A breast reduction or a reduction mammoplasty which is also another term for it is a procedure
carried out on ladies who have a condition called macromastia or large breasts. There's
really no defined size where a lady will benefit from a breast reduction, but mostly ladies
that come to see me often complain that the size of the breast is interfering with clothing.
They find that particularly wearing-- or finding a bra is difficult, A: in terms of size, but
also B: as their bra straps tend to dig into their shoulders. They tend to find clothing
is also difficult, because they made me slim but the size of the breast is out of a portion
to the rest of their body and they also have other physical symptoms in terms of inability
to be able to exercise. The procedure itself is carried out under general anaesthetic.
It takes around two and a half to three hours and most of the patients tend to go home the
same day. In terms of recovery from a breast reduction, I use very, very light dressings
and we have developed a particular technique where we stitch and glue and tape the wounds
and that means that most of the patients would be able to shower the day after the surgery
and the dressings are then removed at two weeks, and at that point most of the time
their wounds have completely healed. The patients are then required to wear a sports bar for
further four weeks. After that they go and get measured for a new bra.
So, there are lots of operations that are available in order to reduce the size of the
breasts. After full history and examination, I would be able to advise you in terms of
which procedure is most suitable. From the simplest end of the spectrum, the operation
can involve liposuction. We tend to use these in ladies who don't need the breast position
changing and who need small decreases in breast volume. This operation is also good in ladies
who have a tendency to form bad scars. Most patients require a formal breast reduction
which involves an anchor shaped scar. The real advantage of this technique is that as
well as actually reducing the size of the breast, it can also combine that with an uplift.
The position of the nipple can be decided between myself and the patient and the patient
can look as young as 21, 25 or over 25 depending on what they're hoping to achieve. Most of
the operations require a general anaesthetic and most of the patients have the procedure
carried out as a day case and so they can leave the hospital the same day.
So, there are lots of benefits to having a breast reduction carried out and I generally
tend to think of these as physical and psychological. In terms of physical, the most obvious benefit
is to have the size of the breasts reduced. I generally tend to agree with the patient
prior to having the surgery in terms of which size they roughly like to be after the procedure.
Most patients find that actually having large breasts has interfered with the clothing and
exercise and reducing the size of the breasts allow them to actually wear normal clothes
and to be able to do things like going to the gym. Other major advantage of having a
breast reduction is that often because of the weight of the breast, the shape of the
breast is not very attractive, and so by having a breast reduction a much more pleasing shape
can be achieved. That shape is also important because most of the bras that are made are
made, are made for a globally shaped breast and by achieving that with a breast reduction
procedure, patients then find that it's much easier to find bras that fit them. In terms
of psychological benefit, the social stigma is often removed and people find this much,
much easier when they tend to interact socially and lastly the other benefit which is often
unrecognised is that breast reduction can also reduce the risk of cancer. We sometimes
carry out these procedures in order to remove the breast tissue and this actually reduces
the chance of developing cancer as there's less breast tissue available.
Well, actually there very few don'ts after this procedure. Most of the patients that
are having a consultation for a breast reduction or considering the breast reduction are often
worried about severe pain after surgery. In fact, the procedure is very, very well tolerated
and as explained earlier most patients have the procedure carried out as a day case. In
terms of do's, we generally tend to advise patients immediately after surgery to take
some relatively light painkillers and to wear a sports bra for six weeks after surgery.
You can come out of the sports bar after six weeks and then go and get measured for a new
bra which will usually be the patient's stable size after that. In terms of don'ts, again
we have very few don'ts, and in general, the dressings are very, very light. I've developed
a technique which involves stitches, glue and a very, very light tape and that means
that essentially patients will be able to shower straightaway. We generally tend to
recommend not to do any heavy lifting or exercise for two weeks after surgery and once I'll
reduce the dressings and we can then have a look to see how the wounds are coming along,
I tend to advise patients in terms of going back to things like gym work or heavy manual
lifting.
Swelling and bruising are common things that patients worry about after having a breast
reduction. In fact, both swelling and bruising are relatively rare after this form of surgery.
There are lots of steps that we take to avoid bruising and swelling after a breast reduction
operation. First of all, during the operation we tend to infiltrate the area with a local
anaesthetic that has adrenaline in there and that essentially reduces the bleeding postoperatively,
and means that patients can have a very, very light dressing after the surgery. We tend
to place my patients in a sports bra immediately after surgery and again, we find this tends
to help the swelling and bruising afterwards. Patients are often then given good pain relief
immediately after the surgery and this reduces the chance of coughing and pain afterwards
and this again helps to stop swelling developing after the surgery. In general, there will
be some swelling within the first six weeks which is why we advise patients not to go
and get measured for a normal bra until the bat period has gone. After six weeks, most
of the swelling has then fully settled down and that means that they can get measured
for a new bra at that point.