Breast Reduction

Length of operation: From 1.5 hrs to 3 hours
Type of Anaesthesia: General
Length of stay in hospital: 1 night hospital stay
Recovery time:  10-14 days for the bruising and swelling to subside. Full  recovery is between 3-4 months.
Time off work: 1 to 2 weeks after operation

About breast reduction: The goal of breast reduction surgery is to make breasts smaller and better shaped in terms of proportion to the rest of the body. This is a common procedure in which excess breast tissue is removed and the skin of the breast is tightened, resulting in a smaller and better shaped breast with a more youthful appearance.The operation usually also achieves a breast uplift.

Suitable candidate: If any one or a combination of the following conditions trouble you – disproportionately large or asymmetrical breasts that are often physically uncomfortable leading to neck ache and backache, problems with buying clothes that fit, sometimes causing self-consciousness and embarrassment, problems with participating in sport and exercise, bad posture, excessive sweating, rashes and infections under the breasts, grooves on the shoulders from bra straps  – then you would be an ideal candidate for breast reduction surgery.

Reasons not to go ahead: Patients on blood thinning medicine, active smoking, overweight patients. A desire to become pregnant needs to be discussed with your surgeon as pregnancy and childbirth can alter breast size and shape in an unpredictable way which could alter the results of the procedure.

Pre op: You can discuss your expectations, learn about the surgery and clarify any doubts you might have at the consultation. The surgeon will perform an examination in order to be able to assess your individual needs and discuss the operation, limitations risks and results in length with you.

On the day: If you decide to go ahead with the procedure, you will receive advice about what to do and what to avoid, prior to surgery. Following the operation, there will be a tube drain that will be inserted into each breast to remove any blood or fluid that may collect in the breast.  A tape dressing is applied to the suture line in the crease underneath the breast.  The tube drain is normally removed within 24 hours and the patient is allowed home in a supportive soft brassiere. Most patients are discharged the following day from the hospital.

Post op: Most patients are able to shower after the operation. Dressings need to be kept dry and clean for one or two weeks after surgery. An appointment will be made for a wound check seven to fourteen days following the operation, when the wounds will be inspected and cleaned. The sutures used are usually dissolving. The patient will receive a complete list of postoperative care instructions before leaving the hospital including how to care for the surgical site and measures to help the swelling and the bruising to settle, medications to take orally for pain relief and specific concerns to look for at the surgical site or in overall health.

A review appointment is usually offered six weeks and four months after the operation.

Convalescence: For the first few days, you will feel tired and sore. The breasts can be bruised and swollen and appears larger in the first few days after surgery than the eventual size. In approximately six weeks the swelling and bruising settles to a large extent and the final shape of the breast becomes evident. There will be scars after the operation and they will be firm and pink for about a month and a half. They may even remain the same size for several months. These scars may take up to two years to fade – the time differs from patient to patient. It is also fairly common for the skin above the incision to feel a bit numb for some months.There is a possibility of numbness of the nipple. In the vast majority of cases the nipples remain natural with normal contraction and relatively good sensitivity.

It is possible to do light activities for the first few days but it is not advisable to do any strenuous activity for the first two weeks. On average, recovery will take around one to two weeks. It is advisable to avoid sexual activity for approximately the first four weeks following surgery, after which care must be taken to be extremely gentle with your breasts for the next month or so.

Immediately after surgery your new breast size will be apparent, but please be aware that that the final shape of your breasts will take around six months to emerge.

Risks and complications: A small percentage of patients can have complications just like for any surgical procedure.
Infection – can be usually readily treated with an antibiotic.
Haematoma (blood clot in the breast) or bleeding – a re-visit to the operating theatre may be necessary.
Delayed healing of the wound – particularly true in case of diabetic patients or those who smoke. This needs to be discussed with the surgeon during the consultation stage.
Mild asymmetry between the the breasts.

Loss of nipple sensation is possible. Nipple necrosis (death of tissue) is a rare complication. The risk is higher in smokers and diabetic patients.

Effects of the procedure:  The level of patient satisfaction resulting from breast reduction is among the highest of any plastic surgery procedure. Although breast reduction makes a striking difference to the way you look, most women become comfortable with their smaller breasts and are usually very pleased with the results of surgery. Unless you gain or lose a significant amount of weight or become pregnant, your breast size should remain fairly constant.