Breast reduction is an operation to remove the excess breast tissue and skin and so to decrease the size of the breast. It is performed under a general anaesthetic – it is usually day care or a possible overnight stay.
At your initial consultation I will ask you about your general health, as well as any specific breast health issues pertaining to surgery. I will examine your breasts (with a chaperone present) and describe the process of breast reduction including the scar pattern involved. If you decide to proceed, another appointment will be made for you to come back and ask any specific questions of concern, at this time a consent form for surgery will be signed and pre–operative photographs taken. There is no charge for this second appointment.
You will come in on the day of your surgery and I will visit you on the Ward prior to going to theatre, Breast reduction is usually a daycase procedure but occasionally patients do stay overnight. You should have a sports bra with you; this can be put on at the end of the operation and provides comfort and support. You should wear this as much as possible for the first two weeks after surgery to help with healing and discomfort. Every effort will be made to achieve the size you desire, but no guarantee can be made relating to size, please bear this in mind.
The operation takes approximately two and a half hours to complete. It is major surgery and I recommend that you take things very quietly for at least a fortnight after the operation, and avoid any heavy exercise for six to eight weeks after surgery.
There are potential complications with the operation, in particular those relating to the scars, which can be of unpredictable quality and include the risk of infection of the wounds, which would leave you with a scar wider than that which is ideal. The scars settle over a period of two to three months, to leave a fine line, though some scars become red, raised and itchy, and remain so for approximately six to nine months after surgery. These settle to leave wide, flat scars, which lighten in colour over time.
The operation requires extensive undermining of the skin and the movement of the nipple to its new position. The extent of the operation may endanger the blood supply to the skin or to the nipple. If this is the case, the nipple may either all or in part necrose, this is extremely rare but given the dramatic nature is important to be aware of.
In addition, the extent of the surgical procedure may reduce the sensation in the nipple or surrounding skin. This usually returns close to normal over a period of time. Whilst I try to ensure that the breasts and nipples are symmetrical and as equal in size as possible, it is possible that there will not be an exact match after surgery. Whilst the operation reduces the size of the breast, with ageing it is likely that the shape of the breasts will change over time.
Please bear in mind that you may get increased discomfort in the breasts with your period. This is normal. All the breast tissue is sent to the pathologist for sampling. Very occasionally we identify breast problems, these are only identified by the pathologist some time after your operation, in this case I will discuss these findings with you and arrange for any further treatment required.
Breast feeding should be possible after breast reduction surgery but cannot be guaranteed. Breast growth can still occur after surgery and therefore your breasts may enlarge again after surgery particularly during pregnancy or weight gain.
Smoking affects your skin blood vessels and makes both bleeding after operation and the risk of skin dying, more likely.