Breast reduction is a major operation, and its risks include bleeding, infection, blood clots and anaesthetic complications, as well as risks specific to the breast: delayed wound healing at the junction of the scars, changes in nipple sensation, reduced ability to breastfeed, loss of part or all of the nipple, fat necrosis, asymmetry and visible scarring. Most women recover well, and the risks are lower in non-smokers at a healthy weight. Understanding what is normal and what needs attention is an important part of preparing for surgery.
General surgical risks
- Bleeding and haematoma: blood collecting in the breast may cause rapid swelling and needs urgent review; a return to theatre is sometimes necessary.
- Infection: usually treated with antibiotics; occasionally a wound needs further care.
- Blood clots (VTE): compression stockings, calf pumps during surgery, early walking and, where appropriate, blood-thinning injections reduce the risk.
- Anaesthetic: your anaesthetist will review your health and explain any specific risks.
Risks specific to breast reduction
- Wound-healing problems: the point where the vertical and horizontal scars meet (the T-junction) is under tension and can open or heal slowly; most heal with dressings.
- Nipple and areola blood supply: rarely, part or all of the nipple or areola loses blood supply; the risk is higher with very large reductions and in smokers.
- Nipple sensation: may be reduced, increased or altered, and changes can be permanent.
- Breastfeeding: the ability to breastfeed may be reduced or lost.
- Fat necrosis: firm lumps where fat has lost its blood supply; these may need imaging to confirm their nature and often soften over time.
- Asymmetry: breasts are rarely perfectly matched before surgery and some difference in size, shape or nipple position may remain.
- Scarring: scars can widen, thicken or remain red; the ends of the horizontal scar are the most prone to this.
- Shape changes over time: the lower breast can settle and descend, and weight change, pregnancy and ageing affect the result.
Who has a higher risk?
Smoking or vaping nicotine significantly increases the risk of wound breakdown and nipple problems, and you will be asked to stop well before and after surgery. A higher BMI, diabetes and very large reductions are associated with more wound-healing complications. A personal or family history of blood clots, breast cancer or other medical conditions should be discussed at consultation, as it may affect planning or require further assessment.
How risk is reduced
Careful assessment, including a breast examination and, where appropriate for your age or history, imaging before surgery, is the starting point. Surgery is carried out in a CQC-registered hospital with a consultant anaesthetist. Techniques that preserve blood supply to the nipple, tension-reducing closure and meticulous control of bleeding all contribute. After surgery, wearing a supportive bra, walking regularly, not smoking and attending follow-up appointments help problems to be recognised early. Removed tissue is routinely sent for laboratory examination.
What is normal during recovery
Swelling, bruising, tightness and aching are expected for the first few weeks. The breasts may look high and square at first and gradually settle into a softer shape over three to six months. Small areas of scab or delayed healing at the T-junction are common and usually heal with simple dressings. Numbness or shooting sensations around the nipple are frequent as nerves recover.
When to seek help
- Call 999: for chest pain or sudden breathlessness.
- Same-day GP or NHS 111: for sudden swelling or pain in one calf or leg.
- Contact the surgical team urgently: if one breast rapidly becomes more swollen, tense or painful than the other, which can indicate bleeding.
- Contact the team the same day: for a fever, spreading redness, discharge, or a nipple that turns dark, blue or black.
You will be given 24-hour contact details before you leave hospital.
Balancing risk and benefit
For many women with heavy breasts, surgery aims to relieve neck, back and shoulder discomfort, skin irritation beneath the breasts and grooves from bra straps, and these benefits are weighed against the risks. Mr Nassab will discuss your individual risk profile in detail. Breast reduction costs from £11,500; the £150 consultation fee is separate. Surgery is for adults aged 18 and over.
Frequently Asked Questions
What is the most common complication of breast reduction?
Minor delayed wound healing, often at the point where the scars meet beneath the breast, is one of the more common problems and usually heals with dressings.
Is loss of nipple sensation permanent?
Sensation often improves over months as nerves recover, but some changes can be permanent.
Is breastfeeding possible after a breast reduction?
Some women can breastfeed afterwards, but the ability may be reduced or lost, so this should not be relied upon.
Does smoking affect breast reduction risk?
Yes. Nicotine increases the risk of wound breakdown and nipple complications. Stopping well before and after surgery is essential.
Will lumps after breast reduction be checked?
Yes. Firm lumps are often fat necrosis, but any new lump is assessed, sometimes with an ultrasound scan.
