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Ideally you should be of normal weight for height at the time of the procedure. Any woman with large breasts may be a candidate for the operation. If your breasts are causing symptoms, then a breast reduction operation may help you. Possible symptoms include:
• Neck, back and shoulder ache
• A feeling of heaviness in the breasts
• Bra strap grooves in the shoulders
• Rashes underneath the breasts
• Pins and needles in the hands
• Striae (lines) or dilated veins on the breast
• Enlarged areolae
A breast reduction operation can improve your self-image, self-confidence and self-esteem. It can liberate you and allow you to perform exercise, and wear clothing such as bathing costumes and T-shirts that you previously could not.
Surgery is performed under general anaesthesia and involves a one-night stay in hospital. I use dissolving sutures, and I like my patients to wear a comfortable bra from the early in the post-operative period.
After discharge from hospital, patients are usually able to gradually return to normal activities after a few weeks, once the wounds are healing nicely. It is usually unsafe to drive for 2 weeks or so after the procedure, and most patients should take a fortnight off work, although those involved in manual activities, such as nurses, may need to take longer.
The surgery involves reducing the size of the breasts, but leaving them in proportion with the rest of the figure.
The procedure leaves permanent scars, although your bra or bathing suit should cover these. The usual scar encircles the nipple-areola complex and extends vertically down to a scar underneath the breast, leaving an anchor shaped scar. For smaller reductions, a vertical scar technique where the scar goes around the nipple, and vertically downwards only (lollipop scar) may be used.
Bleeding (or haematoma) is typically an early event, occurring within hours of surgery. Treatment usually involves a return to the operating theatre where, under general anaesthetic once more, the wounds are opened and any blood that may have collected is removed before closing the wounds again. This complication is very obvious because of the swelling and discomfort that it causes in the breast that is affected.
Infection occurs in a small number of patients and usually evolves over the first week to ten days after the procedure. Symptoms and signs include swelling, redness, pain, fever, feeling unwell and ultimately a discharge of pus from the wound. Superficial infections can be managed by antibiotics alone but more severe infections, perhaps even the development of an abscess, may require re-hospitalisation and even additional surgery.
Removal of breast tissue has an impact on the blood and nerve supply to the nipple. Reducing the blood supply carries with it a very small risk that the nipple may perish (necrosis). In non-smoking women who are otherwise fit and well, undergoing an average breast reduction, this risk is extremely small (less than 1%) but it can occur. Should nipple-areolar loss occur, reconstructive procedures may be needed. Skin loss, especially underneath the breast may be associated with infection. Small skin losses often heal very well with dressings, although this can take some time. Occasionally a small operation or even a skin graft is required to treat the problem.
Loss of nerve supply to the nipple may lead to a loss of skin sensation. Numbness can affect both breasts and may be permanent in approximately a third of patients.
For women who have not yet completed their families and are contemplating breast reduction surgery, it is important to note that breastfeeding may not be possible after breast reduction has been performed. This may be a reason to defer surgery until the family is complete for some patients.
Final size and perfect symmetry cannot be guaranteed. Most women’s breasts are not identical, either in shape or size, and so it is normal to have minor asymmetry after the procedure.
Breast size and shape can affect a woman’s well-being, self-image and lifestyle. Breast reduction surgery is commonly performed, and the results are predictable. Studies show that over 97% of women are very happy following breast reduction surgery, and that if they were in the same situation again, they would opt for the operation once more. Most complications are minor and resolve without the need for further surgery. Breast reduction patients are amongst the happiest in any Plastic Surgeon’s practice.
For more information about the procedure, as well as information regarding benefits & risks, how the procedure is performed and recovery, download the Patient Information form.
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