Breast Reduction Surgery (Reduction Mammoplasty)

What is Breast Reduction?

Some women with larger breasts become large at puberty when they first begin to develop. Others become much larger with the birth of children and never return to their previous size. Some become larger as they grow older. Most women with large breasts (macromastia) have real physical complaints related to the weight of their breasts.

Many women have chronic neck, shoulder or back pain and feel that their breasts are out of proportion to the rest of their bodies. Most complain of shoulder notching from the weight on their shoulder straps. Many have problems with the skin under their breasts, either because of the skin constantly folding upon itself or being chafed by the bra. Carpal tunnel syndrome and chronic headaches have also been related to macromastia. Exercise can be very awkward.

In addition to these physical complaints, many women have difficulty finding clothes that fit well and are not able to wear the styles they would like. Some women dislike the appearance of very large breasts, especially the sagging that usually accompanies this size. Many of my patients seek reduction after breast cancer treatment, either because the non-cancer side does not match the lumpectomy/radiation side, which is much smaller, or because with passage of time, the normal breast has outgrown the reconstructed breast on the other side.

A breast reduction improves the size and shape of the breasts. As one of the breast reduction surgeons in Richmond VA, I have found that many women experience a major improvement in their back and shoulder discomfort following surgery. Many women feel a major improvement in back and shoulder discomfort and other pre-operative symptoms. A breast reduction also reduces the risk of breast cancer and long-term, makes breast self-examinations and mammograms more accurate.

Breast reduction surgeons in Richmond, VA perform reduction mammoplasty to reduce breast size and sagging. In this operation, both skin and breast tissue are removed, and the breast is reshaped into a more normal position on the chest. Usually, the areola (the darker skin around the nipple) is also made smaller.

The suture lines (incisions) which result from this surgery are around the areola in a circle and extend down from each nipple and under each breast (in the crease) in an upside-down T. Occasionally, if a patient has minimal breast droop, the incision may be around the areola with only a vertical scar below.

Every suture line becomes a scar when it is fully healed. The operation cannot be done invisibly, and scars cannot be removed or avoided entirely. The appearance of scars depends on many things, but most of all, it depends on how an individual patient heals. Patients who tend to form keloids (thick heavy scars) may develop these in any breast incision.

A patient who heals well with flat pale scars will usually form acceptable scars after breast surgery, but fairly wide scars can be common after this operation. It usually does not improve stretch marks.

Please purchase and bring a wish bra that you would like to fit into after surgery to your pre-op appointment and with you the day of surgery. This will give Dr. Blanchet an idea of what size you would like to be.

In some patients, especially if a large amount of breast tissue is to be removed, a moderate amount of blood loss is unavoidable. Patients may need to take iron pills (SlowFe) at home for a few weeks.

Risks and Possible Complications

As with any surgery, there are possible complications from this operation. Excessive bleeding may occur during or after the procedure. Infections are rare, but do occur occasionally. In this case, antibiotics are given, and the healing process usually takes longer. Very rarely, stitches may have to be opened to allow drainage of infection. These areas are then allowed to heal on their own, and they usually do over a period of time.

Nipples may become numb as a result of reduction mammoplasty. If this happens, it is usually temporary, but it could be permanent. Even more rarely, it has been reported in the literature that the nipple and areola may lose their blood supply and be lost entirely. This happens in less than 1 in 800 cases, and I personally have not seen it in my practice. In the unusual event that this does happen, a new nipple and areola can be made using skin from other parts of the body. This is usually only a consideration with massive breasts or in smokers.

Your risk of all wound healing complications increases significantly if you are overweight. Please be aware of this.

Additional Information


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