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Guide To Cosmetic Surgery - Breast Reduction

Breast reduction surgery

There are women who are unhappy or distressed with the size of their breasts. Overly large breasts can cause physical and mental problems and can lead to feelings of low self-esteem and depression.

Oversized breasts can also attract undesirable attention or inappropriate comments which can be distressing.

They may be seen as attractive but large, heavy breasts can cause backache, neck and shoulder pain and sores caused by the digging in of bra straps over the shoulders. Other problems include excessive sweating and skin complaints such as rashes.

On a psychological level they can prevent the patient from taking part in sport or other physical activities. There is also the day to day issue of trying to find clothes which fit and don’t attract unwelcome attention.

If you are finding that your posture is affected, or that you are prevented from taking part in sport or other physical activities then breast reduction is an option.

Breast reduction is not just for women: men can benefit from breast reduction surgery too. They can suffer from a condition called gynaecomastia in which they develop breasts as a result of an abnormal increase in glandular tissue. This is covered in more detail in the Male Breast Reduction section. 

Suitability for breast reduction surgery

If you are suffering physical and mental stress caused by large breasts then consider breast reduction surgery. It is important to note that this procedure is successful but it does have its limitations.

Your age, health and motivations are the determining factors for surgery. Your medical history will be discussed in detail; if you have any underlying medical conditions, have an allergy or have undergone surgery in the past then tell the surgeon.

This cannot be stressed enough.  The surgeon wants to be sure that you are in the best shape possible for surgery as there is a risk of complications. Failure to mention anything could affect your recovery and the outcome of your surgery.

Breast reduction is not advisable for women who have breast cancer, uncontrollable diabetes and cellulites (infection of the soft breast tissue). Hardened, dry or broken breast skin are other possible exclusions.

It is not recommended for women who are planning on having children and are looking to breastfeed. If you have or are thinking of starting a family then delay this procedure until you have done so.

If you are in good health, emotionally stable and are realistic about what it can achieve then breast reduction surgery is a good option.

Pre-surgery preparation

You will be given a set of instructions on what to do before surgery. These are, in effect, a list of do’s and don’ts and are there to ensure your safety and fitness for this procedure. These will include advice on what to eat and drink – have your last meal at least 6 hours before surgery and what medications you can take.

In regard to these, the surgeon will advise you about both prescription and over the counter medicines. If you are taking any homeopathic remedies such as garlic, ginseng or evening primrose oil then check with the surgeon about taking these. There are some medications which can affect the body’s ability to heal or can cause other post-operative conditions.

This also applies to vitamin and mineral supplements.

If you are a smoker then have your last cigarette two weeks before your procedure. Do not start smoking again until two weeks after surgery. You will find that the surgeon would prefer it if you did not smoke at all but understands that it can be difficult to give up. If you are looking to stop smoking then he or she will advise you about smoking cessation programmes.

A surgeon will not perform surgery on a patient who is still smoking around the time of their surgery.

Smoking affects the body’s ability to heal and will increase the recovery time.

Try to avoid arranging your surgery at the time of your period.

Other advice will include what to bring with you to the hospital, what will happen on the day of your procedure and afterwards.

The recovery process is an important part of this treatment which means plenty of rest and no strenuous activities. For 24 to 72 hours you will be very tired and your breasts will feel bruised and swollen. You do not want to arrive home afterwards and have to start cooking or any other household activity.

What can help is making a list of all the things you need to do before and after surgery. This will include preparing meals in advance, ensuring that you are up to date on the usual household jobs and asking your other half or a friend to drive you to the hospital on the day of your surgery. Ensure that you have a lift home on the day of your discharge.

It is vital that you have a ready supply of painkillers and any medications that you might need. Ensure that you stock up on these before. The last thing you want is to run out of painkillers and not be well enough to obtain any more.

The breast reduction procedure

There are different techniques available which will depend on your preferences and body structure. These will be discussed beforehand with the surgeon.

The most common procedure involves the surgeon making a series of 3 incisions which form an ‘anchor shape’. The first one encloses the areola (circular area around the nipple), the second runs in a vertical direction from the bottom edge of the areola to the breast crease and the third is made in a horizontal direction, in the crease underneath the breast.

The surgeon then removes excess fat, breast tissue and skin. He or she will then shift the nipple and areola up into a new position. Skin is then brought down and around the areola which helps to shape the new breast.

Liposuction may be used if there are excessive amounts of fat. It can also help to improve the shape of the breast.

These incisions are closed with stitches and small drainage tubes may be inserted to remove excess blood and fluid. These will be removed after a day or so.

Dressings are applied. You may find that you are wearing a special surgical bra (which fastens up at the front) which you will have to wear 24 hours a day for several weeks after surgery.

Dissolvable stitches are used which means no removal afterwards. If any clips have been used then these will be removed in the first aftercare visit.

Recovery

Every patient is different when it comes to post-operative recovery. In general, the recovery time is 2 to 3 weeks although a complete recovery can take around 6 weeks.

You are looking at 2 weeks away from work.

There will be some pain and discomfort although you will have been prescribed medication to deal with this. Expect your breasts to feel sore, swollen and bruised although this will subside after 2 to 3 weeks. You may notice that your breasts feel tender at the time of your first period following surgery but this will ease and is not likely to happen during subsequent periods.

Any bandages and drainage tubes will have been removed a day after surgery (in hospital). You will notice that you are wearing a surgical bra which will have been fitted at the end of your operation. This is meant to support and aid with healing and has to be worn for 24 hours a day for the next 2 weeks.

The scars will settle down and fade in time although this can be months or even years.

When showering or bathing take care not to submerge your surgical wounds underwater as this can increase the risk of an infection. Keep the areas clean but do not apply lotion or any other moisturising cream over the scars.

Avoid any strenuous activities during your recovery. If you go to the gym or engage in a sport it is a good idea to abstain from it and do some gentle walking or swimming instead.

What about sexual intercourse? Abstain from sex for a week following surgery as sexual arousal can cause the breasts, and surgical wounds to swell.

If you notice any untoward symptoms such as a rapid or irregular heart rate or sudden, sharp pain then contact the hospital immediately.

Benefits of breast reduction surgery

The obvious benefit is that of smaller and shapelier breasts.  These will be lighter and more in balance with the rest of your body.

This surgery will also resolve any health problems caused by large breasts such as backache, rashes and poor posture. You will feel more confident and happier with yourself in general. It can take away any feelings of low self-esteem and depression.

Many women have found that since this surgery they are able to take part in sports and other activities for the first time. This means participation without any discomfort or unpleasant comments.

Risks of breast reduction surgery

Breast reduction surgery is very safe and the vast majority of patients do not report any side effects or complications. Having said that, all surgery has risks and these do need to be taken into account.

These need to be weighed up against the benefits when deciding whether to have surgery or not.

There are side effects which are common to all forms of surgery. These include an adverse reaction to general anaesthesia, poor wound healing, scarring, risk of infection and clot formation.

Plus there are procedure specific complications. With breast reduction there is the risk of a loss of nipple sensation which can be permanent. This becomes even more of a problem if the patient is planning on breastfeeding.

In a few rare cases ‘nipple necrosis’ can occur. This is the condition in which the areola or the nipple itself dies.

Breast asymmetry can also occur. This is where one breast differs from the other in terms of size or shape. It may be very slight but if it is more noticeable or the patient is unhappy with this then further surgery may be needed.