Successful Management of Postoperative Galactorrhea after Reduction Mammaplasty

Summary:

Galactorrhea after reduction mammoplasty is a rare postoperative complication, usually associated with hormonal dysregulation or pituitary abnormalities. A 43-year-old woman with symptomatic macromastia underwent bilateral superomedial pedicle reduction mammoplasty. Three days postoperatively, she developed high-volume bilateral milky drainage through her surgical drains. Laboratory evaluation revealed elevated prolactin (96 ng/mL; reference value 5–23 ng/mL). Imaging demonstrated a partially empty sella without pituitary mass. Endocrinology initiated cabergoline therapy, resulting in suppression of prolactin and resolution of the galactorrhea. The patient’s drains were maintained until the galactorrhea ceased, and she went on to heal well without complication. Galactorrhea after breast reduction surgery secondary to transient hyperprolactinemia is a rare but clinically significant complication. Prompt recognition and multidisciplinary management including drain maintenance, lactation suppression, and exclusion of prolactinoma are important steps in preventing wound healing complications and achieving optimal outcomes.