Complication during breast reduction

Even after breast reduction, the breast is subject to the natural ageing process and becomes saggier over time. However, as the weight on the skin has been reduced, breast sagging occurs much later and more slowly than would have been the case without breast reduction. You should avoid major weight fluctuations.

The weight gain causes the skin to overstretch again and can result in sagging if the weight is lost again, which reduces the result of the previous breast reduction.

Possible complications and risks

As your team of plastic surgeons in Düsseldorf, we will inform you in detail about complications and their warning signs so that you can avoid them, recognize them in good time and treat them adequately to prevent the worst from happening.

Below we describe the most important complications that can occur during breast reduction surgery:

Postoperative swelling

After breast reduction surgery, swelling (also on the sides) is normal. It can be more pronounced due to minor bruising or wound effusions. Some hardening may also occur. These changes will improve in the first few weeks after the operation.

Bruising

Breast reduction surgery results in larger wound areas. Effective hemostasis is therefore important. With subsequent compression and the insertion of drains, larger haematomas are rare in patients without coagulation disorders. Smaller hematomas (bruises) can be broken down by the body itself, larger ones may require surgical removal.

Bleeding

We can usually avoid this by carefully stopping the bleeding and then applying compression. It is important to discontinue all blood thinners in good time before the operation to avoid unnecessarily increasing the risk of bleeding.

Scarring disorders after breast reduction surgery

So-called hypertrophic scars (excessive scarring or, in worse cases, keloids = benign tumors) can occasionally occur in people with the corresponding inherited disorder. These can then be treated to a greater or lesser extent with special ointments and, if necessary, injections.

If a scarring disorder is known, serious consideration must be given to whether a breast reduction should be performed at all, depending on its severity.

Infections

At the Yuveo Clinic, we reduce the risk of infection by working in a highly sterile environment and, if necessary, with antibiotic prophylaxis. If cysts (fluid-filled cavities) are found intraoperatively, this is particularly important.

Dog ears

Excess skin is created at both ends of the horizontal incisions. The more extreme the findings are, the more extensive the breast reduction will be and the greater the excess skin will be.

As these resemble small dog ears, they are called ‘dog ears’. We can reduce these using certain suturing techniques. Our team believes that they shrink within 3-6 months and are no longer visible at the end.

If the desired shrinkage effect is not sufficiently effective, we can make a small correction under local anesthesia.

Skin sensation in the nipples after breast reduction

Deterioration or numbness of the nipples must be expected after breast reduction, especially as the small skin nerves supplying the nipples are largely severed. Nevertheless, many patients still experience surprisingly good nipple sensation postoperatively.

However, there is also the possibility of complete numbness after breast reduction. This applies in particular to findings where the nipples have to be raised by more than 10 cm.

The “grievance corner”

Similar to the breast lift and tummy tuck described above, there are also so-called ‘breast corners’ in breast reduction surgery. These refer to the area in the crease under the breast where the vertical and horizontal incisions meet in the T-incision breast reduction.

Here the blood circulation is reduced due to the fact that three skin flaps meet and there is also more tension on the suture. The scar can also become wider than in other parts of the suture.

Our team of specialists can plan a small scar correction after approx. 6 months with the administration of a local anesthetic once the scars have matured.

Tearing open the wound / suture

If there is too much tension and too much movement of the chest, the suture can be overstretched and tear. You should therefore reduce movement in your shoulders and arms, especially in the first week after breast reduction. Overhead movements of the arms in particular should be avoided for several weeks.

Tissue death

Particularly in heavy smokers and with extreme breast dimensions, it is possible that the blood flow to the nipples is not sufficient to supply them. Parts or even the entire nipple may then die off. However, we can assess the blood flow situation during the operation.

If this is not sufficient, we would consider transplanting the nipples or areolas. These grow in in the vast majority of cases. However, the skin sensation is then completely impaired, i.e. the nipples remain numb.

It is important to refrain from smoking before and after breast reduction surgery so as not to further jeopardize the blood circulation.

Wound effusions = seroma

Breast reduction surgery creates relatively large wound areas that can produce wound fluid depending on the individual tendency. In most cases, there are no significant changes. Sometimes small and medium-sized seromas develop, which resolve themselves over time. We sometimes have to puncture the larger effusions with a cannula.

Cosmetically unsatisfactory result

During a detailed consultation at the Yuveo Clinic Düsseldorf, we harmonize the expectations of our patients with the possible surgical result in order to avoid disappointment. In the case of asymmetries or suboptimal scar healing, we can remedy the situation with corrective surgery.

Thrombosis and embolism after breast reduction surgery

We recommend thrombosis prophylaxis with heparin and support stockings.