Breast Reduction
Breast Reduction Surgery
Any women with very large breasts that are problematic can be considered for breast reduction surgery.
Large breasts can have a negative effect on not only your posture, but you may suffer from physical symptoms such as back pain, and find your breasts limit your ability to wear the clothes you want, or play the sports you want.
The size of a woman’s breasts will largely be determined by genetics but it will also be influenced by fluctuations in weight, pregnancy, breastfeeding and hormonal changes.
For these reasons most plastic surgeons advise that surgery is only undertaken when the woman’s breasts have reached maturity (ie best not performed on young teenagers) and the patient maintains a stable weight.
You may be asked to lose weight to achieve a healthy BMI (body mass index) before surgery is offered.
Ideally surgery should be delayed until any planned family is complete but special cases can be considered.
How is the operation for a breast reduction performed?
Breast reduction surgery is performed under a general anaesthetic, takes up to 2 hours to complete and requires between 1 to 2 days stay in hospital.
There are a number of different techniques that can be used in breast reduction. The operation involves making incision around the nipple, vertically down to the lower fold of the breast and perhaps along the fold itself.
By then removing a portion of breast and fat tissue, usually from the lower parts of the breast, the breast can be restored to a youthful and smaller shape.
The choice of operation will be determined by the size and shape of the breasts before surgery and the size that is desired afterwards.
Excess skin, fat and breast tissue is removed and the position of the nipple may be moved up to restore its normal position. Before the operation, depending on your age and fitness, you may have to undergo some simple health checks such as blood tests and a mammogram.
The Principle
The essential principle of breast reduction is to maintain the blood supply of the nipple on a viable pedicle of breast tissue.
The Movement
After breast tissue is resected, the pedicle and nipple can be moved into a higher position.
The Closure
Closure starts by reshaping the breast.
The New Breast
Skin closure is performed by placing dissolving suture to the wound around the nipple, form the nipple to the infra-mammary fold and, most commonly, along the fold of the breast.
Recovery from a Breast Reduction
When you come around from the anaesthetic you will have dressing over the wounds and drainage tube in each breast.
Once you wake up your supporting bra will be fitted by the nursing staff. The drains are usually removed a day or so after the operation at which time you are normally discharged.
You should wear your bra all the time to support your new breasts until you are reviewed at about 10 days.
Patients undergoing this operation do not usually complain of much pain. Nevertheless, pain killing tablets are prescribed to control any discomfort experienced.
At your first follow-up visit dressings will be removed. Ordinarily all the sutures are dissolving. Expect at this stage to still have some swelling and bruising. Over the next few weeks this will settle. However you will not appreciate the final result until the scars have settled, which can take between 12 to 18 months.
You should expect lumpiness and tenderness for some weeks or maybe months after the operation.
Following this type of surgery sensation to the nipple area diminishes and this may be permanent. Whilst it would be possible to breastfeed after a breast reduction you should expect that the volume of breast milk produced may be reduced.
Risks of Breast Reduction Surgery
Severe complications such as nipple necrosis, infection and fat necrosis are rare but more likely in patients who smoke or who suffer certain diseases such as diabetes.
In these situations, you will be advised to stop smoking at least 6 weeks prior to surgery and also perhaps make sure that your diabetes is well controlled.
Whilst surgery aims to produce a symmetrical and even result, on occasion some degree of asymmetry or irregularity can occur. Whilst it is hoped that the surgical scars will heal to produce a fine line, in some patients scars can stretch or become very red (hypertrophic) and thick. The use of a moisturising cream will help scar maturation.
