BREAST REDUCTION
Technically known as reduction mammaplasty, is surgery to reduce the weight, mass and size of the breasts. The surgical procedure involves the removal of fat, breast tissue and skin from the breasts and remodelling the shape of the breasts, making them smaller, lighter, and firmer. The goal is to give you smaller breasts which are attractively shaped and are in proportion with the rest of your body.
Patients who seek breast reduction may have a predisposition for large, disproportionate breasts, a sensitivity to oestrogen during development or pregnancy, may be overweight or may have a significant asymmetry between the 2 breasts.
Although some patients choose breast reduction for cosmetic reasons, many who undergo breast reduction surgery are seeking relief from the many physical symptoms and medical complaints caused by the excessive weight of large breasts. For many the breasts are painful and cause pain in the neck, back and shoulders. In older patients the added weight may make breathing more difficult. Large breasts make it difficult to find clothes that fit and cause painful marks on the shoulders from the bra straps. The fold beneath the breast may become irritated, excoriated, inflamed and uncomfortable.
Many women, especially younger ones, are very sensitive to jokes or remarks about the size of their breasts. Large breasts make it difficult to play sports and can be socially embarrassing.
Breast reduction can usually solve these problems as well as improve the size and shape of the breasts. Following breast reduction, the breasts are more proportional to the rest of the body, activity is not limited, and clothing fits better. Most achieve an improvement in self-confidence and lifestyle.
The best candidates for breast reduction surgery are those who are in good general health, fully understand the procedure including the risks & limitations, and have realistic expectations about the results. It is most important to understand that there will be permanent scars and the nipple sensation may be reduced. Younger women who are planning to breast feed must accept the possibility that they may not be able to breast feed. In most cases, breast reduction is not performed until the breasts are fully developed, however there are exceptions to this depending on the degree of physical and/or psychological discomfort experienced.
We will assess your condition and general health, and plan the treatment that is best suited to you.
The Surgery
Breast reduction is performed under general anaesthetic and takes 3.5-4.5 hours, depending on your size. You will need to stay in the hospital for at least 1 night after the operation. Occasionally you may need to stay another 1 – 2 nights.
There are several techniques. The most common method of reducing the breast involves three incisions: one incision is made within the areola (the pink area around the nipple), the 2nd incision runs vertically from the bottom edge of the areola to the crease underneath the breast, and the 3rd incision follows the natural curve of the breast crease.
The excess breast tissue, fat and skin are excised through the incisions described. The nipple and areola remain attached to the underlying tissue but are shifted to a higher position. The size of the areola is reduced at the same time. Usually, the nipples and areolae remain attached to underlying mounds of tissue, and this allows for the preservation of sensation. The ability to breast-feed may also be preserved by this method, although this cannot be guaranteed.
A small tube is placed in each breast to drain off blood and fluids for the first day or two. The skin and breast tissue are sutured (stitched) in layers. The deeper layers along with the skin and nipple region are sutured with dissolvable surgical thread where possible, but there may be a few non-dissolvable sutures on the outside which will be removed after approximately 10-14 days.
As a routine, all breast tissue removed is sent to Pathology for analysis.
After Your Surgery
Immediately after surgery dressings and soft padding are placed over the incisions, and the breasts are wrapped in firm bandages.
Drain tubes are usually removed a 2-3 days after surgery.
Lighter waterproof dressings are applied at 5-7 days and you may then shower. Before this you may have a bath but try not to get the dressings wet.
Swelling and bruising may last for several weeks. Wearing a surgical bra 24 hours a day can help reduce swelling and support the breasts while they heal.
You will be in moderate discomfort for the first couple of days, especially when you move around or cough. You will be given adequate intramuscular analgesia whilst in hospital. The discomfort will gradually ease over the next 1 – 2 weeks. You will be given strong oral pain killers to take when you go home, and it is recommended that you take these regularly over the first few days. You will be given 2 courses of antibiotics.
At first it will be necessary to restrict your arm movements and you will be more comfortable if you sleep on your back or slightly on your side.
Gentle light activity, particularly walking, is encouraged as soon possible, and you may commence light exercise after 2 weeks.
You must avoid straining, lifting and bending particularly for the first 2 weeks.
Recovery time varies with each individual.
Depending on your job you may return to work after 2 weeks. If your work involves heavy lifting or strenuous exercise you may need 4-6 weeks off.
Avoid vigorous exercise and activities for 3 to 4 weeks or more, and no contact sports for 8 weeks.
You should wear your surgical bra day and night for 6 weeks. After that time it’s important to wear a bra during the day that supports your breasts well, such as a sports or athletic bra. It takes 9-12 months for the wounds to completely strengthen, so the more support your breasts are given during this time, the better the outcome will be.
You will have visible scars on your breasts after breast reduction surgery, although these are almost always in areas that can be covered by a bra or swimsuit. Scars usually fade over time, but they will not disappear.
Your first menstruation following surgery may cause your breasts to swell and hurt. You may also experience random, shooting pains for a few months. You can expect some loss of feeling in your nipples and breast skin, caused by the swelling after surgery. This usually fades over the next six weeks or so. In some patients, however, it may last up to a year or more, and occasionally it may be permanent.
You will notice that the shape of the breasts will change slightly over time. It is only when the scars have completely matured that the breasts will assume their final shape and position. This usually takes at least a year.
It may also take a little time to adjust to your new look.
If you are considering Breast Reduction Surgery we can certainly guide and advise you. We want your new shape to be as attractive and appropriate for you as possible. All surgical procedures have limitations. Therefore, if for any reason we feel that we are unable to fulfill your expectations we will tell you immediately. We look forward to meeting with you to discuss this procedure. Following consultation we encourage you to take as much time as you need to reach your decision, and either contact us or come and see us for further discussions if desired.
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