A Breast Reduction is a procedure to reduce the size and weight of the breasts. It almost always involves an element of uplift or Mastopexy at the same time as it is not uncommon for the nipple to need repositioning in ladies who have large breasts. It can also be used to improve symmetry as many ladies have large and quite different breasts.
Reasons for Breast Reduction Surgery
There can be many reasons for a patient to seek a consultation for a Breast Reduction but the symptoms that are frequently reported to me are back pain, bra straps digging in, deep shoulder grooves, problems with finding clothes to fit on both the top and bottom half, sometimes the skin beneath the breasts can be quite sore and often it can lead to poor posture either because the patient is self aware or because of the sheer weight of the breasts.
A Breast Reduction can help to reduce or eliminate some or all of these symptoms.
Ideally, you should be in good general health, a non-smoker, not taking any medications that may make you bleed or lead to problems with wound healing and are not planning to get pregnant or breastfeed in the future.
I will nearly always see a patient for 2 consultations before proceeding with a Breast Reduction. This is because there is a lot of information regarding the risks and benefits of surgery and I like to give my patients time to think it over and to write down any questions they may have about the surgery. It is sometimes helpful to look at pre and post op pictures here on my website and also on other sites such as Realself.com
It can sometimes be necessary to combine a Breast Reduction and a Breast Uplift (Mastopexy) as well as a Breast Augmentation (in some challenging cases) in order to achieve the final result that a patient desires. It may seem strange to talk of an Augmentation as well a Breast Reduction but a breast implant can be used to create fullness in the upper part of the breast while removing the lower part of the breast in a reduction in order to gain a certain shape and size that some patients like. This is why I require 2 consultations with many patients to discuss all the different options and select the best one. This is also a good way to communicate to me what sort of result you would or would not like to have. You will have a detailed informed consent form provided after the first consultation and you should read this thoroughly and write down any questions you may have.
What is involved in Breast Reduction surgery?
On the morning of surgery I will come and mark you up which means planning the operation by writing on the skin using a special felt tip pen. This is an important part of breast surgery when planning the new position of the nipples and the extent of the skin and glands to be removed.
A Breast Reduction is done under General Anaesthetic ie asleep. It generally takes between 2 and 3 hours to complete the surgery. I do not use drains and I use all dissolving stitches. A small reduction may mean that you are able to go home the same day but if it is a larger reduction then I prefer you to stay in hospital for one night to ensure you are comfortable and the breasts can be monitored for swelling or bleeding.
Post operative procedure
You will be seen the next day by me in your chosen hospital to monitor your breasts and then allowed to go home with a plan to be reviewed in 10-14 days to check the wounds.
It is important to keep the wounds clean and dry and to rest at home. You must
ensure you keep yourself mobile by having a short 5 minute walk every hour as this reduces the risk of post operative clots.
Follow up procedure
I will review you in the clinic 10-14 days later and remove the dressings and inspect the wounds. If all is well then you will usually have a much lighter dressing applied and then a plan to review your progress in about 4 weeks and then 3 months time.
It is important in the post operative period to avoid
anything rubbing or pressing on the wounds and so I ask that you wear a soft and supportive sports bra with no under wiring until I am happy that all wounds have settled nicely.
All operations have the potential for complications and a Breast Reduction is no exception. The most frequently seen issues are small areas where scars meet can sometimes be a little slower to heal. Poor scarring is a risk in any surgery and is not under the control of the Surgeon. A risk that is always discussed is the potential of loss of a nipple. This is because the nipple has to be moved and it needs to carry a healthy blood supply with it. If the blood supply does not feed the nipple then there can be problems with healing or loss of the nipple. This is something I have very rarely seen in my whole career and is more common if a Breast Reduction is being repeated and the Surgeon does not have the information regarding the previous surgery available to them.
The vast majority of patients are delighted with the results of their Breast Reduction surgery and wish they had done it sooner! It can be a truly life-changing procedure for some patients leading to a new lease of life with increased confidence and a whole new wardrobe!