If a patient is younger and has not achieved complete breast size, it is possible that the breasts could get larger after a breast reduction. This would only affect patients that get the procedure in the teen age years. Otherwise the only way for breasts to get either larger or smaller after a reduction would be from large fluctuations in weight, as the breast is composed of a large amount of fatty tissue, more in some patients than others.
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In most cases breast reduction surgery does not require complete removal of the nipple areolar complex. Usually in the standard vertical and inferior pedicle techniques the nipple is left attached to an underlying pedicle of breast tissue and shifted to a more superior position without detaching it. In a small subset of extremely large reductions the pedicle lengths are too long to provide adequate blood supply to the nipple areolar complex and a free nipple graft technique is required.