Last Updated May 2025
Breast reduction surgery (reduction mammoplasty) offers significant relief and improved quality of life for many women experiencing physical discomfort associated with overly large breasts. While patient satisfaction rates are high (80-95%), it’s essential to understand that, like any surgical procedure, breast reduction carries potential risks and complications.
At Dr Scott J Turner’s clinics in Manly and Double Bay, patient safety and surgical excellence are paramount. This article provides a comprehensive overview of potential complications, risk factors, and strategies to minimise risks for optimal outcomes.
What is Breast Reduction Surgery?
Breast reduction mammoplasty is a surgical procedure designed to reduce the size of a woman’s breasts by removing excess breast tissue, fat, and skin. The surgery is typically performed for both aesthetic and functional purposes, creating breasts that are more proportional to the patient’s body frame while alleviating physical discomfort.
During the procedure, which usually takes 2-4 hours under general anaesthesia, Dr Turner makes incisions in the breast tissue, removes excess tissue, and repositions the nipple and areola to a higher position. Recovery time varies depending on individual factors and the extent of surgery, but most patients can return to work within 1-2 weeks, though complete healing takes several months.
Common Complications of Breast Reduction Surgery
Research indicates that complication rates for breast reduction surgery range from 2% to 20%, with most complications being minor and related to wound healing. Understanding these potential issues is crucial for informed decision-making.
Delayed Wound Healing
Delayed wound healing is one of the most common complications following breast reduction surgery, with studies reporting rates up to 21.6%. This occurs when incision sites take longer than expected to close and heal properly, potentially resulting in larger scars or increased infection risk.
Risk factors for delayed healing include:
- Poor blood flow to the incision site
- Existing infections
- Smoking
- Obesity
- Underlying medical conditions (diabetes, autoimmune disorders)
The risk is particularly high at certain anatomical locations, such as the T-junction where vertical and horizontal incisions meet at the breast crease.
Haematoma and Seroma Formation
Haematomas (blood collections) and seromas (clear fluid collections) can develop after breast reduction surgery. These complications cause swelling, pain, and discomfort.
Studies report rates of approximately 3.7% for haematoma and 1.2% for seroma. Risk factors for seroma formation include obesity, with significantly higher risks in patients with elevated BMI.
Treatment typically involves draining the fluid or blood and taking steps to prevent further accumulation. Severe cases may require surgical intervention.
Infection Risk
Infection following breast reduction surgery is relatively uncommon but requires vigilance during recovery. Symptoms include redness, swelling, warmth, tenderness, drainage from the incision site, and possibly fever.
Preventative measures include intravenous antibiotics during surgery. When infections occur, treatment involves antibiotics and possibly drainage of accumulated fluid.
The overall infection risk is estimated at less than 1%, making it one of the less frequent complications.
Changes in Nipple and Breast Sensation
Sensory changes are common following breast reduction surgery. These occur because the procedure involves removing breast tissue and repositioning the nipple, which can affect nerves that supply sensation.
Patients may experience:
- Temporary or permanent numbness
- Hypersensitivity
- Unusual tingling sensations
While concerning for many patients, sensory changes are usually temporary and improve gradually as nerves heal, typically within several months to a year. However, permanent alterations may persist in some cases, particularly with extensive tissue removal.
Breast Asymmetry
Some degree of breast asymmetry is natural even before surgery. Post-surgical asymmetry occurs when one breast appears noticeably different in size, shape, or position compared to the other.
Minor asymmetries typically resolve as swelling subsides over the first few months following surgery. Significant asymmetries may require revision surgery if they cause physical or psychological discomfort.
Patients should maintain realistic expectations, understanding that perfect symmetry is not a surgical goal, while significant imbalances can usually be addressed with additional procedures if necessary.
Scarring Patterns
Scarring is an inevitable consequence of breast reduction surgery. The extent and appearance depend significantly on:
- Surgical technique used
- Individual healing characteristics
- Postoperative care
Typical incision patterns include those around the areola, vertically down the breast, and sometimes horizontally along the breast crease. While scars may initially appear red and prominent, they generally fade over 12-18 months.
Proper scar management can improve outcomes, including adhering to wound care instructions, avoiding sun exposure, and using silicone gel sheets or ointments.
Tissue Necrosis
Though rare, tissue necrosis represents one of the more serious potential complications. This occurs when blood supply to portions of the remaining breast tissue becomes compromised, leading to tissue death.
Risk factors include:
- Smoking
- Poor circulation
- Extensive tissue removal
- Certain medical conditions
Particular concern exists for the viability of the nipple-areola complex after repositioning. Studies report necrosis rates of approximately 5.4% across various types.
Prevention strategies include careful surgical planning to preserve blood supply and strict avoidance of smoking before and after surgery.
Risk Factors for Complications
Understanding the factors that increase complication risk is essential for both surgeons and patients. Multiple studies have identified several significant risk factors:
BMI and Weight Considerations
Obesity or elevated BMI consistently emerges as the strongest predictor of complications. Research shows that patients with:
- BMI under 25 kg/m²: Minor complication risk approximately 3.3%, major complications approximately 6.7%
- BMI 25-30 kg/m²: Minor complications rise to 18.2%, major complications to 13.6%
- BMI over 40 kg/m²: Rates reach 46.9% for minor and 43.8% for major complications
Each BMI category above normal weight progressively increases risk, making weight management before surgery crucial for optimal outcomes.
Smoking
Active smoking represents another major risk factor, particularly for major surgical complications and tissue necrosis. Smokers experience nearly three times the complication rate of non-smokers in some studies.
Strict smoking cessation is typically recommended for at least 4-6 weeks before and after surgery to improve tissue oxygenation and healing potential.
Tissue Resection Volume
The amount of tissue removed significantly impacts outcomes. Research indicates:
- Resection weights exceeding 650g per breast: Associated with twice the complication risk
- Weights over 1000g: Show even greater risk
Other Risk Factors
Additional identified risk factors include:
- Diabetes
- Preoperative radiation therapy
- Bilateral (versus unilateral) procedures
- Age factors (studies show some variability regarding optimal age)
Risk-scoring systems show complication rates increasing dramatically as risk factors accumulate—from 31% with one factor to 90% with four factors present.
Strategies to Minimise Complications
Effective risk minimisation begins with thorough preoperative planning and extends through proper postoperative care:
Preoperative Strategies
- Select a qualified and experienced Specialist Plastic Surgeon
- Fully disclose medical history, medications, and supplements
- Maintain stable weight
- Achieve good nutritional status
- Control chronic conditions
- Avoid smoking and excessive alcohol consumption
Intraoperative Strategies
- Judicious use of antibiotics
- Meticulous haemostasis
- Appropriate tissue handling techniques
- Selection of optimal surgical approach based on individual factors
Postoperative Strategies
- Strict adherence to recovery instructions
- Proper wound care
- Appropriate use of supportive garments
- Activity restrictions
- Medication protocols
- Regular follow-up appointments
Making an Informed Decision
While breast reduction carries potential risks, most complications are minor and resolve with appropriate management. The high satisfaction rates (80-95%) reflect the procedure’s effectiveness in addressing both physical symptoms and psychological impacts of macromastia.
During your consultation with Dr Scott J Turner, Specialist Plastic Surgeon, we will assess multiple factors beyond BMI:
- Overall health status and medical history
- Weight stability over time
- Realistic expectations and goals
- Understanding of potential risks
- Commitment to long-term maintenance
By understanding and preparing for potential complications while working closely with an experienced Specialist Plastic Surgeon, you can maximise your chances of achieving positive, life-changing results from breast reduction surgery.
Contact Us
For more information about breast reduction surgery or to schedule a consultation with Dr Scott J Turner, please contact us at our Manly or Double Bay clinics.
Disclaimer: Individual results vary. All surgical procedures carry risks. It’s important to have realistic expectations and follow all pre and post-operative care instructions provided by Dr Turner and his team.
