Before surgery: what to prepare
Stop aspirin, ibuprofen, naproxen, and blood thinners 10–14 days before. Stop fish oil, vitamin E, ginseng, ginkgo. Smoking and vaping must stop 4 weeks before and through 6 weeks after, nicotine and the long incision pattern together are a major risk for delayed wound healing and visible scar widening. Buy front-closing supportive surgical bras (the clinic will recommend a size). Arrange home help for the first 1–2 weeks. If you have a recent mammogram, bring it; if you are over 35 or have a family history, the clinic may want a baseline mammogram before surgery.
The day of surgery
Breast reduction is performed under general anaesthesia, runs 3–5 hours, and usually requires one night in hospital. Incisions follow a vertical (lollipop) or anchor (inverted-T) pattern depending on the amount of tissue removed. You wake up with a surgical bra, small drains (out within 2–3 days), and dressings over the incisions. Pain is moderate to significant on day 1 and well-controlled by IV and oral medication.
Days 1–3: peak swelling
Pain peaks day 2–3. The breasts feel heavy, tight, and bruised. Sleep on your back with head elevated. No arm-overhead movement, no lifting, no pushing. Drains usually come out before discharge or at the first follow-up. Pink fluid in the drains is normal; bright red blood or large volumes are not.
Week 1: stitches out, bruising fades
Sutures (where external) come out at day 7–10; many surgeons use dissolvable sutures and steri-strips. Office work from day 7–10 for desk jobs. Surgical bra worn continuously. The breasts look bruised and swollen but the new smaller size is already obvious.
Weeks 2–4: back to public
Office work fully resumed. Light walking from week 2. No lifting above 2–3 kg, no chest exercise, no running until week 4 minimum. Scars are pink and at their most visible around week 2–3 then begin to fade.
Months 2–3: swelling resolves
Swelling resolves and the breasts begin to soften. Scars continue to fade from pink. Light exercise expanding; strenuous chest exercise waits until cleared, usually month 2–3. Sensation around the nipple is reduced in most patients and slowly recovers over months; some patients retain partial reduced sensation permanently.
Months 6–12: the final result
Final shape and size by month 6. Scars are noticeably faded by month 6 and continue to mature through month 12. By month 12 the scars are typically pale and concealable under a bra or swimwear though the anchor incision pattern leaves visible lines that never disappear entirely. Nipple sensation recovery is largely complete by month 12 for most patients, but roughly 15% of patients retain a permanent reduction or alteration in nipple sensation. The T-junction where the vertical and horizontal incisions meet in anchor patterns has a small risk of delayed healing or minor wound breakdown; this is usually managed conservatively with dressings.
Red flags: when to call the clinic
Call the clinic the same day for: sudden firm one-sided swelling, sharply increasing one-sided pain, fever over 38.5°C, pus or yellow discharge, increasing redness around an incision, skin at the incision edges that turns dusky white or black, or any change in nipple colour suggesting compromised blood supply. Go to an emergency room for: severe chest pain combined with shortness of breath, or one-sided leg swelling and pain. Routine asymmetric swelling, reduced nipple sensation in the first weeks, and serosanguinous (pink-tinged) drainage in the drains are not red flags. If you have future mammograms, mention the surgery, post-op scarring can show as calcifications that imaging needs to interpret in context.