Breast reduction - How a breast reduction is performed

You will be asked to undergo some general health tests before your operation to check that you are fit to have surgery.

Before the operation

If you smoke, you may be asked to quit in the weeks before your operation. This is because smoking increases your risk of chest and wound infections and can slow the healing of your wounds, leaving you with worse scarring.

Being overweight can also slow the healing process, so if you are overweight you will be encouraged to lose weight before your operation.

Read more information about how to quit smoking and losing weight.

If you take the oral contraceptive pill or hormone replacement therapy (HRT), your surgeon may advise you to stop taking it a few weeks before your operation as these drugs can increase your risk of developing deep vein thrombosis (a blood clot in a leg vein). You should also avoid aspirin and anti-inflammatory drugs.

Before your operation, you will be asked to sign a consent form. This is to confirm that you understand the risks, benefits and possible alternatives to the operation.

Read more about the risks of breast reduction surgery.

The operation

Breast reduction surgery is usually done under general anaesthetic (when you are asleep). You will be asked to follow fasting instructions before your operation. Typically, you cannot eat or drink for six hours before having the anaesthetic.

Surgery takes between 90 minutes and four hours. You may be required to stay in hospital for up to three or four nights afterwards, although most women only need to stay one or two nights.

The surgeon will use a pen to mark the areas of the skin where the incisions (surgical cuts) will be made. With your permission, the surgeon may also photograph your breasts for confidential before and after images for your records.

Most breast reduction surgeries begin with the nipple, which is moved to its new position, usually while still attached to the blood supply. If you have extremely large breasts, the nipples may be removed and repositioned as a skin graft. They will naturally develop their own blood supply.

Excess skin and breast tissue are then removed. The remaining breast tissue is reshaped to create smaller and more elevated breasts.

Breast reduction techniques

There are various different ways to do a breast reduction. Your surgeon will decide which is most appropriate for you depending on the size of your breasts and the desired outcome. The most common techniques are described below.

Anchor type or inverted T reduction

This is the most common type of breast reduction. It results in an anchor-shaped scar starting around the areola, travelling down vertically and then horizontally across the breast crease.

Vertical pattern breast reduction

This technique results in a circular scar around the areola, and a vertical scar passing downwards towards the breast crease (sometimes described as a "lollipop" scar).

Vertical pattern breast reduction has the advantage of leaving no scarring under the breast and a lower chance of wound complications.

However, this technique may leave a small fold of skin initially at the lower end of the vertical scar. This usually resolves itself within a few months, but may require removal under local anaesthetic if it does not resolve. It is also not always suitable for particularly large breasts.

Circumareolar reduction

This technique results in a circular scar around the areola, but it is only suitable when removing a small amount of tissue.