Breasts that are overly large compared to the rest of the patient’s anatomy can be a real burden for the patient, especially if she has an active lifestyle and enjoys playing sports. Breasts that are too big can even cause discomfort during regular, day-to-day activities and make it difficult to integrate into society or have a successful professional life. The emotional struggles associated with the condition can be severe and one of the reasons why patients seek relief from this condition as soon as possible. Breast reduction surgery is a procedure commonly performed nowadays with the purpose of providing the patient with increased functionality and better-looking breasts that are in harmony with the rest of the body. But just like any other surgical intervention, the breast reduction procedure entails risks and complications. One of them can be uneven nipples and areolas after the procedure. Indications for breast reduction surgery The procedure is performed on women who need to reduce the size and volume of their breasts to get relief from constant back, neck and shoulder pain and to achieve a more symmetric and harmonious body figure. In a vast majority of cases, breast ptosis is associated with overly large breasts, even if the patient has no children or is of a young age as gravity is an important factor when it comes to the sagginess of the breasts. The mammary hypertrophy that causes overly large breasts can occur as early as the teenage years or after multiple pregnancies or weight fluctuations. The breast reduction procedure is often associated with a breast lift, and during the operation, the plastic surgeon can also correct other imperfections such as asymmetries. Afterwards, the patient usually notices an aesthetic harmony in the contours of the body and a boost of self-esteem associated with the improvement of self-image. At the same time, the procedure entails certain risks and the results might not be completely up to the expectations of the patient. Unsatisfactory results after breast reduction surgery After any surgery, there is a risk of developing complications. The risks entailed by the surgical procedure must be known by the patient and fully accepted even before scheduling. Knowing what to expect and what can occur after the procedure can significantly reduce the level of the post-operative stress. The main purpose of breast reduction is to remove the excess mammary gland, fat tissue and skin but maintain a harmonious volume in accordance with the desire of the patient and in accordance with her silhouette. The breast volume that remains is enhanced, concentrated and reshaped. A reduction of the chest is often accompanied by a correction of breast ptosis. Effectively, once the excess mammary gland has been removed, a breast remodeling is necessary: the remaining mammary gland is ascended, concentrated, and the surplus skin is removed. The decrease in the size of the breasts is therefore associated with a breast lift. The nipple is also raised (and most often decreased in size) to be positioned in its proper position. The breast is then firmer and more curved. At the end of the surgery, the plastic surgeon makes and places a dressing fitted with elastic bands in the shape of a bra over the patient’s chest. Uneven nipples and areolas after breast reduction surgery In a vast majority of cases, the procedure requires the repositioning and reshaping of the nipple/areola complex. When it comes to enlarged breasts, it often happens that the nipple and areola complex is also bigger than natural and facing down due to breast ptosis. The plastic surgeon needs to reduce the size of the nipple and areola complex to be in accordance with the size of the new breasts and also to move it to a more natural position. However, this is a delicate and complex procedure (even for experienced plastic surgeons), and especially if there is a significant amount of tissue to be removed. One risk is for the patient to be left with uneven nipples and areolas once the procedure is completed and the healing process starts. The breast reduction procedure can be even more problematic than breast augmentation when it comes to achieving symmetry and satisfactory results. Breast augmentation uses implants and they are often of the same size, so symmetry is not difficult to get. But when it comes to breast reduction, the plastic surgeon needs to cut the excess mammary gland. Not removing the same amount from both breasts can result in significant asymmetries and uneven breasts. Keep in mind that each plastic surgeon develops and adopts a technique of his own for ensuring satisfactory results. Ideally, this technique is adapted from patient to patient to achieve superior results. Conclusion The breast reduction surgery is a delicate and complex procedure, even if performed commonly nowadays. It provides relief from back, neck and shoulder pain and helps the patient regain more functionality and breasts more proportionate to the rest of the body. But at the same time, the procedure entails risks and complications such as uneven nipples and areolas. The only way to ensure you have satisfactory results after your breast reduction surgery is to choose a board-certified, highly experienced plastic surgeon to play out your intervention.