Breast reduction surgery can help women of all ages to overcome the discomfort caused by large and heavy breasts. The procedure involves the surgical removal of breast fat, glandular tissue and skin, under general anaesthetic and usually involves a 1-2 night stay in hospital to recover. The objective of breast reduction surgery is to produce a smaller, lighter, improved breast shape, complementary and proportionate to the rest of an individual’s figure.
Miss Anita Hazari, Consultant Plastic Surgeon at One Ashford Hospital discusses breast reduction surgery, who is most suitable for the procedure and expected outcomes.
We always ask you to consider the advice given to you, as many women have different views of what is a desirable size and shape for breasts. It is not possible to guarantee breast size when having breast reduction surgery as bra sizes differ dependent on various manufacturers. You will be able to discuss the things that may affect the procedure, such as your age, general health, body weight, the size and shape of your breasts and the condition of your skin. It is also important that you discuss the amount of tissue that will be removed and where the nipple and the darker area of skin, known as the areola will be positioned, as they will be re-sited during the procedure.
Are there alternatives to surgery?
Breast reduction surgery is never an essential operation. Weight loss may reduce breast size and, having lowered your BMI, you may find you do not need surgery. Correctly fitting underwear and clothing can improve comfort and appearance. Cognitive Behavioural Therapy can be effective in body image problems.
What if I want breast reduction surgery but am still smoking?
Smoking can reduce the blood flow to surgical sites. Smoking has an adverse effect on the healing of all surgical wounds and can result in wound breakdown. Smoking also increases the risk of bleeding, haematoma (collection of blood in the surgical cavity), and infection. The same applies for the use of nicotine replacement therapy as, although this will reduce the craving for a
cigarette, the nicotine will also reduce the ability of the blood to carry enough oxygen to the tissues. Most importantly, smoking will increase the risk of nipple necrosis (when parts of the nipple blacken and die). We advise you to stop smoking at least four weeks before breast reduction surgery. We advise you not to use nicotine replacement therapy for the four weeks before your surgery or whilst in hospital.
What other arrangements do I need to make?
The hospital stay is normally 1-2 days. You should arrange help with shopping, housework and care of small children and pets, as you will not be able to manage these on your own for at least two weeks after surgery. It will be necessary to organise two to three weeks time off from work. If your job involves heavy lifting longer time may be needed. You will not be able to drive immediately after your operation. You should only consider doing so when sufficient healing has taken place to allow you to wear a seat belt without pain. Before driving, check with your insurance company that you have appropriate cover since some companies ban driving for a specific period following surgery. If you are taking the oral contraceptive pill or hormone replacement therapy, do not stop taking this medication. Always seek medical advice.
The benefits of breast reduction surgery:
Breast reduction surgery will reduce the size of your breasts. The aim of breast reduction surgery is to give you smaller, better-shaped breasts that are in proportion to the rest of your body and relieve the severity of symptoms from large breasts such as backache and neckache. The procedure removes fat, glandular tissue and skin from the breasts making them smaller, lighter and firmer. It can also reduce the darker skin surrounding the nipple, known as the areola.
What can I expect before my operation?
An anaesthetist will visit you and examine you on the ward and explain the anaesthetic procedure. I will see you and ask for your consent to proceed with your surgery. Pre-operative photographs are usually done at the same time. I will mark the new position for the nipple in a position higher than the old, reducing the size of the nipple as well as marking the area of skin and breast tissue to be removed. It is vital that you do not wash these marks off. Please ask questions if there is anything that you are not sure about. You must have nothing to eat for a minimum of 6 hours and nothing to drink for a minimum of 2 hours before your surgery. This is for your safety, to prevent any problems during your anaesthetic.
Breast reduction surgery usually takes approximately 2 – 3 hours.
Techniques for breast reduction surgery vary, but the most common procedure involves an anchor shaped incision that circles the areola, extends downwards and follows the natural curve of the crease beneath the breast. I will remove glandular tissue, fat and skin and will move the nipple and areola into their new position. The skin will be brought down from both sides of the breast and around the areola, shaping the new curve of the breast. The nipples remain attached to the breast and its blood vessels (known as a ‘pedicle’). There are several variations of the direction of the pedicle. I often uses the ‘supero-medial’ or ‘superior’ pedicle. However, in some cases, the nipples and areola may have to be removed completely and grafted into a higher position, especially if the breasts are very pendulous with the nipples extremely low. This procedure will result in a loss of sensation in the nipple and areola.
In a small group of patients with good quality skin, the horizontal part of the scar can be avoided with vertical scar breast reduction pattern, but will result in small pleats at the lower end of the vertical scar which may take some months to settle. Sutures are dissolving under the skin and do not require removal.
What can I expect after breast reduction surgery?
When you wake up after the surgery, you will be in the recovery area. The nursing staff are very experienced and will ensure your recovery is as pain free as possible. Painkillers will be given to you on a regular basis for as long as you need them. The operation does not usually cause much pain afterwards, although some tightness and bruising may cause discomfort.
What should I look out for?
Breast firmness and tenderness is common in women and can relate to your monthly periods. After your breasts have healed, these symptoms may return. It may take some months for the scar tissue to settle and at first the scars may feel lumpy and tender. We advise you to become ‘breast aware’ – by getting to know what your breasts look and feel like so you know what is normal for you.
When you are at home after surgery, it is important to check your wounds and if they become red, swollen, and painful or there is a discharge please contact either myself or the hospital for advice.
Why Choose One Ashford Hospital
• Access to leading Consultants within 48 hours*
• Finance options available**
• Competitive fixed-price packages
• Modern purpose-built hospital
• Access to diagnostics including CT, MRI, X-Ray and Ultrasound
• Private, spacious, ensuite rooms
• Specialist Physiotherapy and nursing teams
• Little waiting time for surgery
• Calm, dignified experience
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To book a consultation or learn more about the services we provide, contact the hospital direct on 01233 423 303 or email us