Breast reduction, or mammaplasty, is a surgical procedure to reduce the size of a woman’s breasts. This is usually undertaken to ease the physical discomfort associated with large breasts and to create breasts more in proportion with the rest of the body.
A breast lift (mastopexy) is aimed at correcting the natural sagging that occurs over time by lifting and reshaping the breasts.
Questions and answers
This operation is best left until at least late teenage years when the breasts are fully developed, as further breast growth postoperatively may detract from the outcome. It is also important to consider that your ability to breastfeed may be altered by a breast reduction, although many studies have shown that many women can successfully breastfeed after this surgery.
Women of all ages request breast reduction for the benefits to their health and lifestyle.
The changes in lifestyle after breast reduction can be dramatic and women report very high satisfaction with the results of their surgery. However there are a few decisions to be made before going ahead with surgery:
1. Do you intend to lose significant weight in the next year or so?
2. Do you intend to breastfeed?
3. Are you prepared to have scars on your breasts?
Before meeting with your surgeon, you may want to take the opportunity to discuss your concerns and expectations with one of our specialist nurses. She will give you information about this procedure and discuss what is involved in detail, including post operative care and recovery. She will show you photographs of patients who have had this surgery to help you understand what can be achieved.
Your surgeon will discuss your reasons for wanting surgery and you expectations of what can be achieved. The consultation will include questions about your previous medical history, what medications you're taking, a general examination of your breasts to check for lumps, and measurements of breast dimensions as a guide to what surgical technique may be appropriate.
Photographs will be taken before and after your surgery to plan the procedure and to record your results. Prior to your operation you may need a simple blood test to check your blood count, and a preoperative mammogram will usually be recommended.
There are many different techniques of breast reduction and breast lift. Our surgeons are skilled in all these methods including the modern “short-scar” procedures.
Breast reduction is usually performed under a general anaesthetic – either as day-stay surgery or with a one night stay in hospital. The procedure usually takes between two to three hours, depending on your circumstances.
The techniques of breast reduction most suitable for you will be discussed with you at consultation.
Liposculpture is commonly used during breast reduction to help shape the breasts, especially on the sides of the chest. Occasionally it can be used alone to achieve breast reduction without any skin removal or surgical scars. However, this is only effective in younger women where the skin is firmer and more capable of adapting to the new shape.
We aim to get the best shape with the smallest, neatest scars possible. However, all surgical incisions leave scars and the larger the breast beforehand, the longer the incisions.
The most common procedure leaves a scar around the areola and a lower vertical scar which meets a scar in the breast crease.
The areola is elevated to a position appropriate for the new, smaller breast. For more modest reductions, it may be possible to use a technique that avoids the scar in the breast crease and occasionally only a scar around the areola is necessary. For very large breasts, it may be necessary to reposition the nipple/areolar area as a free tissue graft, however this is uncommon.
It can take six to twelve months for your scars to pass through the normal process of becoming red and thickened, before maturing into pale, flat and soft scars.
When you leave hospital a sports bra is fitted and worn day and night for four to six weeks postoperatively. You should experience mild discomfort during this period. The surgical wounds can sometimes be slow to heal, so regular dressing changes may be necessary. Occasionally infection can occur in the breast tissues. This complication is more common in smokers – a very good reason to quit beforehand.
You can return to normal daily activities at your own pace over the next few days, but avoid heavy lifting and strenuous physical exercise for four weeks. Some women will return to work within a week of their surgery. But for those with physically demanding jobs, two to three weeks is more realistic.
Your surgeon will review you during the six months after your surgery. By now your scars will be settling and the postoperative swelling will have disappeared. The breasts will have attained a more natural shape and the tightness and altered sensation experienced in the immediate postoperative period will have largely resolved.
Throughout your life it is important that you continue to follow your doctor's guidelines for breast self-examination and screening mammography.
There is reliable evidence that breast reduction surgery is associated with a decreased lifetime risk of developing breast cancer.
More detailed information can be obtained during a consultation with one of our plastic surgeons. Please contact the Institute for a consultation.
Breast Reduction & Abdominoplasty following three pregnancies (40 yrs)
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