Breast Reduction

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Breast Reduction

Breast reduction is a procedure with both cosmetic and functional benefits. The procedure is carried out under general anaesthetic and involves two night stay in hospital. The procedure is discussed at length in the pre-operative consultation.

Breast Reduction (Reduction Mammoplasty)

Breast Reduction

WHY ARE LARGE BREASTS A PROBLEM?

Some women have problems with asymmetry (one breast much larger than the other) or have very heavy or pendulous breasts. Very large breasts can cause back ache, neck pain and irritation of the skin underneath the breast. It can be hard to find suitable clothes and comfortable bras, and certain sports can be difficult. For some women having large breasts can make them very self conscious.

WHO CAN HAVE REDUCTION SURGERY?

Any women with very large breasts that are problematic can be considered for a breast reduction. The size of a woman’s breasts will largely be determined by genetics but it will also be influenced by fluctuations in weight, pregnancy, breast feeding and hormonal changes. For these reasons most surgeons advise that surgery is only undertaken when the woman’s breasts have reached maturity (ie best not performed on young teenagers) and the patient maintains a stable weight. You may be asked to lose weight to achieve a healthy BMI (body mass index) before surgery is offered. Ideally surgery should be delayed until any planned family is complete but special cases

can be considered.

WHAT IS INVOLVED IN THE OPERATION?

A breast reduction is usually performed under a general anaesthetic, takes between 2 and 4 hours and requires a 2 to 4 day stay in hospital. There are a number of different techniques that the surgeon can use. There may be a scar underneath the breast, one around the nipple or even a vertical scar running down from the nipple to join the scar underneath. The choice of operation will be determined by the size and shape of the breasts before surgery and the size that is desired afterwards. You should discuss the options and the exact position of the scars with your surgeon before the operation. Excess skin, fat and breast tissue is removed and the position of the nipple

may be moved permanently.

Before the operation, depending on your age and fitness, you may have to undergo some simple health checks such as blood tests and a mammogram. The surgeon will also examine your breasts and draw guidelines with a marker pen before you are under the anaesthetic. If you decide on surgery you will be required to sign a consent form giving permission for the operation. This requires that you are aware of the risks and complications involved

with the procedure.

For more information please read our Treatment Information Sheet

Lejour Breast Reduction

This operation is to help control the symptoms caused by very large breasts. It may reduce breast tenderness, back pain, shoulder grooving (from bra straps), interigo (inflamed, moist skin) below the breast and breast discomfort – but only if these symptoms are actually caused by large breasts. Back pain, for example, due to other causes will not be helped. The operation is performed under general anaesthetic. The anaesthetist will see you before your operation. Discuss any queries you have about the anaesthetic with your anaesthetist. If you have had any difficulties during a general anaesthetic in the past make sure that both the anaesthetist and the ward doctor know about it. On the evening after your general anaesthetic you will feel rather tired and sleepy and should warn your visitors not to expect you to be very good company!

During the operation we remove a large quantity of tissue from within the breast. It is not possible to do this without creating long scars. Your scar will go around the nipple and down the centre of the breast below the nipple. The scar down the centre of the breast below the nipple starts off wrinkled as the skin is gathered up to reduce the length of the scar. This scar takes longer than other scars to settle down. Sometimes even after a period of 6 months or more the skin is not satisfactorily flat and if this is the case you may require a small secondary operation to trim away the excess skin. The scars will never completely disappear and may even stretch (widen) as the years go by. The scars start off red. Over a period of time they will tend to fade – it will take about 18 months for this process to occur. Some people’s fade better than others. If you scar badly, there will be only slight fading and you will be left with red, thickened scars that remain noticeable.

For further information please read our Procedure Information Sheet

Breast Uplift or Mastopexy

Breasts which are droopy or sagging can be corrected by doing a breast uplift operation. This can be combined with an augmentation. The procedure involves a general anaesthetic and an overnight stay in hospital.

Mastopexy (up-lifting of droopy breasts)

Droopiness of the breast is a common legacy of motherhood, nursing and the force of gravity taking their toll, and the effect of pregnancy and a distension of the breasts with milk causes the fibrous bands which support the breasts in their youthful shape to break down and the skin to stretch. With the subsequent shrinking the unsupported breasts settle into the stretched skin and gravity pulls them down.Putting on weight and then losing it can have the same effect. So too does the ageing process, which is why women dislike the appearance of their droopy breasts.

What can be done?

Whilst it is not possible to recreate surgically the natural supporting structure of the breast, it is possible to reshape the breast into one which looks more youthful and feels more firm. The operation is called a Mastopexy. Pleats of surplus skin are removed from underneath the breast, the breast itself is remodelled into a tighter cone and the nipples are repositioned at a higher level so that they lie at the points of the tightened breasts. Mastopexy can also reduce the size of the areola ( the darker skin surrounding the nipple). If the breasts are too small as well as droopy,their size can be increased during the operation by placing silicone breast implants underneath the tightened breasts. The best results are achieved in women with small sagging breast although breasts of any size can be lifted. The results may not last as long with heavy breasts. Many women seek mastopexy when their families are complete so if you are planning to have further children it may be a good idea to postpone the operation for though there is no risks for future pregnancy and mastopexy does not usually interfere with breast feeding, pregnancy is likely to stretch the breast again and reduce the effectiveness of the procedure.

For further information please read our Procedure Information Sheet

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