Breast reduction surgery

Why have a breast reduction procedure?

You might choose to have breast reduction surgery if you’re not happy with the size of your breasts or if they’re causing you problems. Having large breasts can be painful, and also cause pain in your neck pain, backache and shoulder pains or rashes. You might have deep grooves in your shoulders from your bra straps, and red inflamed skin underneath your breasts.

Larger breasts can make it difficult to exercise and take part in physical activities, even in a sports bra, and to find clothes that fit. You might feel self-conscious about how your breasts look, especially if they aren’t even (asymmetry), which can impact your self-esteem and self-confidence.

How do I get breast reduction surgery?

As it is a plastic surgery procedure, you’ll usually need to have a breast reduction surgery privately. You can find a consultant surgeon using the search function on our website. You should still let your GP know you’re thinking about having a breast reduction procedure, so they can be aware of any ongoing care you may need.

Breast reduction surgery may be available on the NHS in very few circumstances. These can include if your breasts are causing you particularly severe physical problems. Even then, breast reduction surgery isn’t offered on the NHS in all areas. You’ll need to check with your GP.

Deciding on a breast reduction procedure

You’ll have an initial consultation with a surgeon to talk about what you’re hoping to gain from surgery. Your surgeon will go through exactly what to expect, including the benefits and possible risks. They’ll talk to you about the different options available. If your breasts are drooping rather than being particularly large, a breast uplift may be an alternative you can consider.

Your surgeon will want to do a physical examination and assess whether you’re suitable for surgery. They may ask to take some photos of your breasts for your records. You’ll be asked if you would like a chaperone before any physical examination. Depending on your age, you may be advised to have a mammogram to check for any signs of breast cancer before going ahead with surgery.

The tissue removed during breast reduction is routinely sent off to a lab to be checked after the operation. It’s possible that cancer may be found during this process. Your surgeon will explain this to you fully before you consent to the procedure.

You’ll have some time to think about your decision before committing to surgery.

How do I prepare for breast reduction surgery?

There are various things you can do to prepare for breast reduction surgery. If you smoke, it’s best if you stop before your operation. Nicotine has a negative effect on wound healing, and smoking significantly increases the risk of other complications too. Try to lose any excess weight, and keep active to maintain your fitness.

Breast reduction surgery is usually done under a general anaesthetic (meaning you’ll be asleep). You’ll usually need to stay overnight after a breast reduction, but sometimes you may be able to be treated as an outpatient and go home on the day of your procedure.

What happens during breast reduction surgery?

There are many different techniques for breast reduction surgery. The procedure generally involves making cuts around your areolae, and then vertically down, often following the natural crease underneath your breasts, like an upside-down ‘T’. Excess skin and tissue is cut away. Your nipple is lifted into a higher position and the remaining skin and tissue is reshaped to form a smaller breast.

Recovery and what to expect after breast reduction surgery

You will likely feel tight and sore around your breast and chest area after the operation. Your healthcare team will talk to you about aftercare procedures and you’ll have painkillers to help manage the discomfort. You’ll have some dressings on your breasts and will need to wear a well-fitting bra with no underwiring for several weeks.

You should be well enough to get out of bed and walk around on the day of the surgery. It’s important to move around as soon as you can, as this reduces the risk of blood clots developing in your legs (Deep Vein Thrombosis).

You should be able to return to light activities within two to four weeks. It can take longer to get back to strenuous activities and heavy lifting. You may need to take up to a couple of weeks off work to recover. Your surgeon will tell you when you can start driving again after your operation. This may be after two weeks or more.

It can take several months for everything to settle down and until you can fully judge the final results. You’ll also have scars from breast reduction surgery, but these will usually become paler over time.

Potential complications of breast reduction surgery

All surgical procedures carry some level of risk. Here are some of the most common complications associated with breast reduction.

• Alterations in breast and nipple sensations, which can be permanent.
• Blood loss during the operation. You may need a transfusion if this happens.
• Haematoma or seroma. This is a collection of blood or fluid underneath your skin, which can make your breast painful and swollen.
• Infection. Your breast may feel swollen and tender, and the wound may look red and have some discharge. You may also feel unwell with a high temperature.
• Delayed healing of your wound, or occasionally breaking down of your wound.
• Loss of tissue from your skin, breast or nipple. This can happen if you lose the blood supply to these areas.
• It is also possible that you will not be able to breastfeed following the procedure.

There’s a risk that you might not be happy with the end result. You also need to bear in mind that the shape of your breasts will change over time as a natural result of ageing. Pregnancy and changes in weight will also change how your breasts look.

How much is breast reduction surgery in the UK?

As a cosmetic procedure, breast reduction isn't typically be available through private medical insurance. You’ll usually need to self-fund this treatment. Breast reduction costs in the UK vary.

Typically, an initial private consultation with the surgeon will cost between £100 and £250, depending on where you live. If you move forwards with the procedure, you’ll be offered one of the following.

• An all-inclusive ‘package price’, where you know the full costs before undergoing treatment. Not all consultants and hospitals offer this.
• A ‘fee-per-service’ deal, where you receive different invoices from the surgeon, the anaesthetist and the hospital. You often won’t know the full costs until you receive the invoices.

For more information, you can read our guide on self-pay.

Helpful websites

• Association of Breast Surgery
• British Association of Aesthetic Plastic Surgeons
• British Association of Plastic Reconstructive and Aesthetic Surgeons

References

• Sachs D, Szymanski KD. Breast reduction. StatPearls. www.ncbi.nlm.nih.gov, last updated 1 August 2021.
• Breast reduction. British Association of Aesthetic Plastic Surgeons (BAAPS). baaps.org.uk (accessed 24 August 2021).
• Your guide to breast reduction. British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS). bapras.org.uk, published 2017.
• Breast uplift. British Association of Aesthetic Plastic Surgeons (BAAPS). baaps.org.uk, (accessed 15 September 2021).
• Lowes S, MacNeill F, Martin L, et al. Breast imaging for aesthetic surgery: British Society of Breast Radiology (BSBR), Association of Breast Surgery Great Britain & Ireland (ABS), British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS). J Plast Reconstr Aesthet Surg 2018;71(11): 1521-1531. doi: 10.1016/j.bjps.2018.07.004.
• Joint briefing: smoking and surgery. Action on Smoking and Health, the Royal College of Anaesthetists, the Royal College of Surgeons of Edinburgh and the Faculty of Public Health, April 2016. ash.org.uk.
• You and your anaesthetic. Royal College of Anaesthetists, February 2020. rcoa.ac.uk.