Breast reduction

Large breasts can cause a variety of problems for women of all ages. Many put up with this inconvenience for years before deciding to do something about it. Although losing weight through exercise and dieting may help it is often not enough. Following reduction surgery most patients are delighted with the results and are amazed at the difference that it makes to their lives. They often comment that they wish that they had got on with the surgery years ago.

Common complaints include:

• Neck and shoulder pain
• Bra strap marks and furrows
• Skin irritation and infection in the fold under the breast
• Problems with fitting into clothes particularly bras and swimming costumes
• Limiting activity in sport and social activities
• Social embarrassment

Breast reduction is frequently performed to deal with these symptoms rather than purely for cosmetic reasons. The aim of surgery is to make the breasts smaller and lighter.

At the initial consultation you will have a careful breast examination. Measurements and photographs may be taken. If you are over 30 years of age you will probably be advised to have a mammogram to ensure that there are no underlying breast problems prior to the surgery. You will need to discuss your preferred breast size. Many women considering reduction are aiming to have a B cup size.

You will require a general anaesthetic and the operation usually takes about 3-4 hours.

There are a number of different surgical procedures available depending on the size and shape of the breast, previous scars and any medical conditions that may affect healing. The most common operation involves an inferior pedicle procedure. The nipple is preserved on an island of breast tissue with its blood supply intact. Excess surrounding tissue is removed. The skin is brought together and the nipple is stitched into place. All sutures are placed under the skin and will dissolve in due course. A small suction drain is left to remove any blood or fluid and this will be taken out before you go home the next day.

You will spend one night in hospital. The incisions will heal in 10 - 14 days. You should avoid strenuous activity for 4-6 weeks to avoid discomfort and to allow the tissue to recover satisfactorily.

Possible Complications

Most patients make a quick recovery and significant problems related to the surgery are uncommon. You should be aware of the following information.

1. Bruising: You may have some bruising that will settle over a period of weeks.

2. Bleeding: There is a small chance of bleeding following surgery. The drains will deal with small amounts of blood. Very occasionally there may be more extensive bleeding from a larger vessel. This will require returning to theatre to deal with the problem effectively.

3. Infection: There is a small risk of infection that may require antibiotics.

4. Scarring: It is important to understand that there will be scarring. With the inferior pedicle technique this will consist of a line around the areola and extending down to the crease under the breast. The line will also run along the length of the crease under the breast. These scars will initially be quite red and lumpy. Over a period of months they will gradually fade and become less obvious.

5. Sensation: Some patients may notice decreased sensation or numbness in the skin over the breast or in the nipple. This often settles down but may be permanent. There will be some swelling of the breast tissue immediately after surgery and you may experience occasional stabbing pains and tingling during the recovery period.

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