dr manafi / Procedures / Abdomen And Trunk / Breast Reduction

Breast Reduction

Large breasts are usually a sign of femininity throughout the history and highlight the natural ability of women for development and nurturing. However, women with substantially larger breasts than the aesthetic standard of the time may seem abnormal or deformed.

There is no doubt that larger than usual breasts cause distress and discomfort women through physical and mental effects. Physically large breasts disturb shape and form of shoulder and neck and cause back and neck pain, they also cause deviation in sitting position and respiratory problems in more severe cases. Large breasts affect the appearance of a woman resulting to an imbalanced look and difficult or impossible exercise.

Psychologically, staring and bold ideas of others make women with large breasts to be ashamed and bashful and to wear loose clothes to hide their disharmony. Breast reduction surgeries are done for many years and in fact, the first women breast reduction was probably performed in 1669 by William Darston in England. Although the main goal of the surgery is to reduce the size and weight of the breasts, the beauty is just as important.

The surgical methods and techniques have modified and improved over the years to ensure more safety and beauty.

It is important that patients who are undergoing breast reduction know that if they lose weight after surgery their breasts will sag again.

Frequently Asked Questions

  • Surgeries requiring anesthesia are associated with some risks, but they can be minimized if the surgeon has more detailed information of the patient’s history, examinations and tests are carried out properly, and the surgery is performed in equipped clinics and hospitals which are approved by the Ministry of Health.
  • Breast reduction performed by a qualified plastic surgeon through an appropriate surgical procedure has few risks, however, specific problems may occur with this operation. Like any surgery, the risk of infection is also important and can be minimized using precise surgical procedures and pre-operative and intra-operative injection of prophylactic antibiotics. However, despite these precautions, a mild infection may occur around the incision site, but it is usually recovered over a period of about two weeks.
  • Risks such as blood clots are rare. Foot massage during and after surgery and walking and moving faster after surgery can reduce this risk.
  • As mentioned, post-operative swelling and inflammation is expected at the operation area. When swelling is mild or moderate, the body re-absorbs it quickly. Sometimes excessive bleeding can create much swelling and hematoma (collection of blood under the skin). If this happens, surgical drains are required for discharge of blood, but this does not affect the final outcome.
  • Nipples are based on the original tissue, and in most cases, normal contractions and some sensitivity remain. In rare instances, the original breast tissue cannot have a good blood supply to nipples and cannot maintain viability of nipples. As a result, the areola should be worn for long time until fusion is normally occurred.
  • Sometimes a part or even rarely all the nipples skin may be lost (especially in smokers). In this case, the nipples should be restored in a secondary procedure. This problem is quite unlikely using modern and new methods and techniques.
  • During the first week after surgery, a part of wound in some patients may not fuse good and may even have scratches or excoriation in each point of the incision.
  • One of the most common places where these events may occur is where the vertical scar reaches to the breast underneath; this is a temporary problem and needs the dressings to be changed regularly. The wound crust in this area will fall subsequently after 3-4 weeks. A bandage with a soft covering for a short period of a few weeks reduces the possibility of such a condition. In addition, some skin loss may occur around the scar and may require reconstructive surgery later.

  • You will have an intravenous line for at least one day after surgery to replace fluids lost during surgery. Blood transfusions are usually not required except in very exceptional and rare cases (excessive bleeding). It is very important to keep the blood circulation in your legs after surgery, therefore, it will be advised to actively move your legs, knees, and hips regularly.
  • After the anesthetic effect, you will notice the bands used around the breasts and the drains, depending on the method used.
  • These tubes are placed at the operation site to discharge the blood or other fluids accumulated sometimes after surgery. When the discharge is minimized, the drains are removed. Your dressings are then re-adjusted and you are taught to wear a sports bra without straps and wire to help keep the breasts.
  • You may also notice a row of stitches or small metal clips on the stitch lines. Before being discharged, you will usually be given an appointment (about five days later) for removal of dressings and lessening of bandages. Breasts may not look very good at this time due to swelling and bruising as well as possible wrinkles and being large; these problems are temporary and will be better in the coming weeks.

  • Breast reduction surgery takes about 3 to 4 hours.

  • The length of stay in hospital depends on the general health of the patient and the extent of discharge from your body. When the discharge is minimized (usually the next day), the tubes are removed and bandages are lessened. You are taught to wear a bra with a tight axillary string lacking wires and rods.
  • Sometimes you may stay for a second night in the hospital.

  • Driving is forbidden for 1 month.

  • You can do light exercise after 2 to 3 weeks and contact sports after 2 months. 

  • Women should use special bras after operation.
  • You should sleep on your back and you can perform the daily activities after 1 week to 10 days.
  • Never press the breast. Do not sleep on the breast.

  • Routine works of general anesthesia are done before the surgery. 

  • Before surgery, doctor Manafi marks the breasts using a markup pen to exactly determine the location and size of the breasts. Excess breast, fat, and skin tissue is removed and the nipples and remained tissues are raised to the new location. All these actions are performed based on the marks made before surgery. Nipples are usually aligned with the middle of your arm.
  • The suture line is stitched around the nipple at new location. This line is continued vertically down, where it may be ended or occasionally continued along the breast fold. Doctor Manafi will tell you about this in the consultation visit.
  • At the end of surgery, depending on the amount of bleeding, drain tubes may be placed under the skin of the breast to discharge the accumulated fluids or blood which may be produced after operation. A suitable bra is used to maintain the dressing.

  • Breast reduction is done under general anesthesia.

  • You will have some swelling and bruising on breasts following surgery. Bruises will usually disappear after about 2 to 3 weeks. While much swelling disappears over time, some swelling may persist for up to 3 months.
  • After surgery, you may find that your breasts are stiff, in particular, at the edges of the incision; this is due to the natural process of wound fusion. When this occurs, a type of massage is trained to you by the surgeon to accelerate healing and to resolve breast stiffness; this condition may take several months to complete.
  • You should expect a reduction of skin sensation of areola and nipples after surgery; this is due to the surgery-induced trauma to the nerves entering to the area. This condition will improve after a few months, however insentience and permanent numbness may occur subsequently.
  • Normally, the breasts will be slightly lumpy and heterogeneous in all women with large breasts. Although all attempts are done to provide symmetry of the breasts, it is not always achieved. Breast reduction is probably one of the most common cosmetic surgeries of the breast. Therefore, it is very important that you talk with your surgeon to see that whether he has a full knowledge of what you want or not. As much as possible, try so say your intention regarding the extent of breast size to your surgeon. This will minimize the possibility of excessive or less than necessary removal of the breast.
  • Although the methods and techniques used by doctor Manafi guarantee the best possible fitness and harmony between the two breasts and nipples as far as possible, they do not guarantee the possibility of breastfeeding after surgery.

  • Scarring is considered a natural post-operative event rather than a complication. Scars remain for somewhat long time in breast reduction surgery and may take months or years to heal.
  • You should expect that scars may be red, warm, raised, and even itching at first, but they will fade and smooth over time. This is the natural process of wound fusion. Although it is important to remember that the process may take two years to be completed.
  • It is recommended to daily massage the scars during this period to accelerate and facilitate this process. However, you should know that a responsible physician cannot predict how the scars will look and the most important factor in scar formation after surgery is related to the susceptibility of the patient’s body in terms of wound healing and this will generally occur when a person is susceptible to produce additional meat which cannot conclusively be prevented. However, as mentioned, the scars will fade and recover gradually.

  • You may experience a reasonable amount of pain a few days after surgery which can be well controlled by analgesics. The pain usually reliefs after 4-5 days

  • Breast reduction is a relatively major surgery and always important per se. Do not try to start fast. Perhaps several weeks should pass before you feel that everything is normal. Although some people can do their light works after 10 to 14 days. Others prefer to rest more for 1 to 2 weeks.
  • Walking in the first 3 to 4 weeks is useful, because it improves blood circulation and may reduce swelling caused by blood clots. Lifting heavy objects or hard activities in the first 6 weeks after surgery is forbidden.
  • If you do something that is uncomfortable, then do not do it!

  • The answer to this question can be obtained in a consultation visit during which doctor Manafi will ask you about your medical history such as details about any previous breast surgery and labor. Although this procedure can be useful for all women of all ages, it is usually not performed before full development of breasts. In addition, patients who are planning to become pregnant should postpone the operation until after the completion of the family, because if pregnancy is occurred after the surgery, the breasts will enlarge again.
  • Therefore, any natural risk and all benefits should be weighed before making decision to undergo breast reduction surgery. If you smoke, you should quit smoking before surgery. Smoking constricts blood vessels and hence reduces blood flow and weakens wound healing. Aspirin, certain anti-inflammatory drugs, and other drugs can increase bleeding, therefore they should be avoided. The best thing is to provide all information to your doctor at the first visit.
  • If you are significantly overweight, it is suggested to reduce your weight first. In fact, in many cases, obtaining smaller breasts can be an incentive to lose weight.
  • Depending on your age, you might need a mammogram before surgery. This will also be advised on the initial consultation.

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