Breast reduction

SHORT SUMMARY

  • women may wish reduction for both functional and aesthetic reasons
  • it improves the size and the shape of the breasts
  • the procedure is performed under a general anesthetic and takes 1-2 hours
  • can be performed on outpatient basis (home the same day)
  • there are no stiches to be removed and shower can be taken after three days
  • the scar will be around the areola, and vertically from the areola to the crease under the breast
  • nipples are likely to be less sensitive for a couple of months
  • sporting activity can be gradually reassumed after three weeks
  • final results will be seen after a couple of months when breasts settle in new position and scars mature

WHAT IS BREAST REDUCTION?

Patients considering breast reduction usually experience physical and/or emotional problems caused by excessive weight of overly sized breasts. With reduction mammaplasty we remove the excessive fat, glandular tissue and skin to improve the size and the shape of the breasts. Nipples are lifted, and the areolas (the darker skin around the nipple) reduced when needed. A breast lift is always incorporated into a reduction to ensure that breast is not only smaller, but also better shaped.

There are several surgical methods to reshape the breasts, each with certain advantages and drawbacks. All of them will involve an incision around the areola, and a vertical incision from the areola to the inframmamary fold. Sometimes additional incision under the breast may be necessary. We always minimize the length of the incision as much as possible.

It is performed on women and should not be confused with correction of gynecomastia, the breast reduction procedure for men.



WHO IS A GOOD CANDIDATE FOR BREAST REDUCTION?

You may benefit form breast reduction if you have one or more of the following conditions:
• breasts that are too big for your body frame
• heavy and sagging breasts with stretched skin and nipples pointing downwards
• frequent skin rashes and irritation under the breasts
• chronic backaches, pain in the neck, grooves in the shoulders from bra straps
• breast asymmetry with one breast being much bigger than the other
• difficulty fitting in clothes and bras
• large breasts restrict you in physical activities
• social discomfort due to unwanted attention
• emotional and sexual problems caused by poor self-image


WHEN IS THE BEST TIME FOR BREAST REDUCTION?

Breast reduction can be performed at any age, but it is preferable to wait until your breasts have developed fully. There is a notable exception in cases with patients who suffer from juvenile breast hypertrophy, which is an excessive growth of breast puberty. This patient might opt for an operation in their later teenager years.

Pregnancy may change the shape and size of the breasts and affect the surgical result. It is hence preferable to plan the breast reduction when your family is complete. All the same, many women burdened with heavy breasts decide to undergo the reduction before pregnancies. Any later changes can be dealt with subsequently. In certain cases breast-feeding might be difficult or even impossible after the breast reduction.


HOW MUCH WILL MY BREASTS BE REDUCDED?

During consultation we will thoroughly discuss your wishes regarding the size of the breasts. You should express any other concerns about the breasts that you would like to see improved. This will help us understand your expectations about the desired breast size and plan the surgical procedure accordingly.

WHAT ARE THE RESULTS OF BREAST REDUCTION?

The breasts following reduction will be better suited to the proportions of your body and will have a nicer shape. The clothes will fit better and you will be able to engage in sport activities without being restricted with large breasts. Successful breast reduction can relieve physical problems and improve the self-image and confidence.

Breast reduction is one of the most gratifying operations in aesthetic surgery as the satisfaction rates are predominantly high among the patients. There are aesthetic and functional benefits even with the reduction of moderately over sized breasts.


ARE THE RESULTS PERMANENT?

The result is generally permanent. The breast size will stay the same unless the body weight changes significantly. Due to gravity and aging the breast will change in time as any normal breast would. This might involve a tendency to descent slowly.


WHAT YOU SHOULD DO BEFORE THE OPERATION?

It is important that you discuss any plans to lose weight with your plastic surgeon. You might be advised to stabilize your weight prior to having breast reduction. Loosing or gaining the weigh after the operation could alter the shape and size of the breast.

Smoking can seriously affect the healing of the breast wounds. You are advised to stop smoking well in advance of surgery.

Depending on your age and the history of breast diseases in your family it might be advisable to take a baseline mammography prior to breast reduction. You will be able to have further mammograms and proceed with breast self-examinations in the future. Breast surgery does not increase the risk to develop breast cancer and it does not impede or delay its detection, if it does occur.


WHAT IS RECOVERY AFTER BREAST LIFT SURGERY?

Breast reduction is usually carried out under a general anesthetic and will often require an overnight stay in the clinic. Bleeding is carefully stopped during the procedure and sometimes drain is inserted. Drain evacuates blood and is usually removed on the following morning. Painkillers are usually required in the first few days to alleviate moderate pain. Scars are taped using surgical tape during a two week period, and it is preferred that they are not exposed to the sun for at least 6 months. The patient can take a shower after a couple of days and a bath after two weeks. Any sporting activities should be avoided for at least three weeks, after which they are gradually reassumed. A well-fitting bra should be worn for a couple of weeks following surgery.

Although you will see the results immediately, it can take months before the swelling subsides completely, breasts settle in a new position and the scars fade. There can be some tenderness and lumpiness of the breasts for several weeks or even months following surgery.


POTENTIAL RISKS AND COMPLICATIONS?

Significant complications from breast reduction are very rare. It is a common procedure and majority of women who undergo this procedure experience no major problems and are very pleased with results. However it is important to consider both the benefits and the risks.

Like any other type of major surgery breast reduction runs the risk of postoperative bleeding (hematoma) and infection. Infection is treated with antibiotics. Sometimes skin can become slough and form a scab which leaves a broad scar. Smokers and obese women are at greater risk of poor wound healing.
Other specific risks are:

  • Significant asymmetry in size, shape and position of breasts or nipple
  • Loss of nipple and areola
  • Temporary or permanent loss of sensation it the nipples
  • Difficulties with breast-feeding

Usually the scars mature and end up as white lines that are hardly noticeable. They are designed to be hidden under normal clothing. However, sometimes scars tend to stretch, and they can stay thick, red and irritable for a long time, especially in people who have inborn tendency for ugly scaring. In the vast majority of cases, the scars are acceptable and a little tradeoff for the benefits of dealing with the problems of large breasts.


CAN BREASTS BE REDUCDED WITH LIPOSUCTION ONLY?

We often add liposuction to a breast reduction to further contour and reduce the outer part of the breast. The overall size of the breasts can be reduced by removing fatty tissue with liposuction, however, with this method excess skin cannot be removed, nor the nipples lifted. For this reason, liposuction is used more as an adjunctive procedure to breast reduction, rather than as the primary method of reducing the breasts.