Breast reduction

How a breast reduction is performed

Before the operation

You will be asked to undergo some general health tests before your operation to check that you are fit to have surgery.

If you smoke, you may be asked to quit in the weeks before your operation. This is because smoking increases your risk of chest and wound infections and can slow the healing of your wounds, leaving you with worse scarring. Being overweight can also slow the healing process, so if you are overweight you will be encouraged to lose weight before your operation.

If you take the oral contraceptive pill or hormone replacement therapy (HRT), your surgeon may advise you to stop taking it a few weeks before your operation because they can increase your risk of developing deep vein thrombosis (a blood clot in a leg vein). Also avoid aspirin and anti-inflammatory drugs.

Before your operation, you will be asked to sign a consent form. This is to confirm that you understand the risks, benefits and possible alternatives to the operation.

The operation

Breast reduction surgery is usually done under general anaesthetic (when you are asleep). You will be asked to follow fasting instructions before your operation. Typically, you cannot eat or drink for six hours before having the anaesthetic.

Surgery takes between one-and-a-half and three hours. You are usually required to stay in hospital for one or two nights. The aim of surgery is to create a natural shape and retain as much function and sensation in the nipples as possible.

The surgeon will use a pen to mark areas of the skin where the incisions (surgical cuts) will be made. With your permission, the surgeon may also photograph your breasts for confidential before and after images for your records.

Most breast reduction surgery begins with the nipple, which is moved to its new position, usually while still attached to the blood supply. If you have extremely large breasts, the nipples may be removed and repositioned as a skin graft. They will develop their own blood supply.

Excess skin and breast tissue are then removed. The remaining breast tissue is reshaped to create smaller and more elevated breasts.

Breast reduction techniques

There are various different ways to do a breast reduction. Your surgeon will decide which is most appropriate for you depending on the size of your breasts and the desired outcome. Techniques include:

  • Anchor type or inverted T reduction: the most common type of breast reduction, this results in an anchor-shaped scar starting around the nipple, travelling vertically down and then horizontally across the breast crease.
  • Vertical pattern breast reduction: this results in a circular scar around the areola, the brownish or pink ring of tissue surrounding the nipple, and a vertical scar passing downwards. This technique has the advantage of leaving no scarring under the breast but is not as effective and reliable when dealing with large breasts and may take longer to heal.
  • Circumareolar reduction: this only results in a circular scar around the areola. This technique is only suitable when removing a small amount of tissue.


Body tissue is made up of groups of cells that perform a specific job, such as protecting the body against infection, producing movement or storing fat.  
An incision is a cut made in the body with a surgical instrument during an operation.
Veins are blood vessels that carry blood from the rest of the body back to the heart.
Blood supplies oxygen to the body and removes carbon dioxide. It is pumped around the body by the heart.
Anaesthetic is a drug used to either numb a part of the body (local), or to put a patient to sleep (general) during surgery.
Hormone replacement therapy or HRT involves giving hormones to women when the menopause starts, to replace those that the body no longer produces.
Last updated: 04 October 2011

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