Thinking About a Second Breast Reduction? New Research Makes “Revisions” Safer Than Ever
When One Surgery Isn’t Enough
Breast reduction surgery typically has one of the highest satisfaction rates in cosmetic medicine. However, bodies change. Due to weight fluctuations, hormonal shifts, or pregnancy, breast tissue can sometimes regrow, or gravity may cause sagging to return years after the initial procedure.
Many women find themselves wanting a Secondary Breast Reduction (a revision surgery) but hesitate due to safety concerns.
Historically, performing a reduction on a breast that has already been operated on was considered risky. The main fear? Compromising the blood supply to the nipple.
The “Unknown Pedicle” Problem
In a primary breast reduction, the surgeon creates a “pedicle”—a bridge of tissue that keeps the nipple and areola attached to their blood and nerve supply while the surrounding tissue is removed.
The challenge with revision surgery is that the new surgeon often doesn’t know which technique the previous surgeon used. If they cut into the old “lifeline” by mistake, it can lead to Nipple-Areola Complex (NAC) Necrosis (loss of the nipple tissue).
The Austrian Solution: A Triple-Safety Technique
A new prospective study published in April 2025 in the Plastic and Reconstructive Surgery journal offers a reassuring solution.
A team of researchers from Linz and Innsbruck, Austria, led by Dr. Sandra Feldler and Dr. Manfred Schmidt, has developed a “Modified McKissock Technique” specifically designed for these complex revision cases.
How It Works
The classic “McKissock” technique uses a vertical bipedicle (a bridge with a top and bottom attachment) to supply blood to the nipple.
The Austrian team modified this by adding a third component: a Central Pedicle.
- Superior Pedicle (Top)
- Inferior Pedicle (Bottom)
- Central Pedicle (Middle)
Think of it as adding an extra emergency power line. Even if the surgeon doesn’t know exactly how the first surgery was performed, this “triple-threat” approach ensures the nipple retains a robust blood supply from multiple directions.
The Results: 100% Safety Record
The study followed 25 breast revisions using this new technique. The results were remarkably positive:
- Zero Necrosis: There were no cases of nipple loss or tissue death.
- Significant Reduction: The average patient had roughly 300g of tissue removed per breast.
- High Satisfaction: 84.6% of patients rated their aesthetic appearance as “excellent” after the surgery.
Why This Matters For You
If you have been told that a second breast reduction is “too risky” or that you aren’t a candidate because your previous surgical records are lost, this research changes the conversation.
This modified technique allows surgeons to navigate the “unknowns” of your previous surgery with a safety net, ensuring you can achieve the smaller, lifted shape you desire without compromising your safety.
Frequently Asked Questions (FAQ)
Q: Why do breasts get big again after a reduction?
A: While the fat and glandular tissue removed during surgery is gone forever, the remaining cells can expand. Weight gain, pregnancy, menopause, and certain hormonal medications can stimulate the remaining breast tissue to grow.
Q: Is a revision recovery harder than the first time?
A: Surprisingly, many patients find the recovery similar or even slightly easier, as less tissue is usually removed compared to the first massive reduction. However, strict adherence to post-op care is vital to protect the blood supply.
Q: Does this technique leave more scars?
A: This technique generally utilizes the “inverted-T” or “anchor” scar pattern. Since most primary breast reductions also use this pattern, the surgeon simply goes through the old scar lines, meaning you likely won’t have new scars, just refreshed ones.
Q: Can I breastfeed after a secondary reduction?
A: Breastfeeding after a primary reduction is already difficult (about 50% success rate). A secondary reduction involves further manipulation of the milk ducts. While the nipple is kept alive and sensitive, the ability to breastfeed is unlikely after a second procedure.
Reference
Feldler, Sandra MD; Zaussinger, Maximilian MD; Ehebruster, Gudrun MD; Bachleitner, Kathrin MD; Steinkellner, Theresia MD; Schmidt, Manfred MD. “Modified McKissock Technique for Secondary Breast Reduction: A Prospective Study on Safety and Surgical and Aesthetic Outcomes.” Plastic and Reconstructive Surgery. April 2025. Linz and Innsbruck, Austria.
