My Breasts Are Too Small After A Breast Reduction – What Do I Do Now?

Q: My daughter had a breast reduction at the age of 14. She is now 19 and would like to have implants to bring some shape and fullness back to her breasts. Can you explain what happened? It seems like we are going in reverse. Once her breasts were too big, now they are too small.

A: While breast reduction reduces breast size by removing tissue volume and skin, the long-term results of the operation are not always stable. In fact, if you look at a woman’s breasts over a lifetime, they do change throughout her life for a variety of reasons.  The younger a breast reduction is done, the more likely the breasts will eventually undergo shape and size changes.

The first explanation is that the initial breast reduction may have been overly done. While it may have initially looked good, once the breast swelling went away the amount of reduction may have been too much. Years later, the breasts will bottom out and look deflated and flat.

Breast reduction results are affected by a variety of bodily changes long after the surgery has healed. The two biggest are weight loss and pregnancy. Both cause breast involution or tissue shrinking, resulting in a decreased breast size and more loose breast skin.

Since her breast reduction was done early at age 14, she was barely through puberty. Often breasts can ‘regrow’ when done this early but I have never seen in my Indianapolis plastic surgery practice significant breast shrinkage after just five years by age 19. If she has become pregnant and delivered, this would explain what has happened. More likely, however, is that the initial breast reduction may have been too aggressive.

Dr. Barry Eppley

Indianapolis, Indiana