a keloid scar below.

Patients with deep skin tones are also more prone to developing keloid scars. You can learn more about deep skin tones and scarring after breast reduction surgery here on the Medbelle blog.

Common areas for keloid scars are the shoulders, neck, upper chest and anywhere on the head including the earlobes. However, keloid scars can develop anywhere on the body. Keloid scars are known to grow over time and can be difficult to treat.

If you develop a keloid scar after breast reduction, your surgeon may prescribe steroid injections into the scar, steroid-infused bandages, or even revision surgery.

Altered breast sensation or numbness after Breast Reduction

The nature of breast reduction means some nerve endings may be disturbed after surgery. This can result in feelings of heightened sensitivity or numbness after breast reduction surgery.

These changes in sensation or numbness after breast reduction surgery can resolve themselves over time as the nerve endings grow back and the breasts heal. However, a breast reduction risk is that this numbness or change in sensation may be permanent.

Modern surgical techniques reduce the likelihood of permanent sensitivity or numbness after breast reduction surgery especially around the breast and nipple. We recommend discussing altered breast sensation with your surgeon if you have concerns.

If you do have altered breast sensation or numbness after breast reduction surgery, you will likely be recommended to wait and see if it improves as your breasts heal.

Pseudoptosis (bottoming out)

Pseudoptosis (pronounced sue-doe-TOE-sis) is the medical term for bottoming out. This means the crease of the breast, where the breast tissue meets the torso, migrates lower than its natural position.

When bottoming out happens after breast reduction surgery, the lower portion of the breast tissue droops downwards. As the majority of the breast volume moves lower on the chest, this results in the nipples looking like they are placed very high on the chest

Bottoming out after breast reduction is more likely to occur in patients who have an Inverted T style incision and have a large amount of tissue removed during surgery. This can happen to one or both breasts after breast reduction.

While there is no pain or health-risk associated with the breasts bottoming out after breast reduction surgery, this complication directly impacts the aesthetic results after surgery.

Bottoming out after breast reduction can usually only be resolved via a revision breast surgery. Most Medbelle surgeons will only recommend revision breast surgery after the breasts have healed from the initial breast reduction.

Generally, patients must wait 3 to 6 months before they are healed enough to have revision breast surgery.

Seroma

After breast reduction surgery, pockets of clear fluid called seroma can form around incision lines.

Seromas are generally not a harmful breast reduction risk. They are not likely to impact the look of your final breast reduction results. The majority of small seromas heal by themselves as the fluid is reabsorbed by the body.

Your surgeon may prescribe having larger seromas drained. This is a quick process that can be done during a follow-up appointment.

There is a very small chance that the seroma will not be reabsorbed by the body which results in a capsule forming around it. Usually, these encapsulated seromas are removed surgically.

Loss of the nipple and areola

The loss of the nipple and areola is a relatively unlikely breast reduction risk. It is more commonly associated with a free-nipple graft breast reduction procedure than more modern techniques.

During a free-nipple graft breast reduction, the nipple and areola are completely removed from the breast and reattached after tissue is removed. This increases the risk of tissue necrosis and numbness and also completely blocks the ability to breastfeed after surgery.

Less invasive pedicle methods that keep the nipple and areola attached to the breast tissue are much more common breast reduction techniques today. While the nipple and areola can still be lost after a pedicle method breast reduction, it is much less likely to occur.

If the nipple is lost after surgery, reconstructive surgery can be performed once the breast is healed. While the reconstructed nipple will have no ability to breastfeed, it will improve the aesthetic look of the breast.

Aesthetic issues or unhappiness with results

While your surgeon will do everything in their power to give you the results you want from breast reduction, there is a risk you may be unhappy with the look of your breasts after surgery.

The best way to prevent this is by being well-informed about the realities of the procedure and having realistic expectations for your results. You can learn more about realistic expectations for breast reduction surgery here.

It’s important to keep in mind that it can take up to a full 12 months for final results to be visible as the breasts continue to heal. In fact, aspects like scaring generally continue to improve for years after surgery.

If you are unhappy with the look of your breasts after surgery, you will need to wait at least 6 months to have any revision surgery. You may even be recommended to wait longer as your healing journey continues.