Breast Reduction
Welcome to my website about breast reduction, also known as reduction mammaplasty.
Breast reduction was said to be first performed over 1300 years ago (obviously an age old problem). However, modern day reduction mammaplasty really started about 80 years ago. Today, breast reduction surgery thankfully is much safer with predictable and better cosmetic results, as well as fewer complications.
You obviously have been thinking about breast reduction for some time. Also, you have reasons which are well known to plastic surgeons for wanting this procedure. These are as follows:
- Your breasts are probably large, droopy, heavy and painful. This condition is also known as Macromastia or Gigantomastia.
- You may have associated chronic mastitis (inflammation) of your breast tissue.
- The weight of your breasts is giving you a lot of pain in your back, neck and shoulders. (If your husband or partner doesn’t believe you, ask him to tie up two balloons with 1litre or more of water, then tie these two balloons with a string and hang the string around his neck for 24 hours)
- Your bra straps are causing indents (depression or dips), deformities in your shoulders. This unfortunately is permanent, even after breast reduction.
- You may have constant discomfort from sweating under your breasts, which often is accompanied by unpleasant smell. Often, you also apply baby powder to dry these areas.
- You may have skin rashes or skin breakdown under your breasts. There may be dark pigmentation of your skin from this condition also known as intertrigo.
- Often, you slouch over and don’t stand up straight. This is either because you are embarrassed or your breasts are too heavy. If you do this long enough, you may get arthritis of your neck, with a posture being in a permanently curved position.
- Because of your slouching posture, your tummy may also stick out.
- You are very conscious of your large breasts and you may want to hide them by wearing large T-shirts or tops. You may also have to buy expensive, special large bras. On top of this, you may have to blouses, coats, dresses and other clothing items specially custom made to fit. All these are very expensive and could also give you a great deal of inconvenience.
- If you are in your teens, it is not uncommon to have constant teasing about your large breasts.
You are probably very embarrassed to change in the locker room before your sport lessons.
- You probably also have great discomfort in sporting activities. This is because you may have to wear special bras to support your breasts from wobbling all over.
- Finally, you may be especially conscious when talking face to face with men. Often their eyes are focused on your breasts instead of your face.
What can Breast Reduction Do for You?
In my experience, reduction mammaplasty patients are often my most grateful ones. They often tell me that literally, a load has come off their chest after the reduction mammaplasty procedure.
I will now relate to you, what you may experience after having the reduction mammaplasty operation.
- You will most likely have relief from the heaviness and pain with your breasts being reduced as well as lifted.
- Your posture will improve with you being able to stand straighter and your rounded shoulders being squarer.
- Although the bra strap indentations will still remain, they will not be as painful like before.
- The sweatiness and the rashes that you may have before the breast reduction will improve significantly.
- Often, your self esteem and self confidence will be significantly improved.
- More than likely, you will be able to buy standard bras and dresses in the shops without having to have them custom made.
- More than likely, you will have a greater range of sporting activities you can take part in. This is because your breasts will be firmer and less wobbly as well as lighter than before the breast reduction procedure.
- Although there is scarring involved, your breasts will be firmer and lifted, with the nipples pointing forwards instead of downwards like before the breast reduction.
All in all, breast reduction mammaplasty will more than likely be a positive experience for women with large, heavy and droopy breasts.
The Basic Surgical Technique
In the majority of breast reduction, the nipples and areolas remain attached to the blood and nerve supplies, while the excess breast tissues are removed. The areolas are also reduced in size. The nipples and areolas are then repositioned at a higher level and the incisions are closed.
Very occasionally, when the areolas are extremely large, the nipples and areolas may have to be completely removed before being repositioned to a higher level. This results in permanent loss of sensation in the nipple and areola and the inability to breastfeed.
All removed breast tissues are weighed for comparison between each sides before being sent for examination by the pathologists.
The Resultant Scars of Breast Reduction Surgery
In the vast majority of reduction mammaplasty procedures, the resultant scarring is an inverted T scar, known as the anchor scar. This scar goes around the areola, vertically from the lower border from the areola, down to the lower breast crease and horizontally along the natural breast crease.
Very occasionally, it is possible to not have the horizontal breast crease scar. Instead, there will be just a scar around the areola and another scar vertically downwards to the breast crease. However, the lower part of the vertical scar is often very puckered and will take months to smooth out.
All breast reductions result in permanent scars. These scars will be red initially, but in the majority of cases would take about a year or more to subside. Sometimes scar revision may be required when the final scars are unsatisfactory.
Facts You Should Know Before, During and After Breast Reduction- Smoking. Smoking increases the risks of complications, including wound healing and chest infections. Therefore, you should stop at least three weeks before the procedure.
- Anaesthetic. The procedure is usually carried out under a general anaesthetic.
- Hospital stay. The stay in hospital is usually overnight.
- Work. If you are in a desk job, then you should be able to return within two weeks. If your work is physical, then you may require four weeks off work.
- Scarring. The scarring as mentioned earlier, is an inverted T, or anchor scar. The scar is usually red initially but improves and resolves over a course of about a year.
- Bruising. There is usually bruising after the procedure and this will take about three weeks to settle.
- Swelling. The majority of the swelling should settle in about three weeks, however it may take up to three months before all the swelling subsides.
- Pain. There will be pain relief provided either with injections initially and later with oral medications. There will always be some niggling pains from the surgery, which may take three to four weeks to finally resolve.
- Tightness of the breasts. Initially, there will be a sensation of tightness of the breasts because of the swelling. As the weeks go by, this tightness should resolve.
- Nipple sensation. If the nipples and areolas are completely removed in the operation before repositioning, then naturally, there will be a loss of sensation, as mentioned earlier. In general, the nipple sensation remains the same, although there is definitely a possibility of alteration of the sensation, i.e. either being more or less sensitive.
- Drains. These are tubes to drain the oozing from your breasts after surgery. They are removed in 24 hours.
- Final breast size. It is impossible to achieve the exact breast size you want. Usually your breasts are one or two cup sizes smaller after the operation. Again there is no guarantee about this.
- Asymmetry. 100% of all breasts are asymmetrical. Although all steps are taken to try to evenly match two sides of the breasts, there will always be a slight difference between the right and left breast. Rarely, there is a redo required to match up the volume of the breasts.
- Droopiness. Depending on your skin tone, the degree of the droop of the lower half of the breast will vary. Given time, there will always be some droopiness of the breast with fullness of the lower half of the breast developing.
- Breastfeeding. If the nipples and areolas are removed completely before repositioning, you will not be able to breastfeed. Otherwise, there is probably a 30% chance that you maybe able to breastfeed.
- Pregnancy. It is unpredictable how large your breasts will develop with pregnancy and after pregnancy. There may also be a chance that you may lose volume after pregnancies.
- Mammograms. You can still have mammograms and ultrasound investigations on your breasts following breast reduction.
- Wearing a bra. You should always wear a bra when you are in an upright position. Not wearing a bra for long periods of time eventually will lead to increased droopiness of the breast.
- Finally, there is no guarantee that you will be satisfied or happy with the outcome of the reduction mammaplasty. The majority of the patients are very happy with this procedure.
Complications of Breast Surgery
- Infection. Although the chances are low, there are always risks of this happening and it usually occurs at the junction of the horizontal and vertical limbs of the scar. This may lead to wound breakdown and in general, this is usually a small breakdown, which will heal spontaneously with dressings and antibiotic cover. Very rarely, will you require a skin graft to cover a raw area. Antibiotic cover is normally routine after the surgery.
- Loss of nipple and areolar tissues. In very rare instances, due to the blood supply being affected or in extreme cases of wound infection, there may be a loss of the nipple or areolar tissue. This may require reconstructive surgery with the use of skin grafting as well as reconstructing the nipples at a later stage.
- Bleeding. Vary rarely, there may be post operative bleeding that is significant enough for the blood clots to have to be removed under anaesthetic. Besides, drains are usually used to drain oozing from your breast tissue for 24 hours.
- Deep vein thrombosis. This complication again, is very uncommon and stockings are worn until you mobilise properly.
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