Awake breast surgery
Awake Breast Reduction in Ottawa
Breast reduction removes tissue and reshapes the breast. It is a larger operation, so general anesthesia is often the safer choice, but smaller reductions may be possible with awake techniques in selected patients.
Breast Reduction at a glance
| Typical operating time | About 2.5 to 4 hours |
|---|---|
| Awake suitability | Smaller reductions only, in selected patients |
| Typical return to desk work | Desk work often within 1 to 2 weeks |
| Anesthesia | Local anesthesia with or without sedation. General anesthesia arranged if needed |
| Setting | Outpatient, with an anesthesiologist present throughout |
Times are typical ranges for planning, not promises. Your plan is individualized.
What is breast reduction?
Excess tissue, fat and skin are removed, and the breast and nipple are reshaped and repositioned. Scar pattern and technique depend on size, skin quality and nipple position.
Who may be a good candidate
- People with symptoms or goals related to breast size
- Patients with realistic expectations about scars
- Non-smokers in good general health
Why awake breast reduction may work
Smaller reductions, or liposuction-based reductions in selected patients, may be performed with tumescent local anesthesia and sedation. Our general approach is to offer awake whenever it is safe, and to tell you plainly when a larger reduction is better under general anesthesia.
When awake may not be the right choice
More extensive reductions are often better suited to general anesthesia because of operative time and blood supply considerations. We will not push an awake plan when it is not the safer option.
Your awake breast reduction journey
1. Before surgery (pre-op)
Your size, symptoms, skin quality and nipple position are assessed. Mammogram history is reviewed.
- A consultation to review your goals, health history, medications and previous surgeries, and a physical examination
- An anesthesia assessment to decide whether an awake plan is appropriate and safe for you
- Photographs, with your consent, and a written plan, quote and consent form
- Medication guidance, including when to stop blood thinners, certain supplements, and smoking or vaping
- Fasting instructions from the anesthesia team. Follow them exactly
- A ride home and an adult to stay with you after surgery
2. Day of surgery (intra-op)
Depending on the plan, you are either awake with sedation or under general anesthesia. Either way an anesthesiologist stays with you.
- You arrive, change, and meet the surgeon and anesthesiologist, and your markings and plan are confirmed
- An IV and monitors are placed. The anesthesiologist stays with you from start to finish
- Local anesthetic is given. Expect brief stinging, then numbness, and light sedation if planned
- You can listen to music, talk with the team, and tell us at any time if you feel discomfort
- Afterward you rest in recovery, receive written instructions and go home with your driver
3. Recovery (post-op)
You are observed in recovery, given written instructions and pain-control guidance, and scheduled for follow-up. Call us or seek urgent care for fever, spreading redness, severe or worsening pain, heavy bleeding, chest pain, shortness of breath, or leg pain or swelling.
| When | What is typical |
|---|---|
| Days 1 to 3 | Soreness and tightness. A supportive bra is worn and drains may be used. |
| Week 1 to 2 | Desk work often possible after 1 to 2 weeks. No heavy lifting. |
| Weeks 2 to 6 | Gradual return to activity. |
| 6 to 12 months | Scars mature and shape settles. |
Timelines are general and vary. Your surgeon gives you instructions specific to you.
Anesthesia options
Anesthesia options range from local anesthesia, with or without sedation, to general anesthesia. An anesthesiologist is present throughout your procedure and recommends an approach after reviewing your health, the extent of surgery and your preferences. If an awake approach is not suitable, general anesthesia is arranged. Plans can change during surgery if comfort or safety requires it, including deepening sedation or converting to general anesthesia.
Learn more: anesthesia options, levels of anesthesia, fear of intubation, and pain perception and music.
Alternatives
Liposuction-based reduction in selected cases, supportive garments, physiotherapy, or no surgery.
Risks
Wound-healing problems, loss of blood supply to the nipple, altered sensation, changes to breastfeeding ability, asymmetry, scarring, bleeding, infection, clots, and anesthesia-related risks.
Anesthetic risks include reactions to medications, breathing or airway events, the need to deepen sedation or convert to general anesthesia, and, rarely, transfer for further care. All surgery carries risk, and results are not guaranteed.
Frequently asked questions about awake breast reduction
Can I be awake for breast reduction?
Some smaller reductions may be. Larger ones are often safer under general anesthesia.
Will I be able to breastfeed?
It may be reduced or lost. Discuss your plans before surgery.
Will the scars be visible?
Scars fade but are permanent. Your surgeon shows you the expected pattern.
How soon will I feel relief?
Many people notice relief from weight and strain soon after surgery.
Related procedures
- Awake Breast Lift (Mastopexy)
- Awake Gynecomastia (Male Chest Contouring)
- Awake Armpit (Axillary) Fat Liposuction
Starting from $12,000 (CAD, before 13% HST), including surgeon, anesthesia and facility fees. Your written quote follows your consultation. See pricing and financing.
Explore your options at a consultation
References
- Tettamanzi M, Filigheddu E, Ziani F, et al. Optimizing gynecomastia correction surgery: efficacy and safety of tumescent local anesthesia approach. Aesthetic Plast Surg. 2024;48(23):5067-5073. PMID 39317861