What is Breast Reduction?
Breast reduction is a surgical procedure that involves the removal of excess breast tissue, fat tissue and skin in order to achieve a breast size proportionate to your body. This will also lighten the upper body and all problems that are associated with excess breast volume.
Who is a good candidate for a breast reduction?
Extremely large breasts which are disproportionate to the body frame can cause not only health problems but can also affect patient psychologically.
The weight of an extremely large breast may influence woman’s daily activities. This takes place due to physical discomfort and several times back and neck pain. For this reason, breast reduction is considered more as reconstructive surgery than purely aesthetic surgery.
Candidates for a breast reduction are the following:
women suffering from back and neck pain, as well as posture problems due to breast weight
women whose breast limits their physical activity
women who have deep strap marks on their shoulders
women with irritated skin under the breast crease
women who are bothered by the feeling that their breast is extremely large
women with realistic expectations
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What to expect at your first appointment:
During the initial consultation, Dr. Karmiris discusses in detail the symptoms causing you discomfort (such as back, neck, and shoulder pain or skin irritation), assesses the size and position of your breasts, and advises you on whether breast reduction is the right solution for you.
More specifically, you will discuss:
what exactly is your concern in the appearance of your breast and if breast reduction is the appropriate treatment for you
your past medical history, if you are on any medication, vitamins or other herbal supplements, if you have any allergies or any other operations in the past
if you smoke (if the answer is yes, how many cigarettes per day).
if there is family history of breast cancer
mammogram or previous biopsy results
Afterwards, Dr Karmiris:
- will evaluate your general health condition and any other risk factors
- will examine you and will take all the detailed measurements from your breast size and shape and he will evaluate your skin quality, as well as the positioning of nipples
- will take preoperative photographs
- will discuss with you all the possible surgical options, depending on your case
- will discuss with you all the possible risks or potential complications, as described in the international literature and finally
- will discuss with you about the anaesthetic plan.
Preoperative assessment primarily includes blood tests, a chest X-ray, and an electrocardiogram, as well as specialized tests depending on the specific case.
In addition, you will need to undergo a preoperative mammogram (unless a recent one is available) to serve as a baseline for comparing any future changes in your breasts.
You will also need to stop smoking before the surgery and during the immediate postoperative period, as well as avoid taking aspirin and anti-inflammatory drugs, given that they increase the risk of bleeding.
Breast reduction surgery is usually performed through incisions made in the breast to surgically remove excess fat, glandular tissue, and excess skin.
In certain cases, excess fat can be removed via liposuction combined with the techniques described below. Although it occurs infrequently, if breast size is primarily due to fatty tissue and there is no significant excess skin, breast reduction can be achieved through liposuction alone.
The procedure is performed under general anesthesia, and there are three main types of approaches:
- The periareolar approach
- The periareolar approach with a circumvertical incision
- The periareolar approach with a J-shaped or inverted-T incision.
Breast reduction surgery can be performed using a variety of techniques, depending on your breasts.
The appropriate technique for you is determined based on:
- The size and shape of your breasts
- The size and position of your nipples
- The degree of breast sagging
- Skin quality and elasticity, as well as the amount of excess skin
The ideal technique for you will be discussed in detail with Mr. Karmiris. The surgeon selects the reduction technique—including the incision type, the amount of tissue to be removed, and whether to combine the procedure with a breast lift—based on your specific anatomical characteristics and symptoms, aiming for a smaller yet firm, symmetrical, and functional breast.
Following the initial incisions, the nipple and areola are repositioned to a natural, more youthful level. If necessary, enlarged areolas are reduced by excising excess skin from their perimeter.
Excess glandular and fatty tissue is removed, and the remaining breast is lifted and reshaped to improve its contour. Additionally, excess skin from the remaining breast is removed to address the loss of elasticity.
Following breast reshaping, the breast tissue is sutured in multiple layers to form the new breast.
The incisions are permanent, but in most cases, they will fade and improve significantly over time.
Immediately after surgery, you will have gauze or dressings over the incisions, which will be gradually reduced. If drains are used, they will be removed within one or two days at most. You will need to wear an elastic bandage or a bra to minimize swelling and support your breasts during the healing process.
In most cases, patients return home the same evening or, at the latest, the following day. Mr. Karmiris will provide specific instructions on how to care for your breasts immediately after surgery, which medications to take, and when you will be seen again.
In general, breast reduction is a safe procedure associated with extremely high patient satisfaction rates. However, like any surgery, it carries potential risks and complications that every patient should be informed about and fully understand before undergoing the procedure.
The most significant potential complications are:
- Bleeding or hematoma formation (occurring in approximately 1% of cases)
- Wound infection
- Fat necrosis
- Poor incision healing
Nipple hypoesthesia (reduced sensation), which may be temporary or permanent (occurring in 5–10% of cases) - Breast asymmetry
- Partial or total loss of the nipple (a rare complication, though documented in medical literature)
- Potential impact on the ability to breastfeed
- General risks associated with anesthesia, such as deep vein thrombosis, as well as cardiac or pulmonary complications.
Mr. Karmiris will explain the entire procedure to you in detail and answer any questions you may have regarding the surgery.
Tip: If excessively large and heavy breasts are causing you back or neck pain, making exercise difficult, or making you feel uncomfortable with your body, breast reduction surgery can offer a substantial, permanent solution. Plastic Surgeon Nikolaos Karmiris plans each breast reduction procedure individually, taking into account both your symptoms and the desired aesthetic outcome, with the goal of achieving breasts that are lighter, more proportionate, and functional.
Ready for the next step?
Contact our practice to book your personal assessment appointment.
Dr. N. Karmiris is a certified Fellow of the European Board of Plastic, Reconstructive and Aesthetic Surgery (FEBOPRAS), a title awarded to him following successful examinations. He is also a full member of the Hellenic Society of Plastic, Reconstructive and Aesthetic Surgery (HSPRAS) and an active member of the Athens Medical Association (ISA) and the General Medical Council (GMC) in the UK.