Sometimes a reconstructed or treated breast will be smaller than your natural breast. If this is troublesome and making it difficult for you to get clothes to fit you may be offered a breast reduction on the other side. In addition if you have gone flat after a mastectomy then you may wish to have a reduction on the other side to allow you to wear a smaller prosthesis. Possible complications after this type of surgery are the same as listed under therapeutic mammoplasty, and any of these complications may require you to have further surgery in the future. You will still need to have mammograms on a breast after breast reduction.
Your Surgeon will explain to you where the scars are likely to be on your breast, but in general these will be going around your areola (the dark skin around your nipple) and then straight down and possibly also along in the fold underneath your breast. Sometimes the blood supply to the nipple may be insufficient following breast reduction and part or all of the nipple can die off. This happens in around 1 in 100 cases, but the risk is increased if you are a smoker, diabetic, and/or have very droopy breasts. Your surgeon will explain if your risk of this is very high and may suggest that you have the nipple removed as part of your surgery. If your nipple is removed or dies off it will be possible to consider nipple reconstruction in the future if you wish.
There may also be problems with lumpiness after surgery caused by reduced blood supply to the fatty tissue of the breast (this is known as ‘fat necrosis’). Fat necrosis can also causes flecks of chalk (‘microcalcification’) in the breast tissue which show up on a mammogram. If either lumpiness or microcalcification occur you may need to have investigations to be sure it is only due to fat necrosis, and rarely additional surgery may be required to remove lumps.
You are unlikely to have a perfect size match with the other side afterwards, although hopefully they will be closer. In addition the breast will continue to droop over time, whereas your treated side will not, so you may in the future find that the breasts start to look a bit different, although hopefully the sizes will be better matched.