All surgery carries risks, and this includes breast reduction procedures. Some complications are minor and easily treated, while others are more serious and complicated. Thankfully serious complications are uncommon with breast reduction surgery.
It is important to not only fully consider the risks before proceeding with your surgery, but to also learn what you can to minimise potentially preventable risks.
Potential Risks of Reduction Mammoplasty
There are a range of possible risks when it comes to breast reduction surgery. These include:
Infections are rare following breast reduction but are a possibility with all surgical procedures. A significant infection following breast reduction usually only occurs if there has been an unrecognised or untreated haematoma (blood collection) in the breast. If you should get an infection following surgery, your surgeon may prescribe antibiotics and monitor your progress closely.
All surgery leaves scars, and some patients scar more readily than others. It is important to work with your surgeon, your post-op team, and follow all instructions to minimise scarring. The “Lollipop” vertical method has the advantage of much less scarring compared to the “anchor scar” method, which is why Dr Drielsma prefers it.
All women have some degree of natural asymmetry. Your surgeon will take this into account prior to surgery. However, it is important to remember that breasts are sisters, not twins, and there will always be some small amounts of asymmetry present after surgery, in size, shape and nipple appearance.
Delayed Wound Healing
Issues with delayed wound healing sometimes occurs in patients. The risk is higher in patients who are overweight, smokers, have poor nutritional intake, or who develop an infection.
Typical incision patterns of breast reduction are the vertical “lollipop” or the “inverted T” or anchor scar method. In both cases, it is not uncommon that some wound healing issues occur centrally in the crease under the breast – the bottom of the lollipop or the “T junction” of the anchor. This may manifest as redness, discharge or sometimes opening and may appear to have minor infection. These issues always heal by themselves with simple dressings and don’t need re-stitching or further surgery.
Your surgeon and nurse will manage your healing process and take any necessary steps if delayed wound healing occurs.
All breast reductions will affect in some way nipple sensation as nerve supply to the nipple is affected in performing the surgery. Most patients will notice a drop in sensation to the nipples, particularly in the first few months following surgery but this will tend to improve and return as bruised nerves recover. Some permanent change in sensation is however to be expected but this will vary from patient to patient and one breast to the other. While permanent complete loss of nipple sensation can occur, this is very rare.
Your ability to breastfeed can be affected after breast reduction surgery. However, it is important to remember that this is a possible risk for all breast procedures. Further, some women with large pendulous breasts are not able to breastfeed prior to surgery. Equally, many women are able to successfully breastfeed after surgery. If you are going to have children after your breast reduction surgery, it is important to discuss this with your surgeon.
Even following very large breast reductions, where a big amount of breast tissue/weight has been removed, the result may still be a D or DD. Over time breast tissue will tend to sag or drop again and in some cases, typically around 5%, “bottoming out” may occur. This is where breast tissue moves to the lower pole and can make the nipple look or feel higher. You can discuss revisional tightening of lower breast skin with your surgeon in this situation.
It is important to have realistic expectations about what size you will be following your breast reduction. If you are quite large, say an F or G cup, it is unrealistic to expect you will be able to be reduced to a B cup or even a C cup and still get a nice looking result. If too much tissue is removed with a breast reduction, it will be at the expense of shape and no one wants unsightly breasts following surgery. Be sure you and your surgeon are clear on expectations of size – ask to see before and after photos of patients of similar size to you so you get a good feel of what size you will be. Patients having breast reduction are almost always very happy with their results, unless they have unrealistic expectations
Serious Breast Reduction Risks
There are some serious risks to breast reduction surgery. However, these are rare.
After surgery, blood can sometimes pool at the surgical site. If a haematoma occurs, you may need further surgery to treat it or remove the haematoma. The incidence of haematoma is around 2%.
You will meet your anaesthetist prior to surgery to discuss any specific concerns you may have. Modern anaesthesia is very safe and well tolerated by virtually all patients. Rarely, however, allergic reactions and adverse reactions to anaesthetic agents can occur. You should notify your anaesthetist of any mediations you are using and concerns with your past health you may have prior to surgery.
Nipple Loss or Necrosis
Necrosis, or tissue decay, is very rare and can affect all or parts of your nipples. It is a rare complication, and it is generally more frequent in those who smoke and the larger the breast reduction.
It is important to let your surgeon, hospital care team, and nursing team know if you have any allergies. This includes allergies to:
- Surgical tape
- Suture material
- Topical preparations
- Blood products
- Injecting agents
Keloid Scars or Large Scars
As said before, all surgery leaves scars. There is always variability between patients and how much they will scar. Further, patients who are prone to keloid scarring and more significant, uneven scars. Your doctor will discuss this with you in your consultation and our team help you reduce scar visibility. It is also important to follow all post-operative recommendations to ensure you have the best post-operative outcome possible.
It is important to remember that other risks also apply. Further, some patients may have elevated risks or unexpected reactions to their breast reduction procedure. Your surgeon will review your potential surgery risks during your consultations.
Risks are also listed in our surgery consent documents, so it is important that you read and understand the information provided.