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ROCKVILLE  •  MCLEAN
 301-656-6398  |  703-442-4919
Adam G. Tattlebaum M.D.

How Small Can A Breast Reduction Go?

Before discussing how small a breast reduction can go, I first want to comment on breast reduction surgery itself.

Breast reduction is perhaps one of the most gratifying operations that I perform for my patients. It is fascinating to me how long people wait before they choose to go ahead with it. Obviously, I know how scary it can be to consider any surgery, yet, breast reduction can be life-changing.

I can never promise to resolve back, neck or shoulder pain in a patient through breast reduction, but I cannot tell you how many people have improved their symptoms or reduced the pain, simply by taking away excess weight of the breasts.

So, how small can you go with a breast reduction?

In truth, there are no limits to reducing the size of the breast, but there are some limitations. The most common breast reduction makes an effort to keep the nipple and the areola attached to healthy living tissue. By keeping the nipple and the areola attached, the patient still has the possibility of breastfeeding and the possibility of maintaining sensation to the nipple (although that is not guaranteed). This is called a pedicle technique – a bridge supplying blood to the nipple and the areola.

If someone wants to be excessively small or the breast starts out excessively large, the pedicle may not be able to support the blood supply to the nipple or areola. In that type of patient, if we really want to go small or if the blood supply were in jeopardy, we take off the nipple and areola, reduce the breast basically to any size we wish, and then stick the nipple back on like a skin graft.

This free nipple graft gives more flexibility in smaller sizes but patients will lose the ability to breastfeed, and they will lose nipple sensation. They often lose some projection of the nipple itself, although that’s not really a problem, and sometimes darker skin patients will lose pigment but that is easily tattooed.

In “Tops” surgery for people transitioning from female to male, almost all of the breast tissue is removed and free nipple grafting is common.

Professional advice is key

When patients come to me for a breast reduction, I do my best to evaluate their size goals, breastfeeding preferences, and other factors to determine a tailored plan that makes sense for them. Most patients will prefer a pedicle technique but patients with excessively droopy or long breasts will be safer and better off with a free nipple graft.

Of course, excessively large-breasted patients are the bulk of breast reduction patients, but often smaller-breasted patients have some degree of reduction as part of a breast lift. The heavier the breast the further it will droop over time. Natural tissue always responds to gravity.

That said, breast reductions, and even breast lifts, can be repeated. Breasts change and fluctuate throughout life – pregnancy, age, weight gain and weight loss all contribute. If a patient is happy with her size but has drooped, the breast can be retightened. If a patient has gained weight and the breast has enlarged, the patient can be reduced for a second or even a third time.

If you are interested in scheduling a free consultation about breast reduction, please get in touch with my practice to learn more.

Quick recap

  • Breast reduction can be a life-changing procedure, with a host of benefits for patients
  • There are no absolute limits on how small a breast reduction can go, but there are limiting factors to consider
  • The main factors are whether a patient wishes to retain nipple sensation and the ability to breastfeed.
  • It’s best to discuss your size goals and preferences on sensation and breastfeeding with an experienced, professional surgeon.
  • Breast reductions (and lifts) can be repeated in the future, if necessary.

January 1, 2023 5:51 pm
Categories: Blog

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