Breast Reduction

Breast reduction surgery is a surgical procedure to reduce the size of the breasts and reshape them. In this procedure, excess fat, tissue and skin are removed, and even the dark circle surrounding the nipple can be reduced. The surgery is performed under general anesthesia. The surgeon makes an incision in one or more of the breasts and sutures the incision after removing the excess. Sometimes the nipple may need to be removed and repositioned. Depending on the situation, the liposuction method can also be applied during the surgery. Natural methods can be tried before deciding on breast reduction surgery. Losing weight with a healthy diet and herbal cures can be tried. The most effective exercises are push-ups and swimming.

What is breast reduction?

Breast reduction surgery is one of the surgical methods of mammoplasty (breast aesthetics). It aims to reduce the size of the breasts by removing excess fat, tissue, and skin. It alleviates the discomfort of large breasts and provides a proportional chest size to the body.

Where and to whom should breast reduction surgery be performed?

Breast reduction surgery is performed by specialist surgeons in the plastic and reconstructive services of private and public hospitals. Choosing an experienced doctor and hospital is extremely important in the success of the surgery.

Stages of the surgery

  • General anesthesia, and sometimes local anesthesia, especially if a small amount of breast reduction is to be applied, is applied to the patient.
  • An anchor-shaped incision is usually made around the areola and under both breasts.
  • Excess breast tissue, fat and skin are removed to reduce the size of the breasts.
  • The breasts are reshaped and the nipple and areola are repositioned. The nipple and areola usually remain attached to the breast, but if the breasts are too large, they may need to be removed and repositioned in the appropriate position.
  • The symmetry between the breasts is preserved or corrected if there is an asymmetry problem, but there may be some changes in breast size and shape.
  • The diameter of the areola can also be reduced.
  • After the procedure is completed, the incisions are sutured, gauze is placed on it, and the breasts are wrapped with an elastic bandage. It is then supported by a special surgical bra.
  • In some cases, drainage tubes may be placed under both arms to drain excess blood and fluid.
  • The operation takes 3-5 hours on average and does not usually require a hospital stay.
  • Antibiotics and painkillers are prescribed to eliminate the risk of infection and pain.


The breasts are the most beautiful feature of the female body. The perfect breasts are considered mainly round, positioned high on the chest, and firm. If breasts are large, their weight tends to pull them down, resulting in neck and back discomfort. Besides, with time breast tissue loses its elasticity and firmness, especially after pregnancies. In such situations, breast reduction or mastopexy is the only solution to improve breast shape. The mammaplasty should ensure good and durable aesthetic results with fewer complications.

Surgical Technique

The goals in any breast reduction or mastopexy are as follows:

  1. Adequate and safe reduction of breast volume or modification of breast shape
  2. Elevation of NAC (nipple-areolar complex)
  3. Superior pole fullness
  4. Stable results in time
  5. NAC with retained vascularity and sensibility

With the patient standing, the preoperative markings are drawn. The new nipple position is marked. The superomedial pedicle is designed next. The superomedial pedicle is designed to extend from the keyhole pattern to the bottom end of the medial vertical limb. The base of the pedicle extends partially in the keyhole and completely in the vertical limb, leaving a 1–2 cm border around the areola.

Skin incisions are performed and the pedicle is deepithelialized. Surgical excision of skin and glandular fat is excised.The excision is extended down to the chest wall. The superomedial pedicle is designed with a thickness of at least 2.5 cm to preserve its blood and nerve supply. Breast reshaping is begun by insetting the superomedial pedicle. The pedicle is thus released until it rotates freely without any tethering of the areola. After pillar closure, drains are used and skin suturing is performed.

Preserving an adequate blood supply to the NAC is the best way to prevent irreversible complications such as NAC necrosis. The superomedial pedicle technique serves the situation well because it conserves the NAC and breast tissue as a composite block, including glands, canals, and medial intercostal nerves. In addition, it offers a nice shape to the cleavage of the breast with superior pole fullness.

Major advantages of the superomedial pedicle breast reduction/mastopexy are superior pole fullness, reliability and safety regarding NAC viability, and more durable results on long-term follow-up with decreased risk of bottoming-out.

Antibiotic cover

All patients are treated with perioperative antibiotics. Cephalosporins are given intraoperatively and for about 3-5 days postoperatively (β lactams), it is associated with not only fewer wound infections, but also a dramatic reduction in suture splitting and wound healing problems.

Procedure completion

All the incisions are covered with steristrips covered with gauze pads.


The usual risks associated with breast reduction are early complications (hematoma, seroma, infection, and ischemia or even nipple- areolar complex (NAC) necrosis and wound dehiscence and late complications (numbness, asymmetry, under-or over- correction,  recurrent  breast  ptosis,  scar hypertrophy, and need for surgical revision for contour problems.


The patient is placed in a medical bra, strips covered with gauze pads.
Dressing change is made in 2-3 days. Patients are allowed to shower in 2-3 days after surgery.
Medical bra is advised for 6 weeks.
Patients are restricted to light activities for the first couple of weeks with return to activities in 3–4 weeks.