Like any surgery, breast reduction procedures carry some risks, like scarring and loss of nipple sensation.

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Breast reduction surgery — known medically as a reduction mammoplasty — is a common procedure done either for medical or aesthetic purposes to reduce the size of a person’s breasts, chest, or nipples.

Generally speaking, the benefits outweigh the risks, and the risks themselves are both minimal and rare.

Still, it’s important to know what’s possible before undergoing any major procedure. Here are the 10 most common concerns after breast reduction surgery.

Even if surgery is deemed medically necessary, the procedure itself is a type of trauma.

In fact, even after uncomplicated surgeries, it’s common for people to experience postoperative fatigue.

Postoperative fatigue is thought to be caused by a combination of the following:

  • an inability to increase your heart rate via exercise
  • nutritional changes
  • hormonal imbalance
  • the energy it takes the body to heal

It typically lasts for a month following surgery.

But it can be sped up by:

Some tenderness and soreness at the surgical site are common and should be expected.

If you think about it, it makes sense! If you slice your finger with a potato peeler, it’s tender for a few days. If you get stitches on your head after running into a post, it throbs for a few days. Even a paper cut makes itself known days after being delivered.

But there is a difference between typical tenderness and tenderness that’s a sign of infection, explains Sean Satey, MD, a plastic surgeon based in Beverly Hills, California.

“Infection after breast reduction surgery is fortunately very rare and occurs less than 1% of the time,” he said.

But when tenderness is combined with redness, discharge, fever, vomiting, or chills, you could have an infection and should get the area looked at by a healthcare professional.

You can expect some scarring. Any procedure that involves surgical incisions will lead to some degree of permanent scar tissue.

The scar’s location and overall visibility depend on the type of breast reduction surgery you have, your body chemistry, and how well you take care of the area.

According to Constance M. Chen, MD, a plastic surgeon and breast reconstruction specialist in New York, you can generally expect scarring around the nipple-areola complex and a vertical scar at the bottom of your breast.

“If you’re curious how your scars will heal, you should look at the other scars on your body,” said Satey.

If you typically have minimal scarring, you’ll likely experience the same after breast reduction surgery. If, however, you typically have keloid scarring, you likely will have keloid scars at the incision site.

To minimize scarring, Satey recommends:

  • working with a surgeon who specializes in breast reduction surgery
  • keeping the wound clean to prevent infection
  • an aggressive postoperative scar management protocol
  • waiting the recommended amount of time before lifting weights

How to care for your chest to prevent scarring

Surgeons typically recommend the following to prevent scar formation:

  • Avoid the sun.
  • Apply anti-scar medication.
  • Regularly massage the scar.
  • Use silicone bandages.
  • Regularly redress the wound.

“The scars can be treated with silicone scar therapy, laser therapy, or microneedle with platelet-rich plasma,” said Alexander Zuriarrain, a quadruple board certified plastic surgeon at Zuri Plastic Surgery in Miami.

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You can expect some differences between sides when fully healed.

“Breasts are sisters, not twins, so they may not be perfectly symmetrical, just as many breasts are not perfectly symmetrical before surgery,” said Chen.

Keep in mind, she adds, that it will also take months for the final shape and size to develop as the tissue settles after surgery.

About 10% of all patients experience some sensation loss, says Satey.

According to holistic plastic surgeon Shirley Madhère, founder of Jet Set Beauty Rx, sensation loss may be more likely if:

  • a high volume of breast tissue is removed
  • a larger portion of the nipple is removed
  • you have a history of smoking cigarettes or vaping nicotine
  • you have an underlying condition that affects your blood circulation, nervous system, or your ability to heal

“Sometimes the sensation loss is lasting and full; other times it is temporary or partial,” said Madhère.

“It’s a myth that people will lose the ability to breastfeed following breast reduction surgery,” explained Jonathan Kaplan, MD, a plastic surgeon with Pacific Heights Plastic Surgery in San Francisco.

Most people will still be able to breastfeed because the milk duct isn’t removed, adds Kaplan.

You may be more likely to lose the ability to breastfeed or chestfeed if your nipple and areola are removed during surgery.

So, if breastfeeding or chestfeeding is important to you, talk with your surgeon about which technique will give you the aesthetic you want and preserve your ability to produce milk in the future.

You can expect healing to take at least a few weeks, according to Chen.

Typically, people experience swelling and tenderness for a few weeks while the wounds heal, she says. “And it takes a few months for the swelling to go down and for the breasts to settle into their new size.”

Still, for some people, the wounds take extra long to heal.

“Delayed wound healing can usually be treated with standard wound care and dressing changes,” said Chen.

If you’re worried about how long your body is taking to recover from surgery, consult with your surgeon.

A hematoma is a type of blood clot that occurs under the skin. Far less serious than a blood clot in the veins, a hematoma is basically a bad bruise.

However, hematomas do become a cause for concern when they don’t stop growing, notes Chen.

“Be on the lookout for an expanding hematoma, which is when a blood vessel starts bleeding after surgery,” she explained. “It can cause the breast affected to become tight, bulging, and painful.”

If you have a hematoma or something you think is a hematoma, go to the doctor ASAP.

“It may require a trip back to the operating room to evacuate the blood and stop any bleeding if it hasn’t already stopped on its own,” she said.

Nipple necrosis, also known as necrosis of the nipple-areolar complex, is a very rare complication of breast reduction surgery.

Put simply, it’s the death of a nipple.

Typically, it happens when the blood supply isn’t successfully reattached to the nipple after the breast was moved or reshaped during surgery.

Without nutrient-rich blood being pumped to the sensitive tissue, it’s unable to heal properly and subsequently dies.

This can also happen if there isn’t enough blood leaving the nipple, as it can cause blood to get trapped in the tissue.

The main sign of nipple necrosis? An unexpected color change.

If your nipple is paler than expected, there may not be enough blood flow into the nipple. If your nipple is purple or darker than expected, there may not be enough blood flow out of the nipple.

If a doctor or other healthcare professional concludes that you do have nipple necrosis, your surgeon can either go back in and reattach the nipple to the blood supply or perform a free nipple graft. The latter involves detaching the nipple from the underlying breast tissue and reattaching it as a graft.

“The incidence of infection after breast reduction surgery is low and generally only appears in 1% to 2% of patients,” said Madhère.

“If an infection does occur, it usually occurs within 5 to 7 days after,” she said.

Common signs of infection include:

  • redness or skin that feels hot to the touch around the incision
  • intense pain or discomfort around the incision
  • foul-smelling discharge from the wound
  • fever
  • chills
  • nausea

How to reduce the risk of infection

“Infection prevention begins before the actual operation,” said Satey.

  • A few days before the surgery: People are typically advised to cleanse the chest with an antiseptic solution to help eradicate the natural bacteria that live on the skin, Satey explains.
  • The day of surgery: Your skin will be prepped with an antiseptic solution, the procedure will be performed with a sterile approach, and the wound dressings will be placed in a sterile fashion.
  • After surgery: A member of your surgical team will teach you how to properly care for your wounds to minimize the risk of infection.
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Breast reduction surgery is a relatively safe procedure for reducing the size of an individual’s breast or chest tissue. But as with most medical procedures, there are some potential risks and side effects.

If you think you’re a good candidate for the procedure, consult with a surgeon to manage expectations and develop an appropriate postsurgery care plan.

Gabrielle Kassel (she/her) is a queer sex educator and wellness journalist who is committed to helping people feel the best they can in their bodies. In addition to Healthline, her work has appeared in publications such as Shape, Cosmopolitan, Well+Good, Health, Self, Women’s Health, Greatist, and more! In her free time, Gabrielle can be found coaching CrossFit, reviewing pleasure products, hiking with her border collie, or recording episodes of the podcast she co-hosts called Bad In Bed. Follow her on Instagram @Gabriellekassel.