Image of woman lifting her breasts

Breast Reduction & Breast Lift

A breast reduction is an operation designed to make large or excessively droopy breasts smaller and/or perked up (mastopexy) and more in proportion with women’s frame. Mastopexy only means to uplift without reducing size. This technique is also used to correct asymmetry. This operation can be combined with fat grafting to correct asymmetry or enhance breast size.

Breast reduction can help relieve the physical symptoms associated with large or heavy breasts such as: Neck pain, back ache, breast discomfort, strain on shoulder, Skin problems underneath the breast, fitting of clothes, difficulties with strenuous activities like exercise, dance etc. and difficulty/discomfort during exercise.

 

Breast reduction surgery aims to lift breast and nipple into a new position. Nipple is kept viable on a flap of tissue. Excess skin and breast tissue is then removed, and the remaining breast tissue reshaped to create a smaller and more elevated breast.

 

The methods of reduction and reshaping vary, and depend upon the patient’s breast size, wishes and needs. The main aim of all techniques remains the same, but different scars.

Anchor-Type or Inverted T Reduction

This is the most common type of breast reduction technique used. This technique results in an anchor-shaped scar, starting around the nipple, travelling vertically down and then horizontally across the underneath breast crease.

Circumareolar Reduction

In Circumareolar breast reduction the only scar is a circular scar around the areola. This technique is suitable when only a small amount of tissue needs to be removed.

Breast reduction surgery involves fairly complex operations that take between two to four hours to perform. The operation is carried out under general anaesthetic and average hospital stay is one night. I prefer to put dressing for a week and rarely use a drain (plastic tubes attached to suction bottles). The drains if used will are removed in few days’ time. I use dissolving stitches. Post-operative pain in minimal and patients will be mobile immediately after surgery and should be back to full exercise within six weeks. Average time to return to work is 2-4 weeks.

All breast reductions result in scarring although the nature of the scars will depend on the technique that has been used. Scars tend to be quite red in the first six weeks, changing to purple over next three months and then fading to white. Most patients will form good quality scars over time, but occasionally and unpredictably some patients will get red lumpy scars that do not improve (keloids).

 

What Complications Can Occur?

Complications are rare after breast reduction. However this is a major operation and you must be prepared for the process and recovery period. Most patients are fully satisfied with the physical and cosmetic improvements that breast reduction brings. However, it is impossible to guarantee a precise size of the reduced breasts.

There will be minor asymmetries between your breasts and the scars. There is less than 1% risk of bleeding after the operation and need to go back to operation theatre. Wound healing problems are quite common, particularly in the T-junction of the anchor scar (where horizontal and vertical scars meet). Most wound problems are minor and can be managed with simple dressings. However, more major wound problems such as infections, skin necrosis and wound breakdown are rare. Sometimes some fat in the breast dies (fat necrosis) and can form lump or lumpiness that takes time to settle. In rare instances, the operation can result in the loss of the nipple. Wound problems, if they occur, can delay healing and result in scarring worse than normal.

Some patients will get alteration in the sensation of the breasts, this will often improve after the operation, but it is possible that you will lose feelings in nipple. After many breast reduction techniques it will still be possible to breast-feed, but this ability might be lost.

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