Are you considering having a breast reduction? This is a major surgery, but one that usually results in a high level of patient satisfaction. That’s because it can provide long-lasting relief from chronic back pain and other discomfort caused by heavy, pendulous breasts. Of course, you’ll want to do plenty of research and ask your plastic surgeons lots of questions during your consultation. Here are a few frequently asked questions and answers to get you started on your research.

Are the results of reduction mammoplasty permanent?

In most cases, women who have their breasts surgically reduced will not grow back any substantial amount of breast tissue. The exceptions include:

  • Teen patients whose breasts are still growing (this is why most surgeons prefer to wait until young women are done with puberty before doing a breast reduction)
  • Women who get pregnant (breasts should get smaller again after pregnancy and breastfeeding are complete)
  • Women who tend to store fatty tissue in their breasts (weight loss should reverse this enlargement)
  • Women with rare medical conditions that boost their estrogen levels on an ongoing basis

Of course, your breasts may continue to change in shape and appearance as you get older. This occurs as your skin and connective tissue lose elasticity. You may wish to have a breast lift later in life to correct drooping.

Will my nipples be removed and reattached?

In most cases, no. Only the skin around the nipple and areola is removed during reduction mammoplasty. The nipple and areola are simply shifted upward and the skin is re-sewn around them. This is called the pedicle technique. There may be changes in sensation in your nipple and areola after surgery (tingling, numbness, etc.) However, many patients regain normal sensation after surgery once healing is complete. Women who have extremely large breasts may be candidates for “free grafting.” This is the type of reduction where the nipples and areolae are severed and reattached in a new position much higher on the breast. Grafting is only done when it isn’t possible to maintain the original blood supply to the nipples through a pedicle approach. Your surgeon should explain which method he is using so you know what to expect. The incision scar around the areola looks similar for both techniques, but healing is easier and less complication-prone with the pedicle method.

Will my breasts be firmer after the procedure?

After a breast reduction, your breast tissue will still feel soft to the touch. This is normal. Since some skin is removed during the breast reduction, the remaining skin may be stretched more tightly around the underlying tissue. This can provide a small improvement in firmness. However, the only way to make breasts substantially firmer is through the use of breast implants.

Will I always need to wear a bra after breast reduction surgery?

Immediately after reduction mammoplasty, you will need to wear a surgical bra for a couple of weeks – day and night. After that, the amount of time you need to wear a bra each day will vary depending on the extent of your surgery and other factors. Generally, women who have a breast reduction can gradually go longer and longer without a bra. Having to wear a bra at night over the long term is not the norm. Whether you decide to wear a bra during the day after you have healed from surgery will depend on your own comfort level. Bear in mind that some sagging and drooping of your breasts is normal as you age. There is no compelling evidence that wearing a bra will stop or slow down this process. However, you may prefer the way your breasts look with a bra that provides support.

Is there a way to reduce scarring?

Your surgeon may recommend the use of silicone sheeting after the incisions are healed to reduce the appearance of scarring. For some patients, the silicone sheeting can limit the redness of the scars and make them smoother. If you have raised scars (hypertrophic or keloid), you may be a candidate for laser therapy or other procedures to improve the appearance of your scars. The most important thing you can do to reduce scarring is to follow your surgeon’s wound care instructions after your operation. Keeping the skin and underlyin