How is breast reduction surgery performed?

Written by: Mr Haitham Khashaba
Edited by: Sophie Kennedy

In this informative guide, we hear expert insight on the key steps involved in breast reduction surgery from revered consultant plastic surgeon Mr Haitham Khashaba. In addition, the leading specialist sheds light on the potential risks associated with breast reduction surgery and the likelihood that breast tissue will regrow following the procedure.

What happens during the procedure?

During a breast reduction procedure, also known as reduction mammoplasty, several steps are typically involved. The following is a general overview of what happens during the surgery:


Breast reduction surgery is performed under general anaesthesia, ensuring that you remain asleep and pain-free throughout the procedure.

Incision placement

Your plastic surgeon will make incisions in specific locations on your breasts. The incision patterns can vary depending on the extent of the reduction and your desired outcome. Common incision types include the anchor-shaped (inverted T), vertical, or keyhole incisions.

Tissue removal and reshaping

Once the incisions are made, your surgeon will remove excess breast tissue, fat, and skin. The remaining breast tissue is then reshaped and repositioned to create a more proportionate and lifted appearance. In some cases, the nipple and areola may need to be repositioned to achieve an aesthetically pleasing result.

Nipple-areola complex modification

If necessary, the size and shape of the nipple-areola complex (NAC) can be adjusted to match the new breast size and position. This involves repositioning the NAC higher on the breast mound and reducing its size if desired.

Closing the incisions

After the necessary tissue removal and reshaping is completed, your surgeon will close the incisions with sutures. They may use traditional sutures or absorbable stitches that do not require removal. Depending on the surgical technique used, your surgeon may also place small drainage tubes to prevent fluid build-up.

Dressing and support

Following the closure of incisions, your breasts will be covered with surgical dressings or bandages. A supportive bra or elastic bandage may be applied to minimise swelling, provide support, and aid in the healing process.

The duration of the procedure can vary depending on the complexity of the surgery and the amount of tissue being removed. On average, breast reduction surgery takes approximately two to four hours.

It is important to note that the specific details of the procedure can vary based on the individual's anatomy, surgical technique, and the surgeon's approach. Your plastic surgeon will discuss the surgical plan, incision options, and expected outcomes with you during the consultation, ensuring that you have a clear understanding of the procedure tailored to your needs.

What risks are associated with breast reduction surgery?

Like any surgical procedure, breast reduction surgery carries certain risks and potential complications. While most breast reduction surgeries are performed without complications, it is essential to be aware of the potential risks involved.

Bleeding and hematoma

Excessive bleeding during or after surgery can occur, leading to the formation of a hematoma (a collection of blood). If significant bleeding occurs, additional surgery may be necessary to control the bleeding and remove the hematoma.


Although rare, infections can occur after breast reduction surgery. Antibiotics are typically prescribed to reduce the risk of infection, and early detection and prompt treatment are crucial to manage infections effectively.

Changes in nipple or breast sensation

Temporary or permanent changes in nipple or breast sensation can occur following breast reduction surgery. Numbness, hypersensitivity, or altered sensation may be experienced, but in most cases, sensation gradually returns over time.


Breast reduction surgery involves incisions, resulting in permanent scars. The extent of scarring can vary depending on the surgical technique and individual healing characteristics. While efforts are made to minimise scarring and place incisions in inconspicuous locations, some visible scars may remain.

Breast asymmetry

Achieving perfect symmetry is challenging, and there is a possibility of slight differences in breast size, shape, or nipple position following surgery. However, experienced plastic surgeons aim to create a symmetrical and balanced appearance during the procedure.

Wound healing issues

In rare cases, wound healing problems may occur. This can include delayed wound healing, wound separation, or skin necrosis (death of tissue). Proper wound care and following post-operative instructions can help minimise these risks.

Changes in breastfeeding

Breast reduction surgery may affect the ability to breastfeed. The extent of this risk depends on the surgical technique used and the individual's breast anatomy. You should discuss your plans around breastfeeding in the future with your plastic surgeon during your consultation.

Anaesthesia risks

General anaesthesia carries its own set of risks, such as allergic reactions, respiratory issues, or adverse reactions to medications. However, these risks are typically rare and managed by experienced anaesthesiologists.

Nipple-areola complex (NAC) loss

While considered a devastating complication, this risk of NAC loss in the breast is rare in the hands of experienced and certified plastic surgeons. It is however an important risk to consider when going for a reduction mammoplasty (breast reduction) especially in very large and ptotic breasts.

It's important to note that these risks are general possibilities, and the actual occurrence of complications varies among individuals. To minimise risks, it is crucial to choose a qualified and experienced plastic surgeon, follow pre-operative and post-operative instructions diligently, and communicate openly with your surgeon about any concerns or questions you may have.

Can breasts grow back after a breast reduction?

After a breast reduction surgery, it is uncommon for breasts to significantly regrow or return to their previous size. The goal of breast reduction surgery is to remove excess breast tissue, fat, and skin, resulting in a smaller and more proportionate breast size.

However, it is important to note that breast tissue naturally changes over time due to various factors, including hormonal fluctuations, weight fluctuations, and the aging process. These natural changes can affect the size and shape of the breasts to some extent. While breasts may undergo some changes following a breast reduction surgery, such as weight fluctuations or changes associated with pregnancy and breastfeeding, it is unlikely for them to regrow to their pre-surgery size.

The amount of tissue removed during the surgery typically provides long-term reduction and reshaping of the breasts. However, factors like significant weight gain or hormonal imbalances can potentially cause the remaining breast tissue to increase in size. It's important to maintain a stable weight and lead a healthy lifestyle after breast reduction surgery to help maintain the results achieved.

If you have concerns about potential changes in your breasts following surgery, it is best to discuss them with your plastic surgeon. They can provide you with personalised advice and guidance based on your specific situation and help you understand the potential long-term effects of the surgery.

Read more about how to prepare for breast reduction surgery in Mr Khashaba’s other expert article on the procedure.

If you are considering breast reduction surgery and wish to schedule a consultation with Mr Khashaba to discuss your options, you can do so by visiting his Top Doctors profile.

By Mr Haitham Khashaba
Plastic surgery

Mr Haitham Khashaba is a full-time plastic surgeon in the NHS who specialises in Breast Reconstruction, tummy tuck, breast augmentation and breast reduction alongside thigh lift, liposuction and arm lift. He undertakes private e-consultations at Top Doctors while his NHS base is County Durham & Darlington NHS Foundation Trust.

Mr Khashaba is highly qualified with an MBBCh and MSc from Ain Shams University in Cairo, Egypt. He's a fellow of the Royal College of Surgeons (FRCS (Plast)) and the European Board of Plastic, Reconstructive and Aesthetic Surgery (EBOPRAS). He went on to specialise in cosmetic surgery, working in Egypt and Kuwait and undertaking a breast microsurgery fellow at North Bristol NHS Trust. He is on the GMC (General Medical Council) specialist registry for plastic surgery.

Mr Khashaba, who won the Chairman Awards and the award for Excellence in Clinical Care from University Hospitals in North Durham in 2020, is committed to continuing his professional development. In order to provide the best outcomes for his patients, he attends conferences and courses which keep him up-to-date with developments in his specialist field.

Mr Khashaba carried out medical research and has presented at national and international conferences and events. He is a speaker at various national and international conferences. His work has also been published in various peer-reviewed journals and he's a member of several professional organisations including the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS), the British Medical Association (BMA), British Burn Association (BBA), and the Royal College of Surgeons (RCS).

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