Breast Reduction

Breast reduction, also known as reduction mammoplasty, is a surgical procedure to reduce breast size, by removing excess fat, glandular tissue, and skin to obtain a smaller breast size and to make your breast firmer. The size of the areola can also be reduced. Women with overly large breasts may experience health problems associated with the weight excess, such as back and neck pain, skin irritation beneath the breast crease or breathing difficulty. The aim of a reduction mammoplasty is to achieve a smaller breast size and shape in proportion with your body.

Breast reduction is rather performed to alleviate a physical problem than for strictly aesthetic reasons. Many women undergoing this surgery are concerned about the excess volume of their breasts, which may impair them to lead an active life and cause physical discomfort. In most cases, it is customary to wait until the breasts are fully developed, although it can be performed earlier when there are serious physical problems. This procedure is not recommended on women who are thinking of breastfeeding after a pregnancy.

In the first visit, the plastic surgeon will assess the size and shape of your breasts, the firmness of your skin and your general health state. A breast screening will also be performed and in some cases a static mammography will as well be required. You will be informed about the different surgical procedures, and your plastic surgeon will discuss with you the shape and size of your breasts after the surgery as well as the options or the combination of procedures that are appropriate for you. You must speak sincerely and frankly about your expectations, so that the surgeon can also be frank and discuss with you the available alternatives for your problem, informing you about the risks and limitations of each and every one of them. You will also be informed about the kind of anaesthetics that will be used, about the need or not of being admitted in the clinic where the surgery will be performed and about the cost of the procedure.

Breast reduction is covered by the National Health Service but only in extreme cases, a condition known as gigantomastia.

Remember to let your surgeon know if you are a smoker or take any medicine or vitamins, and to inform them about the number of previous pregnancies and if you are thinking of becoming pregnant or breastfeeding. Do not hesitate to ask any doubt you may have, especially those related to your expectations.

Breast reduction surgery is performed in an operating room, in a clinic or hospital. Admission is normally required, being discharged the following day in the case of a breast augmentation or a mastopexy, and after 2 or 3 days in the case of breast reduction. The surgery is performed under general anaesthetic, so the patient is asleep during the procedure.

Breast reduction procedures last between 2 and 4 hours, although in some cases it might last longer. There are several techniques, but generally the incisions used are anchor-shaped around the areola, with a vertical line going down from the areola and a horizontal line in the crease beneath the breast. Through these incisions, excess skin, fat and breast tissue is removed, and then the areola and nipple are repositioned; in some cases, liposuction is necessary. In most cases, the nipple and the areola, which remain tethered to its original blood and nerve supply, are then repositioned. The sensitivity remains the same or suffers little alteration. In some cases, like in big reductions, the areola may need to be removed and transplanted to a new position on the breast, being then desensitised. After the surgery, drainage tubes are applied and the breasts are wrapped in a bandage.

It is quite common to feel a little tired after undergoing breast surgery, but you can return to normal life after 24-48 hours. Most discomfort can be easily relieved with the medication prescribed by your plastic surgeon, although your breasts may hurt for a couple of weeks. The first menstruation after a breast reduction can produce swelling and pain in your breasts. The dressing or bandage will be removed in a few days, being replaced by a support bra that you must wear as indicated by your plastic surgeon. It is usual to feel burning in your nipples for the first couple of weeks.

After a breast reduction surgery, it is quite common to lose some sensitivity in the nipples. Generally, this is a temporary situation, except in some reductions in which it can be permanent. The stitches are removed after 7 to 14 days; the oedema does not disappear completely until 3 to 6 weeks after the procedure.

After a breast reduction you can go back to work in 2 or 3 weeks, although you can resume more or less your normal activities in a few days. You must limit strenuous physical activity for a few weeks, until you are recovered from the surgery. It is advisable to avoid sexual intercourse for 1 or 2 weeks to prevent the incision from swelling; you must avoid intense physical contact on your breasts for 3 to 4 weeks. It is usual to find some little scabs or a bit of liquid leaking from the incisions. During the months after the procedure, your plastic surgeon will schedule follow up visits to monitor your evolution. If you experience any discomfort between visits, or have any doubt about what you can or cannot do, do not hesitate to contact them.

Breast reduction surgery is a safe technique, as long as it is performed by a qualified plastic surgeon. There may be, however, risks and complication associated to it, as there are in any other kind of surgery.

Breast surgery leaves permanent, visible scars, although they can be easily concealed under the bra or the bikini. Scarring problems are more frequent among smokers. Some patients may feel their nipples are less sensitive and, in some occasions, completely desensitised. A breast reduction may impair your suitability for breastfeeding.

Bear in mind that the scars resulting from this surgery are important and permanent, although your plastic surgeon will do their best to make them the least conspicuous. With time, the scars will become less noticeable.

After a breast reduction, it will take some months for your breasts to achieve their final appearance; even so, your breasts will change in response to hormone stimuli, pregnancy or weight fluctuations. You might need some time to get used to the new appearance of your body. If your expectations are realistic, you will be very satisfied with the result of the breast reduction.

– Information obtained from www.secpre.org.