Mammaplasty
Breast reduction
Officially called Reduction Mammaplasty, a breast reduction is an operation to reduce the volume of the breasts. Large breasts can cause physical symptoms such as grooving in the shoulders from their bra, rashes under the breasts, difficulty finding bras or clothing, poor posture, neck, shoulder or back pain. It is one of the operations associated with significant improvement in the quality of life for patients.
Benefits of mammaplasty
The benefits from a breast reduction mainly focus on symptom relief from back pain, shoulder pain, bra straps digging in, skin irritation under the breast. Heavy breasts are also difficult to examine from a breast detection aspect.
There is also the psychological element and the clothes fitting aspect.
Breast Reduction procedure
Breast reduction is performed under a general anaesthetic and usually requires an overnight stay in hospital. Patients may need to have a drain in either breast immediately after the procedure and these will be removed prior to discharge. There will be a scar around the areola, down the breast verticallly and along the inframammary fold.
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Options of Mammaplasty
There are different techniques to preform a breast reduction, but the most common are the superior, supramedial and the inferior pedicle techniques. There will certainly always be a scar around the Nipple Areola Complex, a vertical scar down and under the breast in the inframammary fold.
It is difficult to predict the cup size after the surgery, but essentially for every 150g removed you would expect to drop by one cup size. Typically patients will drop by 2-3 cup sizes.
After Care of Breast Reduction
Mammaplasty is a significant operation in aesthetic surgery. There is a prolonged anaesthetic time and there is a need to rest for a least 14 days after the operation. Scars typically heal well. Some areas are particularly vulnerable to delayed healing, for example the T-junction between the breast and the chest. After the wounds heal, it is possible to massage the scars. Most people use a solution like Bio-Oil or apply a silicone gel. You will need to rest for 14 days after surgery.
HealthFormation
are breast reductions painful
Surprisingly breast reductions are not painful after surgery and most patients need oral pain killers like paracetamol and codeine for a couple of days.
When can i measure for a bra
You will need to wait for around 3 months before you measure for a bra to get a final size. During this time we recommend you wear a sports bra or a medical garment to support the breasts.
is it possible to breast feed
The honest answer is we do not know, but most liklely not. If breast feeding is an important factor, we would recommend doing the operation after completing your family. It is possible to have the usual breast cancer screening after the surgery.
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Frequently asked questions about breast reduction
With a breast reduction the breasts will be both lifted and reduced, achieving smaller breasts that are more lifted.
The results will last for a varying time from patient to patient. However the breasts can still change shape or get bigger with future pregnancy and change in weight.
With a breast reduction, the scars will be placed around the nipple, down the breast and under the breast, described as inverted T shape.
Breast reductions results are negatively affected by smoking as that significantly affects wound healing, fat necrosis and other complications. You will need to be smoke free and off nicotine replacement products for at least one month before the procedure and for one month after the procedure.
There are always potential risks and complications associated with surgery. Complications are rare but can occur. The main complications of breast reduction surgery include:
Bleeding
Bleeding can occur after your procedure and oozing from the wounds is common. Some bleeding can accumulate under the skin resulting in a haematoma or blood collection. Small haematoma will usually resolve with time and may not need any further treatment. Larger haematomas, however, may need a return to theatre to remove them and find the source of bleeding.
Infection
Infection can occur and most often can be managed with antibiotics. Sterile procedures and antibiotics given during the operation try to reduce the risk of infection.
Wound breakdown and healing problems
The most common site of wound breakdown or healing delay is the so called T junction. This is the area where the vertical and horizontal scars meet and the point of maximum tension when the breast is stitched closed. If this occurs it may take longer to heal. There are pre-existing risk factors for poor wound healing such as smoking and diabetes.
Scarring
There will be permanent scars on the breast depending on the type of skin incision pattern. Scars can sometimes become hypertrophic or keloid which means they may be raised, red and lumpy. This can occur around the areolar or along all the scars. Patients will usually have a tendency to develop this type of scarring or there may be a family history of abnormal scarring.
Asymmetry
There is always some degree of asymmetry between breasts and nipple areolar complexes. Occasionally, after breast reduction there may be residual asymmetry or patients may become more aware of pre-existing asymmetries.
Change in Nipple Sensation
Due to the nature of surgery and movement of the nipple there is risk of changes to nipple sensation. This is usually reduced nipple sensation after surgery that is often temporary but may be permanent.
Nipple Loss
Very rarely there is risk of nipple loss that can occur when the blood supply to the nipple is disrupted. There is a higher risk of this when the breast is very big and the distance the nipple is moved is longer. In extreme cases, the nipple may be removed pre-emptively and used as a nipple graft.
Fat Necrosis
Fat necrosis occurs when the fat in the breast loses its blood supply. This may result in firm hard areas where the fat has not survived. Small areas often resolve with time.
Can I breast feed after breast reduction?
It is generally said that you will not be able to breast feed after breast reduction. This is because some of the glandular tissue is removed and nipple areolar complex has been moved. There are some cases where patients have been able to breast feed but in general most will not be able to breast feed.
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