What is breast reduction?
Reduction mammoplasty, commonly called breast reduction, is a plastic surgery procedure indicated for women suffering from macromastia — an excessive development of breast volume in relation to body proportions. It is not simply an aesthetic operation: in most cases, very large breasts cause a genuine functional condition that compromises the patient's health and daily wellbeing.
The physical consequences of macromastia can be debilitating: chronic pain of the spine, shoulders and neck; deep grooves left by bra straps; breathing difficulties; dermatitis and infections in the inframammary fold; limitations in movement and sport. To these are often added significant psychological effects, with difficulty finding suitable clothing, a sense of self-consciousness and reduced self-esteem.
Dr. Marco Galati performs breast reduction with a personalised approach, carefully assessing each patient's anatomy to plan a proportionate reduction that guarantees not only relief from physical symptoms but also a harmonious, natural aesthetic result. The goal is a breast proportionate to the body, with a pleasing shape and adequate projection, preserving as much sensation of the nipple-areola complex as possible.
Who are the ideal candidates?
Breast reduction is indicated for women who present one or more of the following:
- Macromastia with documented functional symptoms (back, shoulder or neck pain)
- Marked bra-strap grooves on the shoulders
- Postural alterations attributable to breast weight
- Difficulty performing sport or daily activities
- Chronic dermatitis or skin irritation in the inframammary fold
- Psychological or social discomfort related to breast volume
- Significant breast asymmetry
The operation is not advisable during pregnancy or breastfeeding, or in the presence of untreated breast disease. For women who have not yet completed physical development or who plan future pregnancies, the surgeon will discuss the most appropriate timing.
How the operation is performed
Pre-operative assessment
Before surgery, Dr. Galati carries out an in-depth consultation including clinical evaluation of the breast, measurements, analysis of any associated ptosis (sagging) and definition of the goals. The necessary pre-operative tests are prescribed — blood tests, ECG, anaesthesiology assessment — and, according to age, a mammography or breast ultrasound to rule out glandular disease.
It is essential to inform the surgeon of all current medication, in particular anticoagulants, anti-inflammatories and supplements, which must be suspended in the days before surgery. Smoking must be stopped at least 4 weeks before and 4 weeks after the operation, as it impairs healing and increases the risk of complications.
The surgical technique
Breast reduction is performed under general anaesthesia, as a day case or with one overnight stay, and takes 2 to 4 hours depending on the extent of the reduction. The main techniques are:
- Vertical ("lollipop") technique: indicated for moderate reductions, it leaves two scars — one periareolar and one vertical from the lower pole of the areola to the inframammary fold. It provides good projection and a round breast shape.
- Inverted-T (Wise pattern) technique: indicated for larger reductions, with a periareolar, a vertical and a horizontal scar in the inframammary fold. It allows the management of greater skin excess and significant volume reductions.
In both techniques, the surgeon removes excess glandular, fatty and skin tissue, repositions the nipple-areola complex higher (adjusting its size if necessary) and redefines the shape of the breast. Temporary drains are placed at the end of the operation and a supportive surgical bra is applied.
The day of surgery
The patient arrives fasting (at least 6–8 hours) at the accredited surgical facility. After the pre-operative check with the surgeon and the anaesthetist, she is prepared for theatre. On waking, the breast already appears reduced and reshaped, although swollen and bruised in the following days. After a short observation period the patient can generally return home the same day or the following day.
Recovery and results
Post-operative course
In the first days it is normal to experience moderate discomfort, swelling and bruising, effectively managed with the prescribed pain medication. Drains, if placed, are removed within 24–48 hours. The surgical bra must be worn continuously for the first 4–6 weeks, including at night.
Sutures are removed progressively over the first 2–3 weeks. Dressings must be carried out as instructed, keeping the scars clean and protected. Direct sun exposure of the scars should be avoided for at least 12 months, using high-factor sunscreen.
Indicative recovery timeline
- First 48–72 hours: rest, limited movements, cold compresses to reduce swelling
- 1–2 weeks: light daily activities may be resumed; avoid strain
- 3–4 weeks: gradual return to office work; continue avoiding intense physical activity
- 6–8 weeks: return to moderate sport, with the surgeon's approval
- 3–6 months: residual swelling resolves completely and the result becomes definitive
Expected results
The results of breast reduction are stable and long-lasting. Within the first weeks the patient experiences significant relief from back, shoulder and neck pain. Posture improves, physical activity becomes easier and quality of life benefits in a concrete, measurable way.
Aesthetically, the breast appears more proportionate, firm and well positioned. The scars, initially reddish, fade progressively and tend to become thin and pale over the following 12–18 months. Significant weight changes or a future pregnancy may modify the results over time. Dr. Galati accompanies patients through every phase of the pathway, with regular post-operative follow-up visits.
Frequently asked questions
Recovery generally takes 2–4 weeks before resuming light daily activities. Intense physical activity and heavy lifting must be avoided for at least 6–8 weeks. Swelling and bruising subside progressively over the first weeks, while the definitive result becomes visible after 3–6 months.
The operation leaves scars, usually around the areola and vertically towards the inframammary fold (vertical technique), or in an inverted-T shape for larger reductions. Scars lighten and soften over time, becoming barely visible within about 12–18 months. Dr. Galati uses techniques specifically aimed at minimising scarring and keeping it as discreet as possible.
The operation can reduce, but does not always eliminate, the ability to breastfeed, since part of the glandular tissue is removed and the milk ducts may be affected. If a future pregnancy is planned, discuss it with the surgeon beforehand. In many cases breastfeeding capacity is preserved thanks to techniques that safeguard the neurovascular pedicles of the nipple.
In Italy, breast reduction may be provided under the National Health Service (SSN) when macromastia is documented as a condition causing disabling symptoms (chronic pain, intertriginous dermatitis, postural alterations). A specialist assessment and adequate clinical documentation are required; otherwise the operation is performed privately. Dr. Galati evaluates each individual case at the pre-operative consultation.
In the great majority of cases, yes. Relief is usually noticeable within the first weeks after surgery, as the weight pulling on the spine and bra straps is removed. Posture improves and physical activity becomes easier, with a concrete, measurable benefit to quality of life.