Breast reduction or reduction mammaplasty is a surgical procedure to reduce breast size by removing fat, breast tissue, and skin, making them smaller, lighter, and firmer. It can also reduce the size of the areola. Women with large breasts may experience certain problems due to this excess weight, such as back and neck pain, skin irritation beneath the breast, and breathing issues.

The purpose of reduction mammaplasty is to give the woman smaller breasts with a shape that is more proportionate to the rest of her body.

• Vertical reduction with a lollipop-shaped scar, around the areola and vertical
• Inverted-T reduction, lollipop-shaped scar plus a small one in the inframammary fold.
• Anchor reduction, like the previous one but extended with a longer scar in the inframammary fold.

The type of reduction used depends on many factors. The goal is always to use the option that leaves the smallest scar and provides good results.

Breast reduction is generally performed to relieve a physical problem, rather than purely for aesthetic reasons.

As a requirement for surgery, the woman must be healthy and emotionally stable, able to understand the results expected after the operation. This procedure is not recommended for women who plan to breastfeed after pregnancy.

During the first consultation, we will assess breast size and shape, skin firmness, and your overall health status. You will also undergo a breast exam and, in some cases, a mammography study may be requested (for patients over 35). Different surgical techniques will be explained, and we will discuss the size and shape your breasts will have, as well as the options—or combination of procedures—that best suit you.

You should share your expectations honestly and openly, so that Dr. De San Pío can do the same and present the available alternatives for your situation, including the risks and limitations of each one.

Also, don’t forget to tell us whether you smoke, or if you take any medication or vitamins, how many pregnancies you’ve had previously, and whether you plan to become pregnant again or breastfeed. Feel free to ask any questions you may have—especially those related to your expectations regarding results.

Breast reduction surgery is performed in an operating room under general anesthesia at Hospital Mediterráneo and lasts between 2.5 and 3 hours. Usually, an admission is not necessary, and you will be discharged at 3–4 hours directly from recovery. If it is necessary, you can stay overnight in the hospital. We usually do not use drains.

There are various techniques, but generally I perform vertical reduction using the E. Hall Findlay technique, with reduced scarring (lollipop shape). For very large breasts, incisions in the shape of an inverted T are necessary, placed around the areola, along a vertical line downward from the areola, and along a horizontal line in the fold beneath the breast.

Through these incisions, excess skin, fat, and breast tissue are removed, and the areola and nipple are repositioned to their new location; in some cases, lateral liposuction may be combined. In most cases, the areola remains attached through a wide pedicle that allows normal or nearly normal sensation to be maintained.

For very large breast reductions (gigantomastia), it may be necessary to completely detach the areola and place it in its new position, which results in loss of sensation (graft).

After surgery, a front-opening sports bra is fitted.

You won’t need dressings because the incision is protected with a Micropore 3M, until the stitches are removed at 3 weeks.

After breast surgery, it’s normal to feel a bit tired for a few days, but you’ll be able to live almost normally once you leave the hospital, thanks to the local anesthesia we use during the procedure. You will have to perform movements that begin in the recovery room; this will help prevent shoulder, back, and neck contractures, which are responsible for postoperative pain. (video)

It is important not to do any heavy work during the first two weeks—equivalent to not lifting more than 2 kg—and to avoid sexual relations.

After a breast reduction, you can return to work if you don’t do heavy lifting within one week; if you do heavy lifting, then from the 3rd week onward.

Breast reduction surgery is a safe technique, provided it is carried out by a qualified plastic surgeon.

Breast reduction can leave permanent and visible scars, although they can be concealed under a bra or swimsuit. Healing problems are more common in smokers. Some patients may experience a partial, and sometimes complete, reduction in nipple sensation. The ability to breastfeed may also be affected (50%).

As with any surgery, complications may occur, such as bleeding/hematoma or infection. They are not frequent and can be resolved easily.