Aesthetic surgery
Breast reduction
Listed under aesthetic surgery, but for most patients it is done for back pain, shoulder grooving and skin irritation rather than appearance.
What this treatment involves
Breast reduction — reduction mammoplasty — removes glandular tissue, fat and skin to make the breast smaller, and lifts and reshapes what remains. The nipple and areola are moved to a higher position, usually kept alive on a pedicle of tissue that carries their blood supply; the areola is often reduced in diameter at the same time.
The scar patterns are the same as for a lift: vertical for moderate reductions, an inverted-T or anchor for larger ones. Very large reductions occasionally require a free nipple graft, in which the nipple is removed and replaced as a graft — this always removes sensation and the ability to breastfeed, and is reserved for cases where a pedicle would not be safe.
Unlike most operations on this page, this one is frequently done for symptoms rather than appearance: neck, back and shoulder pain, grooving from bra straps, rashes and infection in the fold, and difficulty exercising.
Who may be suitable
Considered for adults with breasts large enough to cause physical symptoms or significant distress, whose breast development is complete and whose weight is stable.
Weight matters more here than in most breast surgery, because breast volume falls with weight loss; operating before a planned significant weight loss can lead to an unsatisfactory result. Smoking again raises the risk to the nipple’s blood supply substantially.
Age-appropriate breast imaging is arranged beforehand. Tissue removed at surgery is routinely sent for pathological examination, and this occasionally identifies an unsuspected abnormality.
As with a lift, it is generally better to have finished having children, though this is guidance about timing rather than a requirement.
Why patients choose it
Relief of physical symptoms is the most consistently reported outcome — reduction mammoplasty has among the highest satisfaction rates of any procedure in plastic surgery, and that is largely because it treats a problem the patient feels every day rather than one they see.
Practical changes follow: clothes and bras fitting, exercise becoming possible, and the resolution of skin irritation under the breast.
Shape and position improve at the same time, since a reduction includes a lift by necessity.
How treatment works
Consultation and assessment
Day 1
Symptoms, measurements and the amount of tissue to be removed are assessed together, along with nipple position and the pedicle technique to be used.
Planning the scars and size
Day 1–2
Scar pattern and target size are agreed. Aiming for a proportion rather than a cup size is more reliable, since cup sizing is not standardised between manufacturers.
Pre-operative tests and imaging
Day 2
Blood tests, ECG and anaesthetic review as indicated, with breast imaging appropriate to your age and history.
Surgery
Day 3
Under general anaesthetic, generally two to four hours depending on the size of the reduction.
First night and review
Day 3–5
One night in hospital is usual, sometimes two. Drains removed and the supportive bra fitted.
Fit to fly
Day 7–10
Wound check and confirmation from the surgical team. Tissue removed at surgery is sent for pathology and the result follows.
Settling
3–18 months
Shape settles by about three months, sensation returns gradually, and scars fade over a year or more.
What happens in Istanbul
Breast surgery requires a stay of seven to ten days. Consultation, examination and pre-operative tests take the first day or two, followed by surgery and usually one night in hospital. You then remain in Istanbul for review, wound checks and removal of any drains before flying. Departure is confirmed by the surgical team rather than by your booking — flying too soon after surgery raises the risk of blood clots.
Recovery
A supportive bra is worn continuously for several weeks. Drains are sometimes used for the first day or two.
Swelling and firmness settle over several weeks; the breasts feel heavy and tender initially. No lifting, no arms above the head and no strenuous exercise for four to six weeks.
Shape settles over about three months as swelling resolves and the tissue softens. Scars follow the same course as in a lift: worst at two to three months, then fading over twelve to eighteen months. Some numbness of the nipple and lower breast is usual early on, and sensation returns gradually over months in most but not all patients.
Risks and considerations
General anaesthetic carries its own risks. Scarring is certain and follows the pattern agreed before surgery.
Compromised blood supply to the nipple is the most serious specific risk and can cause partial or complete nipple loss. It is substantially more likely in smokers and in very large reductions.
The ability to breastfeed is frequently reduced and may be lost entirely, and is always lost where a free nipple graft is used. Changed or absent nipple sensation is common and can be permanent.
Wound breakdown at the junction of the scars under the breast is not unusual, particularly in larger reductions, and can take weeks to heal. Fat necrosis can produce firm lumps in the breast that take months to soften and can be confused with other lumps on examination — which is a reason for follow-up imaging rather than for alarm.
Asymmetry in size, shape or nipple position is possible. The breasts continue to change with weight and age, and some patients need revision.
This information is general and educational. Whether a procedure is appropriate for you can only be determined by a qualified medical professional after an individual assessment, including your medical history and an examination.
Common questions
Will I still be able to breastfeed after a reduction?
It is frequently reduced and sometimes lost entirely. Where the nipple is kept on a pedicle, some milk ducts are preserved and some women do breastfeed afterwards — but it cannot be promised, and the larger the reduction the more duct tissue is removed. Where a free nipple graft is necessary, the ability to breastfeed is always lost. If future breastfeeding matters to you, say so at the consultation: it may affect the technique chosen, or the advice on timing.
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