Breast reduction - Risks associated with breast reduction

The possible complications of any operation include an unexpected reaction to the anaesthetic, excessive bleeding or developing a blood clot.

Complications specific to breast reduction surgery are described below.

Scarring

The main disadvantage of having breast reduction surgery is that you will be left with permanent scarring. The operation, when done using the more common anchor technique, leaves three scars:

• one around the nipple (areola)
• one from the nipple to the crease below the breast (this is the most significant scar)
• one from the breast bone to the armpit along the crease below the breast

The severity of scarring largely depends on the individual. Some women are left with red and raised scars, but most scars fade over time and should be invisible under normal clothing and most bras or bikini tops.

Uneven shape

Your breasts will change shape after reduction surgery. There is a chance that they may end up slightly lopsided or lumpy and the nipples may be uneven.

Wound healing problems

Wound healing problems after breast reduction surgery are common, particularly after the anchor scar procedure where the vertical and horizontal scars meet.

Most wound problems are minor and can be simply managed and treated. More severe wound complications, such as infection, skin loss and wound separation, may take longer to heal.

Occasionally, some fat in the breasts dies off, leaving them red and lumpy. This is called fat necrosis and can take some time to settle. There can also be some excess skin left around the scars. It may need to be surgically removed if it does not settle after a few months.

If you smoke or have diabetes, you may have poor circulation, which will affect how quickly your wounds heal.

Loss of nipple sensation 

Some women lose sensation in their nipples after a breast reduction and the nipples may also lose their ability to become erect. This is because the nerve supply to the nipple can be damaged during surgery.

Very rarely, a disrupted blood supply may cause your nipple to die and fall off. This is more likely if you smoke heavily or you have poor circulation.

Inability to breastfeed

Some women are unable to breastfeed after having breast reduction surgery as some operations involve separating the nipples from the milk ducts.

Haematoma

Occasionally, bleeding occurs inside the breast tissue, making it swollen and painful. This is called a haematoma and generally occurs within the first 24 hours after the operation. If this happens, you may need to have another operation to drain the blood and stop the bleeding.