PLASTIC, RECONSTRUCTIVE & COSMETIC SURGEON

Breast reduction

Breast reduction is a surgical operation to remove part of the breast tissue and reduce its size. There are a number of reasons why patients may want to reduce the size of their breasts. Patients with large or heavy breasts may complain of neck, shoulder and back pain or irritation of the skin in the breast crease. Difficulty with finding clothes that fit as well as with exercise is also common. Some patients understandably may also feel self conscious about their appearance. A smaller group of patients may have significantly different sized breasts and may benefit from a single sided breast reduction to achieve better shape and symmetry

What should I expect ?

Breast reduction surgery is performed under a general anaesthetic and usually takes 2-3 hours depending on whether one or both breasts are reduced and the size of the breasts. You will be admitted on the day of your surgery and you will usually need to stay in hospital for 1 or 2 nights. There are several techniques of breast reduction and the final scar and outcome will depend on which technique is used. This will be discussed at your consultation. Essentially, all techniques rely on maintaining the blood supply of the nipple through its attachment to the native breast, and reducing the skin and volume of the breast around it. The remaining tissue is reshaped to achieve the final shape and size. A drain is usually inserted to drain any excess blood or fluid that collects within the breast tissues and is removed prior to discharge. On the ward, you should wear a sports bra in your planned new cup size. This should be soft and supportive but not underwired. On discharge, you may shower as the dressings are shower resistant. In the first week, you should take things easy and avoid too much physical activity. Most patients recover fully after 2 weeks however strenuous exercise should be avoided for at least 6 weeks. It is usual to have some bruising and swelling which settles over 3-4 weeks. The breasts will be a little firm initially however this softens and becomes more natural over a period of 4-6 weeks with the final appearance being apparent at 6-12 months

breast reduction
What follow up will I have ?

You will be seen a week after your surgery to check that all is healing well and again at 3 months to ensure to all is well and you are happy with the result

What are the potential risks and complications ?

Breast reduction is a routine operation with the vast majority of patients being happy with the result however as with any operation, you should be aware of the potential risks and complications

Scarring : The shape of the scar varies depending on the technique that is used. There is usually a scar around the nipple which extends down the breast crease and along the crease itself giving an anchor shaped scar. Occasionally the scar along the crease can be omitted if the reduction is not large but this will be discussed at your consultation. The scar is usually red and raised initially but settles down to a flat white line over time. Occasionally, scars can remain lumpy and red

Bleeding : Although every effort is made to control bleeding within the breast tissues during the operation, blood can collect in the breast resulting in a haematoma/blood clot once you are back on the ward. This occurs in approximately 1% of patients. If this happens, you will need to return to theatre to have this evacuated

Wound breakdown : Wounds can breakdown particularly in the breast crease. This happens in approximately 3-4% of patients. These wounds usually heal fine with the help of dressings however it may take a few weeks

Infection : Wound infections occasionally occur and if it does, you will require a course of antibiotics

Altered nipple sensation : The nipple can be either become more or less sensitive following the operation

Breast feeding : Breast feeding can be affected following breast reduction with approximately half of women losing the ability to breast feed

Nipple loss : Nipple loss is very uncommon, occurring in less than 1% of patients. It occurs because the blood supply to the nipple is disrupted during the operation. Nipple loss can either be partial or complete. Partial nipple loss is when only part of the nipple loses its blood supply and therefore the remaining nipple survives. Complete nipple loss is rare. When this happens, the nipple turns black and eventually is replaced with scar tissue. The risk of this occurring is higher in smokers, obesity, old age, very large breasts, and in patients who are undergoing a second breast reduction.

Asymmetry : Small degrees of breast asymmetry is a normal finding. When planning for your surgery, asymmetry will be taken into account and adjusted for, however some asymmetry may remain following your operation

General operation risks : Deep vein thrombosis and pulmonary embolism, the formation of clots in the legs or lungs are rare but can occur with any operation. These are potentially life threatening and so you will be given compression stockings to wear on your legs and blood thinning injections to reduce the risk of this.

Further information can be downloaded here in this Breast Reduction guide

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