Breast Reduction Surgery

What Is Breast Reduction Surgery (Reduction Mammoplasty)?

Breast reduction surgery (reduction mammoplasty, also spelled mammaplasty) is an operation in which excess breast tissue, fat and skin are surgically removed, the remaining tissue is reshaped and the nipple is moved higher. In everyday language it is simply called a breast reduction. It takes about 3–4 hours under general anesthesia.

Large, heavy breasts are not only a question of appearance: back, neck and shoulder pain, grooves left by bra straps, rashes and fungal irritation under the breast, and difficulty with sport and clothing are common complaints. In a prospective study of 179 patients, half reported breast-related pain in the upper back, shoulders, neck or lower back all or most of the time before surgery, compared with fewer than 10% 6–9 months afterwards. In the same study, conservative treatments including weight loss did not give adequate lasting relief (Collins et al., 2002).

Technically, breast reduction uses the same family of incisions as a breast lift; the difference is that volume is also reduced. If there is only sagging, a lift may be enough. In men, breast enlargement is a separate condition: gynecomastia.

Who Is Breast Reduction Suitable For — and Who Is It Not?

If you plan major weight loss, scheduling the operation after your weight has stabilised makes the result more predictable. Depending on your age and risk profile, breast imaging (ultrasound or mammography) may be requested before surgery.

Which Technique for Which Breast Size?

The incision pattern is chosen by how much tissue and skin will be removed, how much the breast sags and how far the nipple needs to be moved up. The drawings below show three typical pictures; they do not measure you or make a diagnosis. The exact plan is decided at the examination, with measurements taken standing.

Related articles: breastfeeding after breast surgery · breast lift

Breast Reduction Techniques: Vertical (Lollipop) and Inverted-T (Anchor) Incision

Breast reduction most often uses a vertical (lollipop) or an inverted-T (anchor) incision. The nipple is moved up on a stalk of tissue (pedicle) that carries its blood supply and sensation; which pedicle is used depends on the size and shape of the breast and can also affect nipple sensation (see “Risks” below).

How It Works: Excess Tissue and Skin Are Removed, the Nipple Is Moved Up

Breast Reduction or Breast Lift? Quick Comparison

The technique is chosen by how much tissue is removed and how much the breast sags, not by how short the scar is.

How Is Breast Reduction Surgery Done? (Step by Step)

1. Planning and marking: The target size, the new nipple position and the incision pattern are marked while you stand.
2. Anesthesia: General anesthesia is given; anti-clot stockings and devices are used.
3. Removing tissue and skin: The planned breast tissue, fat and skin are removed; the removed tissue is weighed and sent for pathology.
4. Moving the nipple: The nipple and areola are moved to their new, higher position on the tissue stalk that carries their blood supply and sensation; the areola is reduced if needed.
5. Shaping and closure: The remaining tissue is shaped upright and the layers are closed; a drain is placed if needed.
6. Recovery: A supportive bra is fitted; most patients stay 1–2 nights in hospital.

Your Treatment Journey — From First Message to Follow-up

1. 1

   First contact

   Message us on WhatsApp or call; consultations are available in English, German and Turkish.

2. 2

   Preliminary assessment

   Front and side photos give preliminary information; they do not replace an in-person examination.

3. 3

   Examination and plan

   Your complaints, breast measurements, target size and incision pattern are assessed together.

4. 4

   Written plan

   The planned procedure, where the operation takes place, the type of anesthesia and what the fee includes are sent to you in writing.

5. 5

   Preparation and tests

   Blood tests, breast imaging depending on age and risk, and an anesthesia review.

6. 6

   Day of surgery

   About 3–4 hours under general anesthesia; usually 1–2 nights in hospital.

7. 7

   Follow-up and result

   Check-ups in the first days and weeks; the breast shape settles in 3–6 months and the scars keep fading over the following months.

Recovery — Day by Day, Week by Week

1. 0–3 d

   Tightness, pain and swelling are normal; pain is controlled with medication. Short walks start on day one.

2. 1–2 wk

   A drain, if used, is usually removed in the first days; desk work usually after 10–14 days.

3. 2–6 wk

   Swelling eases; the supportive bra is worn continuously and heavy lifting and upper-body exercise are avoided.

4. 6 wk

   Gradual return to sport.

5. 3–12 mo

   The breast shape settles; the scars mature and fade.

After Surgery: What to Do and What to Avoid

Getting Back to Daily Life

• Bra: A front-fastening, supportive bra without underwire is usually advised for 4–6 weeks; your surgeon will tell you when you can switch to an underwired bra.
• Showering: Your surgeon will tell you when you can shower, depending on any drain and dressings.
• Exercise: Light walking from the first days; running, heavy lifting and upper-body exercise usually wait 6 weeks.
• Driving: Once pain medication has worn off and the seat belt is comfortable.
• Flying: Usually 7–10 days for short flights and 10–14 days for long ones; wear compression stockings and walk regularly on board.
• Back to work: Desk work usually after 10–14 days; physical work that uses the arms takes longer.

Timings vary with the person, the technique and any combined procedures; your surgeon sets the exact schedule.

Check-up Schedule and When to Call Straight Away

The first check-up is usually in the first days; a drain, if used, usually comes out within the first week. Further check-ups are then planned over the following weeks and months depending on how healing goes. If you are travelling from elsewhere, remote follow-up and photo review are agreed in advance.

Possible Risks and Complications

Breast reduction is a planned operation and, like any operation, carries risks; it is important to know about them in advance:

• Scars: a permanent scar remains depending on the technique and fades over time; in some patients the scar can be prominent or thick.
• Wound-healing problems: small separations can occur, especially where the inverted-T incisions meet; they usually heal with dressings.
• Change in sensation: temporary, sometimes permanent changes in nipple and skin sensation can occur; a prospective study found that loss of sensation depended more on the technique used than on the weight of tissue removed (Schlenz et al., 2005).
• Breastfeeding: the milk ducts are protected where possible, but the ability to breastfeed may be reduced. A systematic review found that, in the first month after giving birth, breastfeeding capacity after breast reduction did not differ from the general population (Thibaudeau et al., 2010); this cannot be expected for everyone.
• Fat necrosis, infection, hematoma and seroma: can occur; smoking and a high body mass index increase the risk.
• Asymmetry: small differences between the two breasts can occur; sometimes a correction is needed.
• Nipple blood-supply problems: rare; the risk rises in very large reductions.
• Deep vein thrombosis: rare but serious; the risk is lowered with early walking, compression stockings and blood thinners if needed.

In a large series of 2,152 breast reductions, discernible scars were seen in 14.5%, wounds not needing surgery in 13.5%, fat necrosis in 8.2% and infection in 7.3%; a body mass index of 35 or more and tobacco use increased the risk of infection (Manahan et al., 2015). A multicentre analysis of the first 30 days after surgery in 2,492 patients found a surgical complication rate of 4.0%, rising from 2.4% at a body mass index below 25 to 7.1% above 45 (Gust et al., 2013). The difference between these rates reflects the studies’ follow-up periods and how complications were defined.

There is no evidence that breast reduction increases the risk of breast cancer; the removed tissue is sent for pathology. Warning signs are listed above under “Check-up Schedule and When to Call Straight Away”.

What Breast Reduction Can and Cannot Fix

Preparing for Surgery

Preparation helps lower the risk of bleeding and wound problems; you receive exact instructions at your examination.

Expected Change (Medical Illustration)

The images in this section are not photos of real patients. The schematic drawing below shows the intended side-profile change of a reduction: from a large, heavy, sagging breast to a smaller, lighter and lifted contour.

The illustrations are schematic drawings for information only. With any surgical or interventional procedure, results may vary from person to person. Please seek detailed advice from your doctor before any procedure. Individual results vary with breast tissue, skin quality and weight, and are not guaranteed.

Op. Dr. Ali Çetinkaya: Specialty and Professional Background

Specialist in Plastic, Reconstructive and Aesthetic Surgery (2017); working in plastic surgery since 2012, including specialty training. Member of TPRECD (Turkish Society of Plastic, Reconstructive and Aesthetic Surgeons), EPCD and ISAPS — membership record. Biography: about me.

Breast Reduction in Istanbul: For Patients Travelling From Abroad

If you are coming to Istanbul, the online consultation, surgery, check-ups and journey home are planned together. Because of the 1–2 night hospital stay and the first check-ups, a stay of about 7–10 days in Istanbul is usually advised; waiting 10–14 days before a long flight helps lower clot risk. The exact length is decided at the examination.

Medical Necessity, Insurance and How Much Is Removed

Documented complaints caused by large breasts (back, neck and shoulder pain, rashes, bra-strap grooves) can make breast reduction medically necessary. Whether an insurer covers the operation depends on the medical reason and the insurer’s current rules; some insurers require a minimum weight of tissue to be removed based on body size (a sliding scale such as the Schnur scale) and a stable weight.

Check in writing with your insurer before booking whether a planned operation abroad is covered. Fees on this page are for self-pay surgery; the operation report and the weight of tissue removed are provided for your records on request.

You usually do not need to reach a specific body mass index, but a stable weight makes the result more predictable, and the risk of complications rises as the body mass index rises (Gust et al., 2013).

Breast Reduction Cost in Turkey: What Determines the Price?

A firm fee is given after the examination, because the amount of tissue to be removed, the incision technique, operating time, hospital stay and any combined procedures vary from person to person.

If you see a very low price, ask in writing where the operation takes place, which anesthesia team is involved and what is included.

What to Confirm in Writing Before You Book

• Who will operate, and who is on the surgical and anesthesia team
• The hospital where the operation takes place and the type of anesthesia
• The planned procedure(s) — incision technique, any combined procedures — and what is not included
• The hospital stay, post-operative check-ups and remote follow-up after you return home
• Medication, supportive bra and dressing materials
• What happens, and what it costs, if a complication needs further treatment or a revision is needed
• Transfer or accommodation — only if offered, and exactly what it covers
• Payment, deposit and cancellation terms

No prices or packages are published on this page; the fee is given after the examination, based on your personal plan.

Frequently Asked Questions

Glossary

Reduction mammoplasty (mammaplasty)

The medical name for breast reduction surgery.

Macromastia / gigantomastia

Excessively large breasts that can cause functional complaints.

Mastopexy

The medical name for a breast lift.

Vertical (lollipop) incision

Incision around the areola plus a single vertical line.

Inverted-T (anchor) incision

Incision around the areola, along a vertical line and in the fold under the breast, used for large reductions.

Pedicle

The stalk of tissue carrying the blood supply and sensation of the nipple.

Fat necrosis

A usually harmless firm area that forms when part of the fat tissue loses its blood supply.

Medical necessity

The procedure being considered necessary for health reasons.

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