What are the risks and complications of a breast reduction?

Even when performed on healthy patients, any surgical intervention carries an unpredictable risk of complications. Therefore, it is essential to take all necessary preventative measures to minimize these risks. This includes reducing or eliminating known risk factors such as smoking, obesity, and treatable illnesses before surgery. Breast reduction surgery is a safe procedure; however, this does not mean we should let our guard down. We must remain vigilant and follow best practices to ensure a successful and complication-free operation for our patients.

Possible Complications of a Breast Reduction

Hypertrophic and Keloid Scars

In rare cases, visible, red, and aesthetically unacceptable scars occur, such as hypertrophic scars and keloids. Various approaches exist to prevent the appearance of such scars, such as the use of specific creams and ointments. However, if scars are already present, surgical intervention may be necessary to correct them. This surgical revision can be performed on an outpatient basis under local anesthesia.

Asymmetry

Asymmetry shouldn't be considered a major complication, as slight discrepancies between breasts, in terms of shape or size, are quite normal and impossible to completely eliminate if originally present. If, after undergoing a breast reduction, you notice significant differences between the two breasts, further surgery is often necessary, generally after at least six months.

Hematoma

In surgical procedures, particularly breast reduction, there's a risk of bleeding before and after the intervention. Most often, this bleeding leads to the formation of a hematoma, an accumulation of blood inside the breast.

Infection

Although infrequent, local infections can occur after a breast reduction. These infections can lead to complications such as suture re-opening and delayed complete healing. In such cases, antibiotic treatment is usually prescribed, and frequent dressings are necessary. Once healing is complete, it is important to assess the quality of the scars and consider surgical revision if they do not meet expectations.

Necrosis

After a breast reduction, problems with blood supply can occur. These problems lead to a total or partial loss of the areola-nipple complex and necrosis of the cutaneous, glandular, or adipose breast tissue. The frequency of this complication is 1 to 2%, according to most scientific publications. The risk is higher in cases of breast reduction exceeding 1000g per breast, especially in smokers.

Reduced or complete loss of nipple sensitivity is transient, although very frequent immediately after breast reduction surgery. In most women, sensitivity improves within a few months, with complete healing possibly taking up to a year. In some cases, however, loss of sensitivity can be permanent and accompanied by a loss of nipple erectile capacity.

Preoperative Preparation to Reduce the Risk of Complications

Before performing a breast reduction, the doctor will carefully verify that the patient is in good physical condition for the procedure. This crucial preparation step aims to minimize the risk of complications. To do this, the doctor will first conduct a thorough examination of the patient's health.

Laboratory Tests and Mammography: Preparation for Breast Reduction

Next, they will proceed with:

• A precise analysis of the breast (size, shape, particular characteristics, etc.);
• Prescription of certain laboratory tests (for example, blood clotting ability is measured to assess the tendency to bleed);
• Review of the patient's most recent mammogram (if the patient does not have one, it is highly likely the doctor will prescribe one);
• If the resulting profile is positive (i.e., there are no contraindications to the operation), the surgeon can address more specific aspects;
• Ask the patient what she expects from the operation and what size she desires for her breasts. It is then up to the surgeon to decide how and to what extent they should intervene;
• Explain to the patient all the risks and benefits of the operation, as well as the admission process;
• Explain to the patient the implications of breast reduction surgery (necessary anesthesia, pre- and postoperative limitations, medications to avoid, etc.);
• Inform the patient of the requirement to be accompanied home after the operation by a relative or friend. This is a safety precaution;

The advice surgeons give to patients undergoing breast reduction surgery aims primarily to maintain an optimal postoperative result and to minimize the risk of complications during and after the intervention.

Medical Precautions Before Breast Reduction: Stopping Smoking and Medication

For a breast reduction operation, the patient must take certain important measures. First, it is imperative to stop smoking (at least temporarily). Cigarette smoke can slow and hinder the skin's healing process. In addition, it is necessary to suspend any antiplatelet medication (such as aspirin), as well as any anticoagulant and anti-inflammatory drugs (NSAIDs). These medications can reduce blood clotting ability, thus exposing the patient to risks of serious bleeding.

N.B.: By complete fasting, we mean both abstinence from solid food and abstinence from liquids (only water is allowed up to a few hours before).

What to Wear After a Breast Reduction?

Breast reduction is a surgical procedure to remove excess breast tissue to reduce breast size. After this procedure, it is crucial to wear a compression bra to alleviate pain and swelling. Generally, this type of bra is provided by the surgeon and should be worn constantly for the first few days after the operation. Afterward, it is recommended to wear a comfortable sports bra that provides good support for several weeks to prevent any irritation in the operated area.

For optimal recovery, it is essential to choose loose, comfortable clothing that does not compress or rub against the breasts. Opt for soft, breathable fabrics to minimize discomfort and promote healing. It is also recommended to favor easy-to-put-on clothes, without having to raise your arms above your head.

After surgery, remember that the area may be sore and swollen for a while. Therefore, it's important to avoid clothing that might rub on this affected area. Also avoid tight clothing, such as underwire bras, which could cause further irritation and pressure on the operated area.

What are the risks associated with breast reduction?

Fortunately, significant complications from breast reduction surgery are rare, and the satisfaction rate for these procedures is high. You should discuss potential risks and complications with your cosmetic plastic surgeon during your consultation and after your procedure to ensure you are on the right track for recovery.

All surgical interventions carry some degree of risk. Some potential complications of all surgeries are:

• Adverse reaction to anesthesia;
• Hematoma or seroma (a collection of blood or fluid under the skin that may require removal);
• Infection and bleeding;
• Changes in sensation;
• Scarring;
• Allergic reactions;
• Damage to underlying structures;
• Unsatisfactory results that may require additional procedures;

Other risks specific to a breast reduction are:

• Numbness in the nipples and areola areas, which is usually temporary but can be permanent for some;
• Uneven breast shape or size in case of complications;
• Nipple damage in rare cases where blood flow is cut off;
• Difficulty breastfeeding if you have a child after your surgery;

Choosing an experienced plastic surgeon working in a certified facility will keep the overall complication rate for the operation low. To reduce the risks of complications during breast lift surgery, it's important to follow the advice and instructions of your certified plastic surgeon before and after the operation.

EXPRESS QUOTE

Would you like more information?

Does health insurance cover breast reduction?

Breast reduction can be an effective solution for treating breast hypertrophy, but its cost can be a concern. A frequent question among patients concerns the coverage of this procedure by health insurance. The answer is positive, but it depends on several criteria such as the severity of the hypertrophy, associated manifestations, and the impact on daily life. Generally, breast reduction is covered by health insurance if it is deemed medically necessary. However, reimbursement by social security can vary depending on each patient's situation. It is therefore crucial to inquire with your health insurance provider for details on coverage.

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