Breast Reduction Complications (Reduction Mammoplasty)

What Potential Complications Can Occur after Breast Reduction (Reduction Mammoplasty) Surgery

When you think about breast reduction surgery, also known as reduction mammoplasty, it’s important to understand that it’s a procedure designed to remove excess breast fat, glandular tissue, and skin to achieve a breast size in proportion with your body. It aims to alleviate the discomfort associated with overly large breasts. However, as with any surgical procedure, breast reduction comes with its own set of potential risks and outcomes that you should be fully aware of before making a decision.

Understanding the process is crucial. Reduction mammoplasty involves a series of steps starting from the initial consultation to the surgery itself, followed by the recovery period. At each stage, Sydney Specialist Plastic Surgeon Dr Jake Lim will explain the procedure, the expected results, and the potential risks involved. It’s a collaborative approach where your medical history, lifestyle, and personal preferences are taken into consideration to ensure an optimal outcome.

Download Dr Lim’s Free 2024 Breast Reduction Surgery Guide (Reduction Mammoplasty)

Why Breast Reduction Complications Occur

Complications from breast reduction (reduction mammoplasty) surgery arise for various reasons. Some factors are related to the individual’s health and lifestyle, while others are inherent to the surgery itself. For instance, individuals who smoke, are overweight, or have certain medical conditions like diabetes or heart disease may face a higher risk of complications.

The complexity of the surgery also plays a role. Breast reduction (reduction mammoplasty) is not a simple procedure; it involves incisions, removal of tissue, and reshaping of the remaining breast. Each step carries potential risks for complications such as infection, bleeding, or adverse reactions to anaesthesia. Moreover, the skill and experience of the surgeon are critical in minimising these risks.

Another factor is the body’s response to surgery. Each individual heals differently, and some may experience more inflammation, scarring, or delayed wound healing. These responses can be influenced by genetics, nutrition, and overall health. It’s essential to follow preoperative and postoperative instructions closely to ensure your body is in the best condition to heal and recover.

Potential Complications Associated with Breast Reduction (Reduction Mammoplasty)

Here are some of the complications that can occur after getting a reduction mammoplasty:

General Risks

Scarring: All surgeries that involve incisions will result in some form of scarring, though the appearance and severity can vary
Infection: The risk of infection at the incision sites is a common concern for any type of surgery
Bleeding (Haematoma): Post-operative bleeding under the skin can occur in any surgical procedure, potentially requiring additional surgical intervention
Poor Wound Healing: Factors like individual health, age, and lifestyle can affect wound healing in any surgery
Deep Vein Thrombosis (DVT) and Pulmonary Embolism: These serious complications can occur after any type of surgery, especially those involving general anaesthesia or prolonged immobilisation
Anaesthesia Risks: Complications related to anaesthesia, including allergic reactions and respiratory issues, are possible with any surgery requiring general anaesthesia
Fluid Accumulation (Seroma): This can happen after various types of surgeries, where fluid collects near the surgical site, sometimes requiring drainage or further surgery

Complications Specific to Breast Reduction (Reduction Mammoplasty)

The list of potential breast reduction complications can seem daunting, but being aware of them is the first step towards prevention:

Changes in Nipple or Breast Sensation

One of the specific risks associated with breast reduction (reduction mammoplasty) surgery is the potential for changes in nipple or breast sensation. This can manifest as either increased sensitivity or a decrease in sensation, including numbness. These changes occur because the surgery involves cutting through breast tissue and nerves, especially when resizing and repositioning the nipple and areola. While for some patients, the change in sensation is temporary and may return to normal within a few months to a year, for others, it can be permanent.

The extent of sensation change can vary widely among individuals and is influenced by the specific surgical technique used, the amount of tissue removed, and individual healing responses. Dr Lim aims to preserve nerve function as much as possible, but in some cases, the repositioning of the nipple-areola complex is necessary to achieve the desired breast shape and size, which can increase the risk of altered sensation.

Asymmetry

Breast asymmetry after reduction surgery is another risk specific to this procedure. While all women naturally have some degree of asymmetry between their breasts, surgery can sometimes exacerbate these differences or introduce new asymmetries. Factors contributing to post-surgical asymmetry include differences in how each breast heals, variations in the removal of tissue, or changes during the healing process that affect the shape, size, or position of one breast compared to the other.

Dr Lim strives to achieve symmetry during the procedure, planning incisions and tissue removal carefully. However, the healing process is unpredictable, and factors such as scar tissue formation or differential swelling can lead to asymmetrical outcomes. In some cases, minor touch-up surgeries may be necessary to correct significant asymmetries that are bothersome to the patient.

Difficulty Breastfeeding

Breast reduction surgery (reduction mammoplasty) can impact a woman’s ability to breastfeed. The procedure often involves the removal of glandular tissue and ducts that produce and transport milk, as well as potential repositioning of the nipple, which can disrupt the natural lactation process. The extent to which breastfeeding is affected depends on the amount of tissue removed, the surgical technique used, and how the nipple is repositioned.

Some women are able to breastfeed after breast reduction, while others may experience a reduced milk supply or find breastfeeding challenging. It’s important for women who are considering future pregnancies and wish to breastfeed to discuss these concerns with Dr Lim. Techniques that preserve as much of the milk ducts and glandular tissue as possible can be considered, although it’s not always possible to guarantee the ability to breastfeed post-surgery.

Counselling and support from lactation consultants can be beneficial for women attempting to breastfeed after breast reduction surgery. They can provide strategies and techniques to maximise milk production and address any breastfeeding challenges that arise.

Loss of Breast Tissue (Fat Necrosis)

Fat necrosis is a condition where fat cells in the breast die after being damaged, which can occur as a result of breast reduction surgery (reduction mammoplasty). This risk is specific to procedures that involve significant manipulation and removal of breast tissue. Fat necrosis can lead to firm lumps within the breast, which may be mistaken for cancerous tumours but are benign. These lumps can vary in size and may be accompanied by skin changes or discomfort.

The development of fat necrosis is related to the disruption of blood supply to the fat cells during surgery, leading to their death. In most cases, the body will gradually absorb the dead cells, but this process can take months, and in some instances, the lumps may remain permanently.

If fat necrosis causes significant discomfort or concern, further medical evaluation and treatment may be necessary, including imaging to confirm the diagnosis and, in rare cases, surgical removal of the affected tissue.

Patients should be aware of this risk and monitor their breasts for changes post-surgery. Regular follow-up appointments with Dr Lim can help ensure any complications are identified and managed promptly.

How to Minimise the Risk of Breast Reduction (Reduction Mammoplasty) Complications

Minimising the risk of complications starts with preparation. Prior to surgery, it’s important to follow all the guidelines provided by Dr Lim. This may include quitting smoking, adjusting your medication, or reaching a stable weight. By adhering to these recommendations, you help set the stage for a smooth procedure and recovery.

During the consultation phase, openly discuss your medical history and any concerns you may have. The more information Dr Lim has, the better he can tailor the surgery to your needs and anticipate potential complications. Don’t hesitate to ask questions and ensure you understand the risks involved.

Post-surgery, adhering to aftercare instructions is just as important as the preparation. This includes taking prescribed medications, attending follow-up appointments, and monitoring for signs of complications. It’s essential to allow your body the time it needs to heal and to avoid activities that could strain the surgical site. Maintaining a healthy diet and staying hydrated will also support your recovery.

When to Seek Medical Attention for Breast Reduction (Reduction Mammoplasty) Complications

Despite taking all the necessary precautions, it’s important to know when to seek medical attention after breast reduction surgery. If you notice any signs of infection, such as increased redness, warmth, swelling, or discharge at the incision sites, or if you develop a fever, you should contact your surgeon immediately.

Bleeding or the appearance of a hematoma, which might present as a rapidly enlarging bruise or swelling, is another reason to seek urgent medical care. Persistent severe pain that isn’t relieved by prescribed medication should also be addressed promptly, as it may be a sign of a complication.

Changes in sensation are expected, but if you experience complete loss of sensation or if the changes don’t improve over time, consult your surgeon. Additionally, any abnormal appearance of the breast that develops suddenly, such as indentation or significant asymmetry, warrants a medical evaluation.

In case you suspect a blood clot, evidenced by pain and swelling in one leg, shortness of breath, or chest pain, you should seek emergency medical attention as these could be signs of deep vein thrombosis or a pulmonary embolism.

Breast reduction (reduction mammoplasty) surgery can offer benefits, but being well-informed about the potential complications is important for a successful outcome. By understanding what to expect, how to prepare, and when to seek help, you can navigate the process with confidence.

FAQs about Breast Reduction (Reduction Mammoplasty) Complications

What people wish they knew before getting a breast reduction?

Many people who undergo breast reduction surgery wish they had been more informed about the recovery process and the emotional adjustments that come with it. Specifically, they often express that they underestimated the time needed for full recovery and the impact of temporary restrictions on their daily life and physical activities. Additionally, some wish they had a better understanding of how their scars would look and evolve over time, as well as the potential for changes in breast sensation or the ability to breastfeed. Understanding the importance of having realistic expectations regarding the outcome and the patience required for seeing the final results is also a common reflection.

Is it safe to reduce breast size?

Yes, reducing breast size through breast reduction surgery (reduction mammoplasty) is generally considered safe when performed by a qualified and experienced plastic surgeon. However, as with any surgical procedure, there are risks and potential complications. These risks can be minimised by thoroughly vetting the surgical team, clearly communicating your medical history and expectations, and closely following pre- and post-operative care instructions.

Do breast reductions grow back?

While breast reduction surgery (reduction mammoplasty) removes excess breast tissue permanently, it’s possible for the breasts to increase in size again due to weight gain, hormonal changes, or pregnancy. The breast tissue that remains after surgery can still respond to these factors. However, significant regrowth is not common, and many patients maintain their post-surgical breast size long-term with a stable weight and lifestyle. It’s important for patients to have realistic expectations and understand that while the results of breast reduction surgery (reduction mammoplasty) are designed to be permanent, changes in body weight and hormonal fluctuations can impact the size and shape of the breasts over time.

Medical References about Breast Reduction (Reduction Mammoplasty) Complications

Breast Reduction Risks and Safety – American Society of Plastic Surgeons
Unfavourable results following reduction mammoplasty
Breast reduction surgery – Mayo Clinic
Breast Reduction Surgery: An Overview – WebMD
Predictors of complications following breast reduction surgery – ScienceDirect