Breast Reduction

What is it?

Large breasts can cause physical problems, such as backache, neck pain, grooves in the shoulders from bra straps and rashes under the breasts. If people make personal or insensitive comments about your breast size it can cause you to feel uncomfortable and self-conscious and have a detrimental impact on self-esteem.

Your choice of clothes can also be limited and, depending on your breast size, you may be restricted on taking part in certain active sports. If you feel that having large breasts is preventing you from living a full and active life or making certain lifestyle choices, then you may want to consider having breast reduction surgery.

What to expect

A breast reduction is a surgical procedure that is performed under general anaesthetic. It involves removing breast tissue, fat and skin, repositioning the nipple and areola (the darker skin disc around the nipple) and reshaping the breast to make it smaller.

Surgery leaves a think anchor-shaped scar on the breast. Reducing the size of one breast can also help to correct asymmetrical breast sizes.

What results can be achieved?

Following breast reduction surgery the most obvious change is the loss in weight that makes an instant change to your quality of life. The physical problems you have been experiencing should be alleviated and you can start to participate in a wider range of activities and wear a broader selection of clothes. Over time, the psychological impacts should also start to lessen which should positively affect your overall confidence and self-esteem.

Possible Risks

All surgery carries risks and cosmetic surgery is no exception. Fortunately, there are rarely any significant complications associated with breast reduction surgery, which is a commonly performed procedure.

After surgery

After surgery, dressings will be placed around your breasts, so the nipples are visible and can be looked at easily. This is so the blood supply to your healing breast can be checked regularly, during your initial post-op recovery. Drains (tubes that drain tissue fluid by connection to suction bottles) are placed in each breast during surgeryand remain for the time of your hospital stay. This is usually for 2-3 days after which the drains are removed on the ward, prior to you being discharged home.

Most women experience only mild discomfort following breast surgery that can easily be controlled with painkillers. Wearing a sports-bra for six weeks can offer extra support and help with your recovery. After a week, you will be invited into the clinic for a wound check and your surgeon will advise you about showering and getting the incision sites wet. You should refrain from physical exercise for six weeks after surgery. After three months, most of the swelling will have settled and this is a good time to be measured for a bra.

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Common risks

The risk of most types of cosmetic surgery is similar and these will be discussed with you during your consultation. You can help to minimize certain risks by following your surgeon’s advice and instructions after surgery. Some of the common risks include:

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  • Minimal discomfort – this can be treated with over the counter painkillers.
  • Minor swelling and bruising – your surgeon will advise you how long this will last based upon your individual procedure.
  • Scarring – Any scars will be hidden in normal clothing, concealed under a bra or bikini top, as much as possible. Scars fade over months to become paler and less obvious. However, they will always be present and visible out of clothes In most women, scars will be thin, but in some they can stretch or become red, sensitive and unsightly. Surgical revision of the scars may be needed, when bad scars fail simple treatments (silicone application / steroid injections).
  • Inexact cup size or shape – The final size and shape of your breasts after breast augmentation surgery is unpredictable, but your preference will be taken into consideration during the planning stages. Initial post-operative swelling will take time to settle – normally around three months – and it is only after this time that you will be able to get an accurate idea of the shape and size of your breasts. The breast is a glandular organ that changes throughout your life. Ageing, pregnancy and weight loss or gain can affect the final result.
  • Asymmetrical breasts – Nothing in our body is naturally symmetrical and this includes our breasts. Breast augmentation surgery is not an exact science as it relies on the artistic eye of the surgeon. As such, some level of asymmetry is inevitable after surgery.
  • Inability to breastfeed – Breastfeeding is no longer possible after breast reduction surgery as the nipples and underlying milk ducts are divided during the procedure. You can still get pregnant but if you are of childbearing age you may want to take the fact that you will be unable to breastfeed into account before embarking on surgery.
  • Loss of sensation – The nipples can lose sensitivity after surgery due to disruption of the nerve supply and it is quite possible that numbness will extend over part of the breast as well. This is usually permanent.
  • Breast changes – It is very unlikely that your breasts will regrow after breast reduction surgery but they will change if you gain or lose weight or become pregnant. As we age our breasts naturally droop and sag. These natural bodily changes are likely to impact on the shape and size of your breasts in the future.
  • Skin folds – When reducing large breasts occasionally folds of skin at the end of the scar, both between the breasts and at the sides, may develop. These can be corrected under local anaesthetic.
  • Dissolving skin stitches not holding properly – if this occurs the stitches may need to be removed under local anaesthetic.
  • Stitch granuloma – sometimes a tender lump or abscess can occur at the stitch site. This is generally more common where the skin is thinner, such as in front of or behind the ear. The stitch may need to be removed or it may be treated with antibiotics.
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More serious risks
The symptoms listed above are normally temporary or without serious consequences. There are some more serious risks associated with cosmetic surgery, which will be discussed with your surgeon as part of the initial consultation.

Plastic surgery alone cannot change your life but it can give you the confidence to make those changes for yourself.

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