breast reduction
Breast reduction is a surgical procedure that transforms large or sagging breasts to a more comfortable size and shape. There are many reasons why women decide to have their breasts reduced. Some do it for appearance reasons, others because of problems like:
• back and neck pain
• strap marks and shoulder strain
• poor posture
• skin irritation and infections (intertrigo)
• shortness of breath
• difficulty participating in recreational activities
• difficulty fitting bras, swimming costumes and clothes
• social/sexual embarrassment / harassment
• depression
Breast reduction can lead to better posture, enhanced appearance and self-confidence and greater freedom to participate in sport and exercise.
Is breast reduction the right thing for me?
A consultation with one of our breast surgeons will help you decide whether breast reduction is right for you. You should talk about why you want the procedure and what you hope to achieve from it. It is important to have realistic expectations about the results and discuss these frankly with your surgeon. Every patient - and every surgeon, as well - has a different view of what is a desirable size and shape for breasts. The aim of surgery is to make your breasts proportionate in size but it is difficult to guarantee what cup size will result.
How is breast reduction performed?
Breast reduction is done in a hospital, as an inpatient procedure. The surgery itself usually takes only two hours.
The techniques for breast reduction vary, but the most common procedure involves an anchor-shaped incision (‘inverted T’) that circles the areola, extends downward and follows the natural curve of the crease beneath the breast. The surgeon removes excess glandular tissue, fat, and skin and frequently reduces the darker skin around the nipple in size. The nipple and areolar are moved into their new position and the skin is wraped 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. In most cases, the nipples remain attached to their blood vessels and nerves. However, if the breasts are extremely large or pendulous, the nipple and areola may have to be completely removed and grafted in a higher position. (This will result in a loss of sensation in the nipple and areolar tissue).
As a result of surgery there will be scars on the breasts but these are carefully placed so that they are relatively inconspicuous once faded and are hidden by a bra or swimwear. Liposuction can be used to remove some of the excess fat.
 
 
 
What happens after the surgery?
After surgery, your breasts will be wrapped in an elastic bandage or a surgical bra over gauze dressings. A small suction drain may be placed in each breast to drain off blood and fluids for the first day or two. The bandages will be removed a day or two after surgery, though you’ll continue wearing the surgical bra day and night for four weeks, until the swelling and bruising subside. Your internal stitches will dissolve and the skin incisions will be covered with steristrips (adhesive paper tapes).
There is a post operative consultation 5-7 days after surgery. At this time the dressing will be removed and the wound checked.
How long will I stay in hospital?
Recovery time vary between individuals, but the average length of stay in hospital is 24 hours.
How much time will I need to take off?
This will depend on your occupation.However most people can be back at work within a week. To allow proper healing you should avoid excessive exercise for the first 4 to 6 weeks. Your surgeon will help you decide when to return to work.
How do I get back to normal?
Although you will be up and about the day of surgery, your breasts may still ache occasionally for a couple of weeks. You should avoid lifting or pushing anything heavy for three or four weeks. Most women can return to work (if it’s not too strenuous) and social activities in about two weeks. But you’ll have less stamina for several weeks and should limit your exercises to stretching, bending and swimming until your energy level returns. You’ll also need a good sports bra or lycra crop top for support. Do not wear an underwear bra for at least 4 - 6 weeks.
Although much of the swelling and bruising will disappear in the first few weeks, 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.
What are the possible complications and outcomes?
Scars
The procedure does leave permanent scars, although your bra or bathing suit will cover them. (Poor healing and wider scars are more common in smokers).
Assymetry
The procedure can infrequently leave you with slightly mismatched breasts in shape and size or unevenly positioned nipples.
Breast feeding
Future breast-feeding may be possible and is encouraged.
Nipple problems
Some patients may experience a permanent loss of feeling in their nipples or breasts. Rarely, the nipple and areola may lose their blood supply and the tissue will die (necrose). The nipple and areola can usually be rebuilt, however, using skin grafts from elsewhere on the body.
Wound infection and bleeding
Rarely women develop a post operative complication such as a wound infection or haematoma (bleeding into the wound). In some instances this may necessitate a return to theatre. Generally you should expect comfort levels to improve each day .
It is important that you discuss these general and any specific risks that relate to you with your surgeon. If you feel that these have not adequately been discussed or are unclear in your understanding of these, please contact the clinic for further information.
How much does it cost?
The exact cost of your breast reduction will depend on the length and complexity of the procedure. Your surgeon will be able to give you an accurate cost following consultation and examination.
A free consultation is available with one of our St.Marks Breast care nurses.
The nurse will take you through your options.
Your health insurance company may pay part of the cost, depending on your policy. Check with your insurance company.
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