Surgical Procedures - Breast Surgery

Breast Reduction (Reduction Mammaplasty)

Hear Breast Reduction Patient Comments
Ann Harsha
Contact Us for Further Information on Breast Surgery or to Book a Consultation.

Surgically reshaping exceptionally large breasts to increase the patient's comfort and satisfaction.

The excessive weight of very large, pendulous breasts may cause a variety of medical problems - back and neck pain, skin irritation, breathing problems, even skeletal deformities. Bra straps may leave indentations in shoulders and unusually large breasts can make a woman or a teenage girl feel extremely self-conscious. Breast reduction, can help such women by removing fat, glandular tissue, and skin from the breasts, to make them smaller, lighter, and firmer. It can also reduce the size of the areola, the darker skin surrounding the nipple. The goal is to give the woman smaller, more shapely breasts in proportion to the rest of her body. What can and should be done in your case will depend on a consultation with your surgeon. However the following introductory paragraphs will, we hope, be helpful. Please be sure to ask your surgeon if there is anything about the procedure you don't understand.

RIGHT FOR YOU?

The aim of breast reduction is usually physical relief rather than cosmetic improvement since very large, sagging breasts restrict activities and cause physical discomfort. Breast reduction is not normally performed until the breasts are fully developed but it can be done earlier if large breasts are causing serious physical discomfort. Ideal patients are mature enough to understand the procedure and risks fully and to have realistic expectations about the results. Breast reduction surgery may be postponed in women who intend to breast-feed.

Some Risk

Breast reduction is not a simple operation but, performed by a highly qualified plastic surgeon, it is normally very safe. Nevertheless, as with any surgery, the possible complications, including bleeding, infection, and reaction to the anaesthesia. Reduce the risks by following your physician's advice closely both before and after surgery. The procedure does leave permanent scars but they will be covered by your bra or bathing suit. Poor healing and wider scars are more common in smokers. The procedure may also leave you with slightly mismatched breasts or unevenly positioned nipples. Importantly, future breast-feeding may be impaired since the surgery involves removing many of the milk ducts that lead to the nipples. Some patients experience mild or even permanent loss of feeling in their nipples or breasts. Very rarely, the nipple and areola may lose their blood supply and the tissue will die. In such cases the nipple and areola can usually be rebuilt by using skin grafts from elsewhere on the body.

PLANNING

Every patient and every physician will have a different view on what is a desirable size and shape for breasts. It's very important, therefore, to discuss your expectations fully and frankly with your surgeon. He will examine your breasts and will probably photograph them for reference during surgery and afterwards. He will explain the variables that may affect the techniques to be used, such as your age, the size and shape of your breasts and the condition of your skin. He will also agree with you where the nipple and areola are to be positioned since they will be be moved higher on your body during the procedure. Your surgeon will describe the procedure in detail, explain its risks and limitations and make sure you understand that scarring will result. He will also describe the anaesthesia that he will use, the facility where the surgery will be performed and the costs. Some insurance companies will pay for breast reduction if it's medically necessary. However, they may require that a certain amount of breast tissue be removed. Please be certain what your policy covers before agreeing to surgery.

PREPARATION

A breast X-ray (mammogram) may be required before surgery. You will also give be be given specific instructions on how to prepare for your surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications. Breast reduction very rarely requires a blood transfusion. Be sure to arrange for someone to drive you home after your surgery and to help you out for a few days if necessary.

WHERE?

Our surgeons perform breast reductions in an operating theatre in one of the London private hospitals where they serve as a Consultant. The surgery usually takes two to three and a half hours, but may take longer. Many patients are able to go home on the day of the surgery; some remain in the hospital for one or two days.

ANAESTHESIA

Breast reduction is nearly always performed under a general anaesthetic. You sleep through the entire operation.

WHAT HAPPENS?

The most common procedure involves an anchor-shaped incision that circles the areola, extends downward in a vertical line, and then follows the natural curve of the crease beneath the breast. Your surgeon removes excess glandular tissue, fat, and skin, and moves the nipple and areola up into their new position. He then brings the skin from both sides of the breast down and around the areola, shaping the new contour of the breast. Liposuction may be used to remove excess fat from the armpit area or to further improve the shape the breast.

AFTER SURGERY

You will wake up wearing a surgical bra over gauze dressings. A small tube may be in placed in each breast to drain off blood and fluids for the first day or two. Naturally you are likely to feel some pain for the first couple of days, especially when you move around or cough, and may feel some discomfort for a week or more. Your surgeon will prescribe medication to lessen this pain. The bandages can be removed a day or two after surgery, but you will probably have to continue wearing a surgical bra around the clock for several weeks while the swelling and bruising subside. Almost all the stitches used will simply dissolve so very little removing of stitches is required. If your breast skin is left very dry, you can apply a moisturiser several times a day, but you must carefully avoid the stitched areas. Your first menstruation following surgery may cause your breasts to swell and hurt. Some pain may also be experienced at times during the first few months. Some loss of feeling in your nipples and breast skin is natural, caused by the post-surgical swelling but this usually fades over the next six weeks or so. In some patients, however, it may last a year or more, and rarely it may be permanent.

RECOVERY

You should be up and about in a day or two but your breasts may still ache occasionally for a couple of weeks. Avoid lifting or pushing anything heavy for three or four weeks. Our staff will give you detailed instructions about resuming your normal activities. After about two weeks most patients can return to work, provided it is not too strenuous, and enjoy social activities. Nevertheless, you will have much less stamina for several weeks, and should limit your exercises to stretching, bending, and gentle swimming. For this you will need a good athletic bra for support. You may be instructed to avoid sex for a week or more, since sexual arousal can cause your incisions to swell, and to avoid anything but gentle contact with your breasts for about six weeks. A small amount of fluid drainage from your surgical wounds, or some crusting, is normal. If you have any unusual symptoms, such as bleeding or severe pain, don't hesitate to call our office at once.

HAPPY?

Much of the swelling and bruising will disappear in the first few weeks, but it may be six months to a year before your breasts settle into their new shape. Even then, their shape may fluctuate in response to your hormonal shifts, weight changes and pregnancy. Your surgeon will make every effort to make your scars as inconspicuous as possible, but it is important to remember that breast reduction scars can be extensive and will be permanent. They often remain lumpy and red for months and then gradually become less obvious, sometimes eventually fading to thin white lines. Fortunately, the scars can be placed so that you can wear even low-cut tops. Breast reduction causes the most immediate and profound body-image changes. You will be freed from the physical discomfort of large breasts, your body will look better proportioned and clothes will fit you better. However, it will take you time to adjust to your new image. Your family and friends will also need time to adjust. Be patient with yourself and with them. Keep in mind why you had this surgery and, the chances are, that, like most women, you will be extremely pleased with the results.

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