Breast Reduction Revision?

I had a breast reduction several months ago and I still think my breasts are a bit larger than I would have preferred. I wanted to be a C cup but was left with small Ds. Is it possible to have another breast reduction to reduce my cup size a bit further? If so, what risks are involved? Do you think I'm making a mistake going in for a revision? Will my scars be worse? Thank you! 


F, Georgia

Breast reduction revisions are performed for a variety of reasons. As in your case, some women feel that their breasts were not sufficiently reduced during the initial surgery and wish to undergo a second surgical procedure to reduce the breast size further. If the original surgery did not meet your goals, or deliver the beautiful results you deserve, then breast revision surgery can be an option worth considering.

In general, it’s recommended that patients wait six months before undergoing a second breast reduction. The healing process from the first procedure takes at least six months to complete before the body is ready for another surgery.

The reduction revision procedure is very similar to the original surgery. The surgeon makes incisions along the existing scars to reduce additional scarring as much as possible. During the revision procedure the surgeon removes and reshapes breast tissue, removes scar tissue and incorporates any additional cosmetic procedures to improve the placement and appearance of the breasts.

Breast reduction revision is generally a safe procedure when performed by an experienced breast surgeon. However, one risk is that is rare but can happen is that the blood supply to the nipple-areola complex is cut off. If another plastic surgeon performs your revision surgery, it is vital that he or she is familiar with the specifics of the original surgery and knows the origin of the blood supply to the nipple.

Most women report that they find recovery from revision surgery more comfortable than their first surgical recovery. Although some swelling and soreness is common, most patients can return to their everyday life after a week or two. Although no surgery can guarantee perfect results, revision breast reduction can help you achieve the breast shape and size you were hoping for if you were disappointed with the outcome of your first surgery.

Dr. Neil Zemmel has 2 Breast reduction before & afters:

Breast reduction before image performed by Dr. Neil  ZemmelBreast reduction after image performed by Dr. Neil  ZemmelBreast reduction before image performed by Dr. Neil  ZemmelBreast reduction after image performed by Dr. Neil  Zemmel

» View Dr. Neil Zemmel's full profile

I'm sorry to hear that your breast reduction surgery didn't result in the outcome you had hoped for. The size of the breasts is the most critical factor affecting patient satisfaction, which is why a lengthy and honest discussion with your doctor is essential during the initial consultation prior to surgery. There are a small proportion of patients who do undergo a breast reduction revision because they’re unhappy with their post-op size and wish to further reduce the size of their breasts.

Revision surgery is possible but patients are generally advised to wait at least six months before a second breast surgery is attempted. By this stage all residual swelling should have dissipated and the final results should be apparent. After this time the breasts will be smaller, and you may decide you do not want or need the revision procedure. The other reason for waiting six months is to allow scar tissue to heal and your body to recover from the first surgery.

If after six months you do decide you would like to go ahead with revision surgery, it is vital to ensure your surgeon has a clear understanding of the outcome you are hoping for. Discussing the breast size you are hoping to acquire in terms of cup size is not always helpful as cup sizes are not standardized--they differ depending on the bra manufacturer. Using other tools to communicate your goals can be more effective -- board-certified plastic surgeons usually use 3D imaging technology to help patients conceptualize how different breast sizes would look, or before and after photo galleries of previous patients. Make sure you both have a shared understanding of the results you are hoping to achieve.

In most cases, when a surgeon performs a breast reduction revision procedure, he or she will use the same incisions as the original surgery so there are no new scars. Fortunately, revision procedures that involve further size reduction are fairly straightforward. Ideally the original surgeon who carried out the first procedure will also carry out the revision as they will know where the blood supply to the nipple is. If another surgeon is going to perform the revision procedure they will need access to the original operative record so the revision surgery can be carefully planned.

Dr. Christine Blaine has 1 Breast Reduction before & after:

Breast Reduction before image performed by Dr. Christine BlaineBreast Reduction after image performed by Dr. Christine Blaine

» View Dr. Christine Blaine's full profile

Yes, repeat breast reduction surgery can be completed.  It is very important to wait 6-12 months prior to any decision regarding size and shape after your initial breast reduction surgery.  The breast shape and size can change over the first year after surgery.  Make sure that your weight is in the optimal range; BMI around 25.  View before and after photos from your original surgery.  Then make your decision based on shape, size and body contours of how your new breast size and shape fit YOUR body.  Do not base your decision on "Cup size" alone.  Repeat breast reduction carries about the same risk for incision scarring; but may have an increased risk for problems with blood supply to the nipple.  Liposuction can be an alternative to reduce the fatty tissues in and around the breast.  Liposuction can reduce the breast volume by 1 cup size.  Speak with your surgeon regarding your desires. 

Breast reduction surgery seeks to achieve neck and back discomfort. Breast Cupsize is poorly sized by stores and specialty outlets such as Victoria Secret frequently "over size" women. True measurements are difficult when taken with a bra on and clothes on, so often an incorrect Bra Size is selected. 

I always measure patients before surgery and let them know that while I have performed numerous operations for breast reduction that determining the post operative size is nearly impossible based on the variabilities of where a patient may go to get a bra.

The amount of tissue removed is often based on a calculation of height and weight of the patient and has little to do with the pre or post op Bra size. 

Removing breast tissue involves a potential risk of removing breast parenchyma which includes blood supply to the nipple.

Taking too much tissue may imperil the viability of the nipple which is a potential complication of breast reduction surgery. 

Achieving a particular breast cup size with breast reduction is a secondary consideration and one which may fall under a cosmetic mastopexy category. If further reduction in breast volume is desired and concerns for changing existing scars, then consideration to a breast liposuction procedure should be pursued. Look for a plastic surgeon with experience with this technique.

Breast Reduction Revision, submitted image. Breast Reduction Revision, submitted image.

I would wait at least 6-12 months before assessing the size of your breasts.  If after that time you are still unhappy with the size, you can definitely have a further reduction.  Often times it can be done with just liposuction going through the existing scars.  But if a full reduction has to be done, generally the same scars can be used, so they should be no worse than the ones you have now.

Dr. Gary Breslow has 5 Breast reduction before & afters:

Breast reduction before image performed by Dr. Gary D. BreslowBreast reduction after image performed by Dr. Gary D. BreslowBreast reduction before image performed by Dr. Gary D. BreslowBreast reduction after image performed by Dr. Gary D. BreslowBreast reduction before image performed by Dr. Gary D. BreslowBreast reduction after image performed by Dr. Gary D. BreslowBreast reduction before image performed by Dr. Gary D. BreslowBreast reduction after image performed by Dr. Gary D. Breslow

» View Dr. Gary Breslow's full profile