Breast Reduction


About The Procedure

Breast reduction surgery is one of the procedures performed by plastic surgeons that generates the highest patient satisfaction levels, and this is certainly true in my experience.

Patients with large breasts are constantly troubled by back and neck pain, shoulder pain and indentation by bra straps. In warmer weather skin irritation and rashes beneath heavy breasts makes life uncomfortable. A desire to exercise can be hampered by both the weight and movement of large breasts and women are often very self-conscious about their breast size.

I am still amazed by the freedom that breast reduction affords women in terms of living their daily life without pain, fitting clothes better, being confident to socialize and often sleeping better.

Suitability

Breast reduction surgery is, of course, not the answer for everyone, and careful patient selection and candid discussion of what can be achieved is paramount in delivering results. Factors such as weight stability, family planning and breastfeeding need to be considered. The risk of breast cancer and screening mammography needs to be discussed. Subsequent breast growth or changes in size with weight gain or loss also need to be considered. As such, it is important that every patient is treated individually and that frank discussion is facilitated between patient and surgeon.

Surgical Techniques

Breast reduction surgery is about removing excess breast tissue as well as excess skin. There are many techniques of breast reduction surgery, however, in principle, they can be divided into two main groups:

  1. Dealing with the skin, which produces the scar pattern.
  2. Preserving sensation and circulation to the nipple and areola or creating a pedicle.

Generally, the excess skin is removed to leave a vertical scar extended to encircle the nipple and areola. This may be extended to a more traditional anchor shape with a further horizontal scar in the fold beneath the breast (Wise pattern).

Sensation and circulation to the nipple and areola are preserved by maintaining a “pedicle” of tissue attached beneath the nipple. Inferior and supero-medial pedicles are the most common methods used and this tissue forms a large part of the final breast volume.

The best technique varies from patient to patient and depends on the size and shape of the breast. The final size is intended to be proportional to your overall body shape rather than a specific cup size and the merits of this will be discussed prior to your surgery along with the planned technique.

The Procedure

The operation takes about 3 hours depending on the size and shape of the breast. It is performed under general anaesthesia in an accredited hospital facility.

Most patients stay in hospital for 2-3 days for care of drain tubes and pain relief requirements. Whilst the operation is significant, the pain subsequently is surprisingly minimal.

Recovery

Recovery after surgery is arbitrarily said to be about 6 weeks. This allows adequate time for wounds to heal and swelling and bruising to subside. You will be able to shower and get all wounds wet after 48 hours. To help reduce swelling, you will need to wear a post-surgical bra with no underwire for 6 weeks. It is recommended to avoid strenuous exercise for this period of time as well, however, walking is encouraged.

Complications

As with all surgery, there is a risk of complications with breast reduction. These include bleeding, infections, wound healing problems, seroma (fluid collections) and asymmetries. There is also a small risk of change in sensation to the nipple, or even loss of the nipple entirely. General anaesthesia itself carries a risk.

There is a risk of clots in the legs (DVT) and subsequently pulmonary emboli (PE) and whilst these are rare, they are potentially life threatening. As such, routine precautions including careful positioning, calf compressors and anticoagulant medication, are used to prevent them. You will be actively encouraged to walk early in your recovery in hospital.

Further Information

In making a decision to have a breast reduction, it is important to ensure that you see a qualified specialist plastic surgeon to discuss your options and suitability. We look forward to meeting you to do this and to answer any questions that you may have.