Introduction Reduction mammoplasty is a major and invasive operation. The surgery reduces the size of very large breasts by removing the excess glandular tissue, fat, and skin. Even though it is a sophisticated procedure, the risks can be reduced when performed by an experienced plastic surgeon. However, the associated risks cannot be entirely ruled out. You must discuss these risks with the surgeon during the consultation session. The risks of reduction mammoplasty can vary from patient to patient. Some patients are more prone to the risks. People with medical conditions are more at risk of the complications during and after the operation. Be sure to share your complete medical history with the plastic surgeon so that he can take precautionary measures during the surgery to reduce the risks. What are the main risks? – Unfavorable scarring Reduction mammoplasty involves major incisions on the breasts. The plastic surgeon will make incisions on the breasts and then remove the excess glandular tissue and fat through the incisions. At the end of the procedure, the surgeon will suture and close the incisions. Just like any other cut made on the body, the incisions will slowly change into scars. Scarring after the surgery is a normal reaction of your body against the trauma. Your body produces collagen to seal the incisions in the form of scars. In most cases, the scarring usually happens and fades over time. However, there is a risk that abnormal or unfavorable scarring may occur. Unfavorable scars are raised, more prominent, and aesthetically unpleasant. They overshadow the improvements achieved in the breasts as a result. The common factors that cause unfavorable scarring include genetics, carelessness during the surgery, certain medical conditions, and surgical error. You can reduce the risk of unfavorable scarring by sharing your complete medical information with the surgeon, selecting your surgeon carefully, and being careful during the recovery period. – Infection During the surgery, the doctor will make incisions on your breasts. The incisions will open up your body to possible infections. Women with a weak immune system are more at risk of disease. When an infection occurs and is limited to the incision or skin, it can be treated with oral antibiotics. However, when the infection goes deep and affects the underlying tissues in your breasts, you will need to be admitted to the hospital and have the disease treated with IV antibiotics. To reduce the risk or prevent infection, you must keep your breasts clean after the procedure. Do not let any person other than the authorized medical staff touch your breasts. Also, some surgeons prescribe antibiotics right after the surgery so that the risk of infection can be reduced. If your surgeon has prescribed antibiotics, be sure to take the medicines according to his instructions. – Change or loss of nipple sensation Since reduction mammoplasty is highly invasive, your nerves may be injured or damaged during the operation. The nerves are located in the skin and are responsible for maintaining your natural nipple sensitivity. When the nerves are injured or damaged, it may result in a change or loss of nipple sensitivity. In most cases, this condition is temporary. If the injury done to the nerves is not severe, your body will heal the nerves and you will gradually regain your natural nipple sensation over the next few weeks or months. However, if the damage done to your nerves is severe, the nerves may fail to heal, which means the change or loss of nipple sensation is permanent. – Anesthesia risks Reduction mammoplasty is done under general anesthesia. You will be unconscious after the anesthesia is given to you. You will not remember how the operation was performed or how traumatic it was. The pain and discomforts will also not be felt. This procedure is performed under general anesthesia because it is invasive and involves tissue removal from your breasts. Many patients experience an allergic reaction to general anesthesia. If you already know that you have an allergy, you must discuss it with your plastic surgeon. After the surgery, you may feel sick. Vomiting, nausea, and exhaustion are other side effects of general anesthesia. – Loss of breastfeeding capability During the operation, the plastic surgeon will remove the excess glandular tissue and fat from your breasts. There is a risk that your milk ducts may be injured or damaged during this process. In case this happens, you may experience a reduction in milk production or lose your breastfeeding capability. This is a rare but significant risk. To avoid this risk, you must select your plastic surgeon carefully. – Breast asymmetry or contour irregularity Reduction mammoplasty is performed with the goal to decrease your breast size and weight. The surgeon will remove the excess fat and tissue from the breasts, in addition to removing the excess skin. In case more tissue, fat, or skin is removed from one breast than the other, your breasts will become asymmetrical. Also, the surgeon needs to have a higher sense of aesthetics of the female breasts and anatomy and the artistry to sculpt the breasts beautifully. In case the surgeon lacks this quality, there is a risk your breasts will appear poor in shape or irregularly contoured. This will make your breasts look aesthetically unwelcoming. It can even affect your overall body outline. The risk of breast asymmetry and irregularity can be reduced by choosing an experienced and board-certified plastic surgeon having a deep understanding of the female anatomy and can sculpt your breasts accordingly. – Excessive bleeding or blood clotting During and after the surgery, there is a risk that the patient may experience excessive bleeding. If you have diabetes, you are more at risk of excessive bleeding during and after the operation. Many patients are careless during the recovery period, which often leads to splitting of the surgical wound and bleeding. Blood clotting after the surgery is also possible, particularly if you have a history of blood clotting or are a smoker. During the first two weeks after the surgery, the patient will be resting and spending the most time in bed. This inactivity can also trigger blood clotting. You can reduce the risk of bleeding by sharing your complete health information with the surgeon and being careful during the recovery period. Be sure to avoid any activity that can apply pressure to the breasts. However, the surgeon will encourage you to get up and take short and slow walks every few hours during the recovery period. Doing so will reduce the risk of blood clotting that may result from inactivity. You should also stop smoking at least two weeks before the surgery and avoid smoking during the recovery period. It will decrease the risk of blood clotting considerably. – Poor and slow wound healing Some patients may experience poor and slow wound healing after reduction mammoplasty. This happens mostly if the patient has diabetes, is careless during the recovery, does not wear the compression bras, or experiences infection. Typically, the breasts should heal completely within six weeks. If it prolongs, it may be a sign of an underlying condition like an infection. In such a case, you should contact your plastic surgeon. – Fluid or blood accumulation Since the surgery involves incisions, there is risk blood or fluids discharged at the incision site may accumulate under the skin and even become clotted. Fluid accumulation under the skin is called seroma, whereas blood clotting under the skin is called hematoma. Most plastic surgeons place drain cannulas under the skin at the incision site to avoid these conditions. The drain cannulas will drain away the fluids and blood released at the incision site. The cannulas usually remain with the patient for a few days. – Persisting pain Pain in the breasts after the surgery is a normal side effect. It will subside within a few days and can be managed with painkillers. However, there is a risk the pain may persist and even become severe. If this happens, it may be an indication of a complication like an infection. The patient must contact the surgeon in case of pain that persists beyond three days or becomes worse. Conclusion Reduction mammoplasty is a major plastic surgery procedure that is used to decrease the size of huge breasts and alleviate the physical and emotional discomforts linked to the condition. The surgery involves incisions and removal of the excess glandular tissue, fat, and skin from the breasts. Because the surgery is highly invasive and traumatic, there are many risks associated with the procedure. These risks can happen during or after the procedure. In this article, I have explained the main dangers linked with reduction mammoplasty. I have also provided tips for decreasing these risks. You must discuss the risks of the surgery with the doctor during the pre-operative consultation.