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Breast Reduction



                                        Breast Reduction Risks and Complications

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RISKS of Breast Reduction Surgery


Small differences in shape or size of the breasts are not uncommon following breast reduction surgery. Including unevenly positioned nipples.




Fat necrosis occurs when fat cells lose blood flow. Fat cells are living cells and if there is no blood flow, they may die and cause "fat necrosis". The liquefied fat cells can harden overtime underneath the skin, causing firmness or contour irregularities. Surgical intervention might be needed to help alleviate some of the symptoms caused by fat necrosis.

"Fat necrosis is more common in larger resections. A study by Strombeck reported a 16% incidence of fat necrosis in obese patients having resections of more than 1000 g. However, the incidence of fat necrosis has been reported as low as 0.8% in 371 patients undergoing an average resection of 870 grams per breast". This problem may prompt later investigation or biopsies to differentiate these lumps from those associated with breast cancer.





Dog ears are small folds of skin which occur at either end of the scar, caused by a natural folding of the skin when the wound is closed. Dog Ears occur approximately five percent of the time.  Great care is taken during the surgery to avoid this complication however; sometimes this cannot be avoided.  

Small dog ears which are seen in the early post-operative period will normally settle on their own during the first six to nine months after surgery. If they do not settle after this time, they can be simply cut out in a minor procedure under local anesthetic.

Photos of "Dog-Ears"




Skin or tissue necrosis following breast reduction is a very rare complication; however there are increased risks with patients who fit a certain profile.

Patients with increased risks of necrosis occurring:

  • compromised wound healing - or wound separation

  • patients who smoke

  • patients with circulatory problems

  • diabetes

  • patients who have undergone chemotherapy or radiation


Necrosis can occur in the following places following breast reduction:

  • breast tissue

  • breast envelope

  • breast incision line

If tissue necrosis occurs after breast reduction, there is great promise with hyperbaric oxygen therapy HBOT. 



As with any surgical procedure, infection can occur during or after the breast reduction operation. Infections can sometimes occur if wound separation happens. It is very important to make sure you take all of your prescribed antibiotic medication. 


Signs to call your surgeon immediately:

  • Fever – temperature of 101 degrees or higher

  • Chills

  • Sweating

  • Excessive pain or redness from the incision site

  • General malaise

  • Drainage from the incision has a greenish tint

  • Bad odor coming from the incision site

  • Draining too steadily

All the above symptoms are signs of an early infection, and if caught early enough, then sometimes all the patient might need is an increase in antibiotics. Infections can cause a delay in wound healing as well as prolong the recovery time for breast reduction surgery. Because of the risks that are associated with an infection with this surgery, you need to be in the best of health at the time or the procedure to give you the very best odds.

Read more about the signs and symptoms of an infection




Possible loss of feeling in breasts can happen from breast reduction surgery. 

Numbness in the nipples and the surrounding breast tissue after breast reduction surgery is normal. This will go away after a few weeks or so. In some rare cases this numbness can be permanent.  Plastic surgeons will tell their patients to give this at least a year before diagnosing this as permanent sensation loss, as nerve fibers grow at a very slow rate and can take months before the feeling comes back into the breast area.

Shooting pain from the nerves and tingling during breast lift recovery is also normal. This means the nerves are trying to regenerate, so these sensations are a good sign that the nerves are returning to normal function.




As you heal after breast reduction surgery, the lower half of the breast tissue may stretch out below the level of the nipple/areola complex.  This causes the nipple/areola complex to point upward and all the fullness of the breast is below this area causing asymmetry to the breast creases. This condition is called Bottoming Out.  If this should happen after breast reduction, it may require additional surgery to excise some of the extra skin along the lower incision lines.




Dark spots can cause permanent hyper-pigmentation from the bruising that occurs from this surgery. Treatments are available if you should get this rare complication, including Intense Pulse Laser treatments. Application of warm compresses after you are healed helps with the dilation of blood vessels and the re-absorption of blood.




Post operative blood loss is normally a rare complication with breast reduction surgery; however, if you do get this you should seek medical help immediately. Blood transfusions may be necessary in severe cases. 

Your plastic surgeon will instruct you before the surgery to stop taking any anti-coagulants before your surgery, and an include aspirin and aspirin containing medications, Vitamin E, anti-inflammatories or Warfarin etc.




  • Hematoma or Seroma

A hematoma or a seroma can be a complication of breast reduction surgery.  A hematoma is a collection of blood in a body cavity in which pain, scar tissue, swelling, edema, and also infection is possible. 

A seroma is a collection of the watery portion of the blood in a body cavity in which can also cause pain and scar tissue to form. 

Read more about Hematoma and Seroma




This is a risk of most surgeries, including breast reduction. A pulmonary embolism is a blood clot in the lung. A clot can break free from the surgical site, and travel to the lungs. This condition can cause the patient great distress and could lead into myocardial infraction or possibly a coma which leads to the loss of oxygen rich blood to the brain. 

Pulmonary Embolism normally happens within the first 72 hours after surgery; however it has been known to happen for up to three weeks after a surgical procedure. The important factor to know with this complication is that it can occur without any warning and normally happens suddenly.




Most patients will have some change in nipple sensation following mammoplasty. This is usually temporary but could take months to return. 

Hypersensitive nipples can occur after any breast surgery. To help with the discomfort patients should try wearing some sort of gauze pad or Band-aid to help prevent the clothing from rubbing the affected area.




Sometimes the incisions will pull apart. This does not require additional surgery. It is treated with moist dressings. However, if this occurs, recovery time is much longer.

Breast Reduction Photos of Delayed Wound Healing / Wound Separation




Since breast reduction surgery removes most of the milk ducts leading to the nipples - future breast feeding might not be possible.

Read more about breastfeeding and breast reduction




Fortunately most "bad reactions" to anesthesia are not life-threatening. However, all forms of anesthesia including the different forms of local, can carry a risk of an allergic reaction. Anesthesia exposes the body to controlled levels of toxic chemicals in order to make sure there is no pain felt during a surgical procedure. The main goal of anesthesia is to either stop pain temporarily or to induce a semi-conscious or unconscious state. Even though anesthesia carries a risk, the benefits outweigh any potential disadvantage.

The most important factor is making sure that whoever administers the anesthesia are board certified in anesthesiology. By doing this, you reduce the risks of any complication that might arise during surgery. All body functions and chemistry are monitored during your surgery to ensure a safe procedure.

The most common reaction or danger of having anesthesia is an allergic reaction to one of the medications used.  This is addressed immediately by the attending anesthesiologist by monitoring your vital signs.  If an allergic reaction occurs, your anesthesiologist is equipped to handle this immediately. Severe allergic reactions during anesthesia are fortunately rare.

It is very important to tell your anesthesiologist every medication you take on a regular basis, so that he can prevent any potential problem during surgery. 

Read more about anesthesia's risks and complications




Permanent and wider scars are more common among smokers. Information about hypertrophic and keloid scarring, and if you are at risk.

Read more about scars




Some patients might not be totally satisfied after breast reduction surgery with their size.  Sometimes the surgeon might not take off as much breast tissue as they had hoped for. Make sure you tell your surgeon the size and look you are after before your procedure.




Common in very young patients with large breasts (Juvenile Hypertrophy).




Recurrence of ptosis is a very common problem, after several years the breast may begin to droop again. Although it will not be to the extent it was before surgery, what you will notice is that you loose some of the superior pole fullness. Some of the newer techniques however; do focus on maintaining more fullness superior by glandular reshaping.





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