Breast reduction - The risks

Scarring
Scars after breast reduction take some time to fully mature. Scars may thicken or stretch and occasionally need a helping hand to optimise the outcome.

Bleeding
The breast has a very rich blood supply and some bleeding is not uncommon. Drains are often left in place for a short time. On rare occasions, a trip back to theatre may be required to remove a blood collection.

Infection
Wound infection is relatively uncommon – deeper infections are usually associated with fat necrosis (see fat necrosis).

Fat necrosis
Fat is sensitive to changes in its blood supply and responds by turning hard. This can present as tender painful lumps in the breast or may liquify creating a discharge. While the process of fat necrosis will usually resolve itself with time, any new lump needs to be discussed with your doctor and investigated.

Wound healing
Breast reduction involves complex remodelling of the breast; a consequence of this may be a reduction of the blood supply to wound edges leading to delayed healing. This is rarely a significant problem and is usually managed with dressings only. In those few cases where it is a more serious problem, tissue loss may require surgical intervention.

Changes to the nipple/areola
Breast reduction can affect the nipple in three ways

1. Interference with the blood supply – is a very rare but recognised complication which can result in partial or total nipple loss (significantly less than 1%)
2. Interference with the nerve supply may result in reduced nipple sensitivity.
3. Interference with the milk ducts could result in a reduction in ability to breastfeed.

Breast shape
Mild asymmetry is not unusual following breast reduction surgery. Other minor shape differences include ‘dog ears’ and pleats, asymmetric areola, and nipple height discrepancies.

Sensation of the breast
The breast itself can have patchy areas of reduced sensation following breast reduction. Most of these resolve with time, but occasionally they can be longer lasting.

Breast pain
Pain following surgery is usually mild and is normally controlled with simple analgesia. Very rarely some patients may complain of more prolonged pain.

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