Women may choose to undergo breast reduction surgery to address:
- Large, heavy breasts that contribute to upper back, shoulder and neck pain.
- Ongoing skin infections in the fold under the breast that doesn’t respond to conservative methods.
- Dents in the shoulders caused by heavy breasts pulling on bra straps.
- When patients feel their breasts don’t fit their body shape, or they feel self-conscious or embarrassed about having large breasts.
- Asymmetric breasts, where one is naturally larger than the other.
What can I expect?
A breast reduction can reduce the breast volume and weight, and elevate the position of the breast and tighten the breast skin, creating a more projected and perky shape. The nipple is raised up on the chest, whilst some of the the underlying glandular tissue and skin is reduced and shaped.
There are many different techniques available when performing a breast reduction, all comprising excision of excess breast tissue from areas of the breast where we don’t need it, whilst leaving breast bulk in areas where we want to keep it. The breast tissue that remains carries nerves and blood supply to the breast and nipple, whilst providing a great shape in proportion to the rest of your body. Whilst this is always part of a personalised surgical plan, Richard most often uses a ‘supero-medial pedicle’. Removal of excess skin places surgical incisions on the lower half of the breast and around the areola. Depending on the initial size and shape of your breast, your aims for final breast size and acceptance of fine line surgical scars, Richard may offer a vertical incision (or ‘lollipop’ design), a J-shaped incision or Wise pattern (or ‘anchor’ design) to provide the best outcome.
Despite this highly effective technique, the breast shape and size will still continue to be affected by changes in body weight, skin stretch, ageing, pregnancy and of course, gravity. As such, it’s really important to approach a breast reduction with a stable body weight. If you go on to gain weight following breast reduction, your breasts may also increase in size.
What happens before surgery?
As part of your consultations, you will be able to describe your desired breast shape and size, and together with Richard, you can make some decisions about how best to achieve this. Richard will make some routine measurements to help plan your surgery and take pre-operative photographs. As with all surgeries, Richard will need to know about your body weight, height, other medical issues and smoking status. Depending on your age and family history, Richard may request that you have a pre-operative screening mammogram.
On the day of surgery, you’ll arrive in the hospital, paperwork checked and taken up to theatre. You’ll have a chance to speak with your Anaesthetist and Richard prior to surgery, and Richard will make some surgical markings on your breasts to help guide during surgery.
What happens during surgery?
In theatre, your Anaesthetist will place you safely under general anaesthetic, monitoring your health throughout the procedure. Richard will meticulously undertake your surgery and ensure the final shape. As is routine, the removed breast tissue will be weighed and sent for examination by a Pathologist to rule out the presence of any undetected breast tumours. Richard doesn’t routinely use surgical drains. A surgical bra will be placed over your light dressings whilst you’re still asleep, then you will be taken out to the recovery room where you will wake up.
What happens after surgery?
Most patients go home the same day or the day after surgery, and you should plan to have an adult around to help for the first few days or so you can concentrate on your recovery. You should expect a moderate degree of discomfort, which settles over the first week or two. This is most often controlled by regular oral analgesia as guided by your Anaesthetist. It’s really important to keep your surgical bra on full time for the first month, and no upper body weights or heavy lifting for a month and 6 weeks before jogging. You’ll be seen in our rooms at one week to ensure you’re doing well and at around six weeks with Richard. As always, please don’t hesitate to contact us if you have any concerns. Over the coming 6-12 months, your shape will settle and scars start to mature.
Possible complications:
The decision to undergo breast reduction surgery should only be made after considering if the potential benefits can achieve your aims, and whether the risks are acceptable to you. The possible risks/ complications of breast reduction include (but are not limited to):
- Cardiac problems, including heart attack or arrythmias.
- Venous thromboembolism (including deep vein thrombosis and pulmonary embolism, which may be fatal).
- Surgical site infection.
- Haematoma requiring return to theatre.
- Wound breakdown, delayed healing or protruding sutures.
- Nipple/ areolar necrosis (partial/ total).
- Conspicuous scars, including hypertrophic, stretched or migrated scars.
- Altered sensation to the breast, nipple or areola. This may be increased (hypersensitivity) or reduced sensation. This may be permanent or temporary.
- Loss of the ability to successfully breast feed.
- Possible need for revisional surgery. Richard will only consider revising your breast reduction if he believes:
- there is a definable structural issue with the breast position, shape or size,
- this issue is realistically able to be improved with surgery and
- the risk of revisional surgery causing a worse result are minimal.
- Dissatisfaction with the degree of breast reduction.
- Breast asymmetry or non-round areolae.
- Apparent lateral chest or axillary fatty tissue not part of the breast tissue.
- Resorption or failure of fat grafting (if undertaken).