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Breast reduction, technically known as reduction mammoplasty,
is designed for removing fat, glandular tissue, and skin from
the breasts, making them smaller, lighter, and firmer.
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Women with very large, pendulous breasts may experience a variety of medical problems caused by the excessive weight-from back and neck pain and skin irritation to skeletal deformities and breathing problems. Bra straps may leave indentations in their shoulders. And unusually large breasts can make a woman-or a teenage girl-feel extremely self-conscious.
Breast reduction, technically known as reduction mammoplasty, is designed for such women. The procedure removes fat, glandular tissue, and skin from the breasts, making 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, better-shaped breasts in proportion with the rest of her body.
If you're considering breast reduction, this will give you a basic understanding of the procedure- when it can help, how it's performed, and what results you can expect. It can't answer all of your questions, since a lot depends on your individual circumstances. Please be sure to ask your doctor if there is anything about the procedure you don't understand.
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Your surgeon will have discussed your general medical history, together with details of any previous breast surgery. After examination he will have shown you what may be expected post-operatively by defining the area of breast tissue to be removed and the new position of the nipple. Most ladies wish to be made “as small as possible”, but occasionally, a large breasted lady will prefer to be still larger than average after breast reduction surgery.
It is normal for breasts to be asymmetric and although the surgeon will strive to make the breasts symmetrical, it is not possible to achieve this exactly. You should discuss this fully with the surgeon in order that you have a proper understanding of breast reduction surgical procedure.
After Breast Reduction surgery, breast-feeding is unpredictable. If this is of concern to you, perhaps it may be wise to delay the operation until a more appropriate time.
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Breast Reduction is carried out under general anaesthesia and requires one or two nights' stay in hospital. The procedure takes approximately two hours.
Having marked out the incision sites pre-operatively, the surgeon will remove the excess skin from the breasts having left the nipple on a stalk. The nipple is then repositioned in a lifted position. The suture line will be anchor shaped extending around the nipple in its' new position, then vertically downwards to the under-breast crease and extending in that crease from a point near the mid-line around towards the underarms.
In some cases it may be possible to leave a single vertical scar but this depends on the amount of tissue to be removed. D issolvable sutures will be used which will not require removal. Dressings will be applied and an intravenous drip is required for several hours after the operation.
Drainage tubes are inserted at the end of the operation to remove any ooze of fluid or blood post-operatively. These will be removed (a relatively painless procedure) once the fluid has stopped, usually on the first post-operative day. New dressings may then be applied and the patient will then be allowed to go home.
As blood clotting is sometimes a problem with this procedure, you may be asked to wear anti-embolism stockings (TEDs) on your legs as a precautionary measure. These should not be removed until advised. You will also be expected to get out of bed and move around as soon as possible after surgery.
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Following surgery your breasts will probably be uncomfortable, possibly painful, however, this is easily relieved, initially by an injection and thereafter by taking two mild pain-killing tablets (such as Paracetamol) as required. Aspirin must be avoided. You should be aware that bruising of the skin of your new breasts may occur and swelling of the breast tissue may cause them to appear larger than anticipated. However, this will probably improve markedly in two to three weeks and settle in two to three months. To help rapidly decrease swelling and bruising, we recommend the taking of Arnica one week prior to surgery and two weeks afterwards.
Meticulous care is taken at the operation to stop any bleeding points. Occasionally, a blood vessel leaks after the operation is over and if a significant collection (haematoma) occurs, it may necessitate a return to theatre. If a haematoma is minor, then natural re-absorption will occur.
As in any surgery, there is a possibility of infection but this is readily treated with antibiotics and/or dressings as required. In some patients there is some minor loss of wound adhesion, but this is a temporary complication resulting in a small scab, which separates after a few weeks. Delayed wound healing is more likely if you smoke tobacco or drink excess alcohol after surgery.
Immediately after surgery your new breast size will be apparent, but you must understand, the final shape may take around six months to emerge. The dressings should be kept clean and dry for one to two weeks following surgery in order to allow sound healing to occur. A comfortably fitting bra is also necessary for the first six weeks.
Numbness of the nipples and the surrounding skin is common after Breast Reduction although many patients experience the return of sensation immediately, albeit not completely normal at first. The nipples are preserved on a stalk of breast tissue and in the vast majority of patients they remain natural with normal contraction and some sensitivity. Exceptionally, the stalk of the breast tissue has inadequate blood vessels to maintain nipple viability and part or even the entire nipple may die. This complication means that prolonged dressings may be required over the nipple area until natural healing occurs. It is then possible to reconstruct the nipple as a secondary procedure should this be required.
The scars can initially be hard, red, raised and lumpy and can take up to eighteen months to become pale and flat depending on the healing qualities of the individual. Firm pressure on these scars with a well fitting bra will help if this is a problem.
Expect to feel tired for up to two weeks following surgery. You may drive after the first week but do not return to vigorous exercise for at least six weeks and, as dressings may have to be prolonged if healing is delayed, it is advisable not to make any travel plans for a month or so.
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Scarring is a consideration with breast reduction. As explained, they will eventually return to normal skin colour, but you should not assume that they can ever be described as hairline. Bearing this in mind, the results following Breast Reduction are usually excellent.
It is probably one of the most successful and immediately satisfying of aesthetic plastic surgery procedures, allowing the patient to enjoy a more active life with increased self-esteem and confidence.
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You will need to sleep on your back for 2 weeks. Avoid any activity that puts stress on the
wounds, this includes raising your arms above your head, lifting and twisting etc. Try using
pillows or cushions to prop yourself up. You should avoid driving for at least 3 days.
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| To help decrease the amount of bruising and swelling, we suggest that you take Arnica for
one week prior to surgery and two weeks afterwards.
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The sutures are dissolving, but not waterproof until the 10th day after surgery. You will have
a dressing on the breasts, which will stay in place for 5 days and will be removed at your first
follow up appointment. Please keep the area dry
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Avoid strenuous exercise or anything that is likely to increase your blood pressure,
particularly within the first 10 days, otherwise these can be resumed in 4 –6 weeks.
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Please avoid taking aspirin/anti inflammatories as these can cause bleeding. You may
recommence your usual medication as soon as you can eat or drink unless otherwise advised.
We suggest that you take regular pain relief following surgery, but please be aware that
painkillers can cause constipation.
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You may notice changes in nipple and breast sensation; this is normal. It is fairly common for
the skin above the incision to feel slightly numb for some months, and this rarely extends to
the nipple. Some patients describe increased sensation, which can last for two or three
months.
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Scars will improve within a few months of surgery; they are noticeable initially, but will
assume normal skin colour in time dependent upon the healing characteristics of the
individual. Once your dressings have been removed at the follow up appointment, you will
be advised on how to best care for the area. This may involve placing tape over the incision
site for a few days.
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During office hours you are welcome to telephone or visit Mr Ion’s nurse at the consulting rooms.
Please call her prior to your visit on 0207 486 77 57.
In an emergency or in case of doubt regarding your surgery and post operative condition, out of office
hours, please contact Mr Ion’s nurse on 0774 96 44 519 or the hospital where you had your surgery:
The Wellington: 0207 586 5959
The Cromwell Hospital Resident Medical Officer: 0207 460 2000
St Luke’s Hospital: 0207 388 4954
The Hospital of St John & St Elizabeth 0207 806 4000
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NEXT: More Information
If you would like to know more information on Breast Reduction,
please do not hesitate to get in touch.
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The Complete Article
About the Procedure
Informative Brochure
