May I commend you on a good first step forward to consider and understand the risks associated with your surgery.
As with any surgical procedure, there are risks involved and patients have to be counselled about these potential complications.
The most common complications from breast reduction surgery are bleeding, bruising and wound breakdown or infections. Occasionally hematoma (blood clots) or seroma (fluid collection) can occur which require drainage. Fat necrosis of the remaining breast tissue or unequal removal of breast tissue can lead to an asymmetry of the breast shape or nipple position which may require a second surgery to correct. Decreased or loss of sensation of the nipple can occur in certain cases.
One of the rare but feared complications in breast reduction surgery is death of the skin of the nipple which results in subsequent scarring or removal of the nipple. Breast reduction surgery is done under general anaesthesia and hence the risk of anaesthesia also apply but these are usually low.
The risks and complications may sound numerous and scary but in reality, the occurrence is very low when the surgery is performed by experienced MOH-certified plastic surgeons.
An important consideration is the size of the reduction. Studies report widely differing complication rates in breast reduction surgery because the size of the reduction can be so variable. There is a huge difference between a 300-400 gram reduction versus a 1,500-gram reduction. With larger reductions, the surgery is more involved, there is usually excess skin which requires more skin excision leading to more scars. The increased distance of the nipple to the chest also increases the risk of nipple complications. (A cut off mark of the nipple to sternum distance of less than 35 cm is usually safe.) For most patients where the reductions are between 300-500 grams, the complication rate is less than 5%. Most patients who come for breast reduction tend to be in their late 20s to early 40s and are usually fit and well. For patients who are overweight, have diabetes or heart conditions, the incidence of wound complications and complications increases exponentially.
Breast reduction surgery ranks as having one of the highest patient satisfaction scores among plastic surgery procedures and the reason being that not only are their physical symptoms relieved, they also look much better after the surgery.
Depending on your insurance plan, breast reduction may be covered if the doctor is able to document a medical need. The breasts would need to be sufficiently large compared to your frame (usually in excess of 250 gm) and there have to be symptoms such as chronic headaches, neck or backaches and rashes.
