Breast Reduction Glossary

Breast reduction (reduction mammaplasty)

Surgical removal of excess breast tissue, fat and skin to reduce breast size and reshape the breast. Performed for medical reasons (back, neck and shoulder pain from breast weight) and aesthetic reasons (proportion, comfort). The procedure typically removes between 400 and 1,500 grams of tissue per side.

Wise pattern (anchor / inverted-T)

The most commonly used breast reduction skin excision pattern. Produces a scar around the areola, vertically down the lower breast, and horizontally along the inframammary fold — forming an anchor or inverted-T shape. The standard choice for moderate-to-large reductions where significant skin removal is required.

Vertical scar reduction (lollipop)

An alternative skin excision pattern that produces a scar around the areola and vertically down to the inframammary fold — forming a lollipop shape with no horizontal scar. Suitable for small-to-moderate reductions where the inframammary horizontal incision can be avoided.

Inferior pedicle technique

A standard breast reduction technique in which the nipple-areolar complex remains attached to the breast tissue from below (the inferior pedicle). Preserves blood supply and nerve supply to the nipple, which is important for sensation and breastfeeding capability after surgery.

Superior pedicle technique

A breast reduction technique where the nipple-areolar complex remains attached via tissue from above. Often combined with vertical scar pattern. Produces an upward-projecting breast shape.

Free nipple graft

A technique reserved for very large reductions or older patients in which the nipple-areolar complex is fully removed and grafted back onto the reshaped breast. Used when the distance the nipple must travel is too great for safe pedicle preservation. Does not preserve nipple sensation or breastfeeding capability.

Pedicle

The strip of breast tissue retained during reduction surgery to maintain blood supply and nerve supply to the nipple-areolar complex. Pedicle orientation (inferior, superior, medial) describes which direction the tissue stays attached.

Reduction weight (grams per side)

The mass of breast tissue surgically removed from each breast, measured in grams. Insurance coverage in some countries (notably the UK NHS and US private insurance) is determined by minimum gram thresholds, often 500 g per side. Dr. Erdal has performed reductions removing over 1,500 g per side.

Nipple-areolar complex (NAC)

The combined unit of the nipple and the surrounding pigmented areola. Preservation of NAC viability is the central technical challenge in breast reduction — the surgical pedicle must maintain adequate blood flow and nerve supply.

Inframammary fold (IMF)

The natural crease where the lower border of the breast meets the chest wall. The horizontal scar in Wise pattern reduction sits along the IMF, where it is hidden by the breast itself when standing.

Breast ptosis

Sagging of the breast due to age, gravity, weight changes or pregnancy. Graded I through III based on nipple position relative to the inframammary fold. Most breast reduction patients have some degree of ptosis that is corrected as part of the reduction.

Macromastia

Medical term for excessive breast size relative to body frame. Usually defined as breasts large enough to cause physical symptoms (back/neck/shoulder pain, posture issues, skin irritation, exercise limitation). Macromastia is the medical indication for reduction surgery, distinguishing it from purely cosmetic procedures.

Compression bra (post-surgical bra)

A soft, supportive bra worn continuously for 4–6 weeks after breast reduction surgery. Reduces oedema, supports the new breast shape during healing, reduces seroma risk, and improves final aesthetic outcome. Selection and proper fitting is one of the most patient-controllable variables in result quality.

Drain

A small thin tube placed at the surgical site for the first 24–72 hours after surgery to allow drainage of fluid that would otherwise collect under the skin. Removed at the post-operative review. Modern technique often uses no drains (drain-free reduction) when the reduction is moderate and haemostasis is good.

Seroma

A collection of clear serous fluid beneath the skin in the post-operative period. Typical incidence 1–4% after breast reduction. Managed with continued compression and aspiration if persistent.

Haematoma

A collection of blood beneath the skin, the most acute post-operative complication. Incidence 0.5–2%. Most resolve with conservative management; large haematomas may require surgical evacuation.

Wound dehiscence

Partial or complete separation of the surgical wound edges during healing. Most common at the T-junction where vertical and horizontal scars meet in Wise pattern reduction. Usually heals with conservative wound care; rare cases require revision.

Nipple sensation change

Reduced or altered sensation in the nipple after breast reduction surgery. Reported in approximately 5–15% of cases (transient in most). Permanent reduction in 2–5%. Pedicle technique selection affects risk.

Breastfeeding capability

The ability to nurse a child post-surgery. Most breast reduction techniques (especially inferior pedicle) preserve some breastfeeding capability, but the proportion of women who can fully breastfeed after reduction is approximately 50–60%, vs. 70–85% in the general female population. Free nipple graft eliminates breastfeeding capability.

Insurance coverage (UK NHS, US private)

Some health systems cover breast reduction as medically necessary surgery when specific criteria are met — typically symptomatic macromastia documented over 12+ months, conservative management failure (physical therapy, weight optimisation, supportive bras), and minimum reduction weight thresholds. Cosmetic-intent breast reduction is rarely covered.

BMI requirement

Most surgeons require BMI under 30–35 for elective breast reduction surgery, both for surgical safety (anaesthesia risk, wound healing) and durability of result (significant subsequent weight loss can produce skin laxity requiring revision).

Smoking cessation

Smoking impairs wound healing and significantly elevates complication rates in breast reduction surgery — particularly nipple necrosis, wound dehiscence, and skin necrosis. Most surgeons require minimum 4 weeks abstinence pre-operatively and 4 weeks post-operatively. Some require 8 weeks each side.

FACS

Fellow of the American College of Surgeons. A senior surgical certification awarded after demonstrated clinical competence, ethical practice, and contribution to surgical literature. Awarded to Dr. Erdal at the ACS Clinical Congress 2025 induction ceremony.

FEBOPRAS

Fellow of the European Board of Plastic, Reconstructive and Aesthetic Surgery. The European board certification for plastic surgery, requiring rigorous written and oral examination plus evidence of clinical practice.

JCI accreditation

Joint Commission International accreditation, an international standard for hospital quality and patient safety. Hospitals where Dr. Erdal operates are JCI-accredited.

Mastopexy (breast lift)

Surgical reshaping of sagging breasts without significant volume reduction. Sometimes combined with breast reduction in patients with both volume excess and ptosis. The skin excision patterns are similar (Wise, vertical) but tissue removal is minimal.

Augmentation-mastopexy

Combined breast lift and augmentation procedure — opposite indication to breast reduction. Mentioned here only to distinguish from reduction; relevant when patients are evaluating which procedure they need.

Symmastia

A rare condition where breast tissue crosses the midline due to congenital anatomy or post-surgical complications. Not a common reduction indication but mentioned for differential context.

Tubular breast deformity

A congenital condition producing narrow-based, conical breasts. Reduction surgery in tubular breasts requires specific technical considerations and is an uncommon variant of breast reduction.

Drain-free technique

Modern breast reduction approach in which surgical drains are omitted. Possible in moderate reductions with good intraoperative haemostasis and tissue layer closure. Reduces patient discomfort and shortens hospital stay; not appropriate for all cases.

Assoc. Prof. Dr. Ayhan Işık Erdal, MD, FACS, FEBOPRAS

Double board-certified plastic surgeon · 30+ peer-reviewed publications · Memorial Sloan Kettering & Ghent University Hospital trained · ISAPS World Congress 2023 Gold & Bronze Awards