BREAST REDUCTION

(REDUCTION MAMMAPLASTY)

What is a breast reduction?

A breast reduction is a surgical procedure to reduce the size of the breast.
The breasts are usually reshaped and lifted at the same time.
(Mastopexy or breast lift is a similar but smaller operation to lift and reshape rather than reduce the breast size.)
Different techniques

Is it right for me?

Breast reduction is individualised to your requirements.  Typically 500 –1000gms (1-2lbs) are removed from each breast.  However, if necessary, much more can be removed.
Breast reduction is frequently very helpful in relieving symptoms such as back ache, in cutting bra straps and rashes under the breasts.  Many women improve their posture following surgery.
Smaller reductions with an emphasis on lifting and reshaping are usually regarded as a mastopexy (breast lift).
A one sided reduction may help with breast asymmetry.
A breast reduction may be a useful procedure to remove a breast cancer. 

Medical considerations

Illnesses            Discuss at consultation
Obesity              Lose weight before breast reduction surgery if you are over weight
Medication       Discuss all medication at your consultation
                           Oral contraceptive pill  ‘the pill’ – doubles the risk of clots in the leg veins. 
                           Discuss discontinuing it 4-6 weeks prior to the operation with your surgeon.
                           Avoid aspirin and non steroidal anti-inflammatory drugs e.g. ibuprofen for 10 days                            before surgery
Smoking           Stop smoking 4-6 weeks before surgery to reduce complications

The operation

Anaesthetic      General Anaesthetic
Duration           3 to 4 hours varies with type of operation and size of breasts
Incision / scar  Depends on the technique used
       1) Standard reduction scar is anchor shaped (The 'Wise' pattern)
       2) Vertical scar reduction (Lejour type) - circle around nipple and strait line from the nipple
       3) Circumareolar technique – scar just round nipple – not usually used for reductions

Your recovery?

Hospital stay    2 nights following surgery
Stitches             under the skin and absorbable (‘dissolving’).  Do not require removal
Drains               Usually removed next day.  ( Drains are not always required).
Dressings          Sticky tape over wounds
Driving              Usually start 10 –14 days following surgery
Return to work  10 –14 days light work   i.e. office type
Gym                    After 4 weeks gentle lower body / 6-8 weeks return to normal activity
Swimming        When fully healed.  Typically 4-6 weeks after surgery.

What are the risks?

All operations carry risks. Most people are pleased with the results of their surgery and do not suffer significant complications.  Serious, including life threatening complications are very rare.  Complications can result in the need for further surgery.
General complications are those that may occur with any operation and include:
Complications of the anaesthetic.
Complications of the surgery including bleeding, infection, wound breakdown, slow healing, poor scarring (red, thick, lumpy or stretched scars. Keloid scars).
Reduced mobility following surgery increases the risk of clots in the legs (deep vein thrombosis).  Clots can move the lungs (pulmonary embolus) where a large clot can be fatal).
Special considerations for breast reduction surgery:
See section below

Special considerations for Breast Reductions Surgery

Breast Feeding        Usually not possible after breast reduction surgery
Nipple sensation     Usually feeling in the nipple is lost. 
                                   It may return with time but you should not assume that it will
Nipple loss                The nipple is moved during the operation (usually not taken completely off).                                     There is a small risk to the nipple.  This can result in scarring or loss of colour.                                      Very rarely the nipple may die
Breast shape             The breasts will be smaller and higher following surgery. 
                                    Your breasts will not normally enlarge again unless you put on weight.
Asymmetry               There may be differences in size and shape of the breasts following surgery.                                     (This is common for women who have not had surgery!)
Fat necrosis               Hard lumps of fat in the breast sometimes for following surgery. 
                                    These may cause anxiety but are not serious. 
                                    Sometimes removal is recommended
Bottoming out          Over time the breast may droop this may result in the nipples appearing too                                    high

Complications are more likely if you are overweight.  It is desirable to achieve your ideal weight prior to surgery so as to minimise risks.  
Smoking increases the risk of complications and stopping smoking for 4-6 weeks before surgery will help to minimise the risk.

My new look and expectations

Your breast will be smaller.  They will be higher on your chest and have an improved shape.  Breast reduction is frequently helpful with reducing back pain, improving posture and reducing self consciousness, although these benefits can not be guaranteed.  Most people are very pleased with the results of breast reduction surgery.