Why is breast reduction surgery needed?

UK breast reduction surgery is often sought by people who experience physical and emotional discomfort due to disproportionately large breasts. This procedure can help address a range of medical and practical issues that affect daily life and overall wellbeing.

Common reasons for undergoing breast reduction surgery include:

• Chronic back, neck, and shoulder pain caused by the weight of the breasts placing strain on the spine and upper body.
• Persistent skin irritation or rashes beneath the breasts, particularly in warm or humid conditions.
• Nerve pain, such as tingling or numbness in the arms or chest.
• Restricted physical activity, especially during exercise or routine movement.
• Discomfort with body image, where the size of the breasts affects confidence or causes emotional distress.
• Difficulty finding suitable clothing or supportive bras, which can add to daily inconvenience.
• Grooves in shoulders from bra straps which can cause chronic pain.

Living with very large breasts can lead to ongoing discomfort and affect quality of life. For many, female breast reduction surgery provides welcome relief from physical pain and makes everyday movement, posture and exercise more manageable.

In addition to the physical benefits when breasts feel smaller, lighter and give more freedom for movement, many people report improved confidence and a more positive body image after surgery, particularly if they previously felt self-conscious or restricted by the size of their breasts.

Although breast reduction surgery is most commonly performed on adults, it may be considered for individuals under the age of 18 in severe cases, provided their breast development is complete and the impact on their quality of life is significant.

What to expect during breast reduction surgery

Breast reductions are generally performed under general anaesthesia so you will be unaware during surgery. Your surgeon will be expected to follow the procedure as discussed during your pre-operative consultation, they should also have made you aware of realistic outcomes and assess your suitability for the surgery.

During the procedure

The specific surgical technique used during breast reduction surgery can vary depending on the size of the reduction, the shape of your breasts and your individual anatomy. Typically, the procedure involves making incisions in the breast to remove excess skin, glandular tissue and fat. In some cases, liposuction may also be used to assist in reducing volume, particularly where fatty tissue is the primary concern.

In most breast reduction procedures, the nipple and areola remain attached to the underlying breast tissue and blood supply, allowing them to be repositioned higher on the breast once the excess tissue has been removed. This helps to preserve sensation and, in some cases, the ability to breastfeed. However, in very large reductions, free nipple grafting may occasionally be used, which can affect sensitivity and function.

The overall goal of the procedure is to achieve a smaller, lighter and more proportionate breast shape, while maintaining a natural and symmetrical appearance.

After the procedure

Immediately following breast reduction surgery, your breasts will typically be covered with gauze dressings or bandages. In some cases, small drainage tubes may be placed under each arm to help remove excess blood or fluid and support the healing process.

• First few days post-op: it is common to experience tenderness, sensitivity and swelling in the breast area at first as you recover. Bruising around the incision sites is also expected during this period. You should avoid lifting your arms above shoulder height, as this may place tension on healing incisions and increase the risk of bleeding or irritation.
• Three to four weeks post-op: by this stage of recovery, most people report minimal discomfort, and any visible swelling or bruising is usually much improved. However, if complications occurred during the procedure, some residual bruising may still be present. If you are concerned about ongoing swelling, discolouration or discomfort, it is important to speak with your surgeon.
• Four to six weeks post-op: at this stage, most people are nearing or have reached full recovery. Swelling and bruising should have resolved, and regular activities can usually be resumed without restriction.

Your surgeon should arrange a follow-up appointment to assess how your breasts have healed and to confirm that your recovery is progressing as expected.

What to do after breast reduction surgery

After breast reduction surgery, your surgeon should provide clear and personalised aftercare guidance to support a smooth recovery. Adhering to these instructions is essential, not only to aid healing but also to minimise the risk of complications and achieve the best possible outcome.

General aftercare advice typically includes:

• Wearing a surgical bra: a supportive, well-fitted surgical bra should be worn as advised by your surgeon. This helps to reduce swelling, stabilise the breast tissue and protect the healing incisions with sports bras being acceptable to wear after the first six weeks.
• Caring for your wounds: keep all dressings clean and dry. Good wound care is vital to prevent infection and support healthy tissue repair. If you notice any unusual redness, discharge or odour, contact your surgeon immediately.
• Avoiding baths and submersion: do not bathe, swim or submerge your chest in water until your incisions have fully healed. Moisture around the surgical site can increase the risk of infection and delay healing.
• Limiting physical activity: light movement is encouraged to support circulation, but avoid stretching, strenuous exercise, lifting heavy objects or bending. This should be avoided for several weeks or until you are medically cleared to resume them.
• Avoiding arm elevation: lifting your arms above shoulder height should be avoided for at least the first two weeks after surgery, and possibly for up to six weeks. Doing so too soon can place stress on the incision sites and may disrupt healing.
• Taking pain medication as prescribed: post-operative discomfort is normal as the remaining breast tissue swells up, prescribed pain relief can help manage this while also reducing the inflammation. Never exceed the recommended dosage, and report any severe or prolonged pain to your surgical team.

Following the aftercare will help to increase your chances of having an optimal surgical outcome, however if your surgeon failed to uphold their duty of care, you may still experience problems.

What are the potential complications of breast reduction surgery?

Like any other cosmetic procedure, breast reduction surgery does have some risks. Bleeding, infection and an adverse reaction to anaesthesia are all common risks of every surgery. However, there are also risks more specific to breast reduction that patients should be made fully aware of before proceeding.

Potential complications may include:

• Scarring: while some scarring is expected, it may be more prominent or extensive than anticipated from what was discussed during consultation, particularly if the surgical technique is not appropriate or post-operative care is inadequate.
• Loss of nipple or areola sensation: changes in nipple sensation can occur, and in some cases, this loss of sensation may be long-term or permanent.
• Breastfeeding difficulties: depending on the technique used, breast reduction surgery can impact the ability to breastfeed. In some cases, this ability may be partially or completely lost.
• Asymmetry or irregular results: differences in the size, shape or position of the breasts or nipples may become apparent after surgery, sometimes requiring further corrective procedures.
• Inadequate or excessive reduction: if too much or too little breast tissue is removed, the results may not meet expectations. This can lead to physical discomfort, aesthetic dissatisfaction or the need for revision surgery.

Before undergoing breast reduction, look for a surgeon who is appropriately qualified, experienced in breast reduction procedures, and listed on a professional medical register such as the General Medical Council. Look into how many breast reduction operations they have performed and opt for a surgeon with extensive experience. A reputable surgeon should provide clear information about risks, manage expectations, and offer support throughout your recovery.

What are your surgeon's obligations?

Your surgeon is legally and professionally required to uphold a duty of care throughout your surgical journey - before, during and after breast reduction surgery.

They must provide clear information about what the procedure involves, outline realistic outcomes and explain any potential risks. You should be fully informed about the recovery process, including how to care for your wounds, what symptoms to expect and when to seek medical advice.

Your surgeon also has an obligation to monitor your recovery during follow-up appointments. This includes checking for signs of complications - such as infection, delayed healing or abnormal scarring - and addressing any concerns you raise. If a problem is identified, they must take prompt and appropriate action to prevent further harm.

Failing to provide proper aftercare, ignoring or dismissing post-operative symptoms or not acting on signs of a complication may constitute negligence.