Breast Reduction

One or more of the following feelings or conditions may indicate that you are a good candidate for a Breast Reduction:

• You are physically healthy and at a stable weight

• You have realistic expectations

• You are a non-smoker

• You are bothered by the appearance of your large breasts

• The size of your breasts are causing you to endure health problems such as include back, neck and shoulder pain, and skin irritation beneath the breast crease

• The weight of excess breast tissue is restricting your ability to lead an active life

• For men, you have excess skin and breast tissue

The anchor shaped reduction is the most common way of performing this surgery. This goes around the areola and proceeds downward along the natural curve of the area beneath the breasts. Removal of the excess glands, fat and skin tissues take place next. The nipples and areolas are then moved into their new positions. Shaping and replacement of the skin takes place next, but usually only after excess fat tissue is removed from the armpits if necessary. It’s very rare to have a situation where the nipples are not reattached to the nerves and blood vessels, which would cause a loss of sensation if left unattached. Stitches are almost always used in every situation, be sure to ask your doctor if you’ll be able to do the surgery without stitches, this will reduce the scaring. Once the procedure is complete you’ll be wrapped in a surgical bra over the dressings. In most cases a small drain tube is used to help carry away blood and fluids for the first day. There can be some pain involved during the healing process especially when you move around. This is completely normal and will subside quickly as you heal, the more you pay attention to the diet and health advice the sooner the healing will be complete and the pain will subside earlier. Your surgeon will also prescribe a pain relief medication in most cases.

For standard cases, the surgery will go as follows:

ANESTHESIA The patient will be placed under general anesthesia in order to be completely asleep during the procedure. The breast reduction is typically considered an outpatient procedure; however, some patients may require an overnight stay.

INCISION The surgeon will make an incision using one of three techniques – an anchor incision (traditional incision that is made around areola, vertical down the breast, and then horizontally along the crease); a vertical incision (around the areola and vertical down the breast for less scarring); or a scarless incision (tiny incisions are made at the crease of the breast or at the armpit and liposuction is administered to remove fat).

BREAST REDUCTION Fat, tissue, and any excess skin are removed from the lower portion of the breast. Women with mostly fat tissue in the breasts could just require liposuction to reduce the breast size, which results in less scarring, less breast tissue trauma, and less chance of health complications occurring.

NIPPLE PLACEMENT The nipple will be repositioned higher up on the breast. The surgeon may or may not need to remove the nipple from the breast and then graft it in the correct place. Usually women with very large breasts require the nipple to be removed to be repositioned. The surgeon will inform the patient whether or not nipple sensation will be lost as a result.

CLOSE INCISIONS The surgeon will close the incisions using sutures. Various techniques may be used for sealing the incisions that your surgeon will discuss with you prior to the surgery.

Bandages will only take about two days before being removed but the surgical bra will have to remain for the 8-12 weeks. This will help maintain the shape of the breasts and protect them until the swelling and the bruising are reduced to normal. Stitches stay in for at least one week and sometimes can remain for two or more weeks. Almost all cases involve dry skin after surgery. Your first menstruation after the procedure may cause your breasts to swell. This has been known to cause shooting pains that will come and go for the next couple of months. It’s not as painful as it sounds but you will notice it. There will also be some loss of feeling in your nipples and skin caused by this swelling but usually fades no more than six weeks or so afterwards.

At the time of your breast reduction surgery, your surgeon may place drains in your breasts in order to prevent a build-up of fluid in the breast area and to promote faster healing. Fluid that collects at the end of the drains will need to be emptied about once a day. Your surgeon will give you specific instructions regarding your drains. If the drain fills immediately after it is emptied or you need to empty it more than three times per day, you should contact your doctor.

After breast reduction surgery, your doctor will wrap your chest area in sterile dressings. The dressings will need to be changed one to two days after surgery and will eventually be replaced by a surgical bra, which will need to be worn for several weeks during your breast reduction recovery. You will be required to wear the surgical bra at all times, except when bathing.

Our surgeons require you to wear a compression garment once your drains have been removed. You MUST wear this compression garment for a minimum of 8-12 weeks – it is a good idea to purchase two or three garments so you can wash and wear. This will help in healing and controlling the swelling. Then move into a strong suportive bra for the next 6 months during the healing phase. Please do not go braless during the healing phase to ensure the best support.

We encourage you to walk around after you leave the hospital, so this is where you can take short trips to do some shopping, sightseeing or you might want to just go out to lunch or dinner. But this is not the time to do heavy sightseeing – you must stay in cool airconditioning so you do not increase your swelling (NO sunbaking or swiming) – enjoy great foot and leg massages and pampering. Please listen to your body and do not overdo it, it is very important to rest during your recovery from surgery. When you return home, please take it very easy and do light duties and do not pick up objects for about 2 months as this can put pressure on the stitches internally and externally. A few weeks after surgery, sutures used to close the deeper layers may spontaneously surface through the skin. Although these are expected to be absorbed within 4-6 months following surgery, these are still material foreign to the body and may be “pushed outwards” as healing continues. This can become visible or produce irritation and removal may be required. You may be able to remove these yourself or please see your local GP and they can remove them.

In addition to possible breast reduction health complications that are common to many surgical procedures, there are specific potential breast reduction cosmetic risks. When deciding whether you are a breast reduction candidate, you should be aware of possible asymmetry, sensation problems, and future breast feeding issues associated with breast reduction surgery.