Breast reduction
What is a breast reduction?
A breast reduction reduces the size and volume of the breast. At the same time it lifts the breast and moves the nipple to a higher position, giving the breast a more youthful and lifted appearance.
Why have it?
Women may wish to have breast reductions for aesthetic reasons, or because, large, pendulous breasts may be causing social embarrassment and lead to poor posture.
Women with enlarged breasts may suffer from neck and back pains, bra straps can dig into the shoulders; and women can suffer from repeated infections in the crease below the breast. Wearing fashionable clothes or swimwear may be difficult, and large breasts may interfere with sports activities.
Following the procedure, self-confidence and self-esteem are boosted, as women are more able to wear more fitted clothes. Posture is improved, and taking part in sporting activities should be easier. Of all plastic surgery procedures, those women undergoing breast reduction surgery experience the most satisfaction.
Reasons not to have it
Being overweight and smoking can increase the incidence of complications from breast reduction surgery. It may be wise to delay surgery until smoking is stopped or cut down, and a proportion of excess weight lost.
Aspirin increases the risk of bleeding by preventing blood from clotting. If you are taking aspirin you will be asked to stop this for at least ten days before the procedure.
Further information
Consultation
Before your consultation you should consider what breast size you would like to be. Mr Roblin will discuss this with you when you meet. Prior to your procedure your breast will be photographed. Mr Roblin will take measurements and mark your breasts in preparation for the surgery.
You will be asked about your general health, particularly information regarding heart disease, diabetes, and deep vein thrombosis (clots in the leg). Mr Roblin will want information about your medical history and any previous surgical procedures.
Procedure
Mr Roblin uses 3 different procedures, the choice of which he will discuss with you during the consultation
Wise pattern breast reduction
This technique is employed for those requesting a moderate to large reduction in their breast volume. This technique results in scars around the areola, with a vertical extension down to the crease underneath the breast, and further scars along the length of this crease. The final scar is shaped like a ship's anchor. The nipple, on a 'pedicle' of breast tissue, is moved to a higher position
Lejour type breast reduction
This technique is employed for those who are requesting are small to moderate reduction in the size of the breast. It is only suitable for those with sufficient elasticity in the skin (younger age group), and in those in whom there is a limited amount of skin to be excised. With this technique the amount of scarring is confined to that around the areola and a single vertical scar from the areola down to the crease on the under side of the breast. The lower end of the scar is scrunched up and flattens over a few months. In a percentage of patients a short transverse scar is required at the time or as a minor revisional surgery under local anaesthetic at a later date.
Free nipple graft breast reduction
This technique is reserved for those ladies in whom a very large breast reduction is requested. Because of the distance the nipple has to be moved, its blood supply can be compromised endangering the survival of the nipple. In this case the nipple and areola are removed from the breast and reapplied as a skin graft. The success of this grafting procedure is very high. The down side to this is that the nipple will lose sensation, although for ladies with breasts of this size the sensation of the nipple is often poor anyway. The scars are the same as for the Wise pattern technique.
Anaesthetic
The operation is performed under general anaesthesia and takes approximately 3 hours
Length of stay
1 night following the operation. There will be a drain in each breast, which will be removed between first or third day. You are able to go home with the drains in the latter case.
Risks/Possible complications
Early (1-2 days):
Frequent
- Bruising
- Swelling
- Temporary numbness
Infrequent
- Bleeding (haematoma)
- Infection
- Discomfort
- Partial or total nipple necrosis (very rare)
Later (after one week):
Frequent
- Breast-feeding - usually not possible afterwards
- Altered nipple sensation
Infrequent
- Scars - can be lumpy, may stretch and widen.
- Delayed wound healing
- Fat necrosis
- Loss of nipple sensation
- Asymmetry
- Too much or too little tissue is removed.
General anaesthetic
- Deep vein thrombosis
- Chest infection
- Allergic reaction to drugs or tape
Recovery
Immediately after the operation
- You will feel bruised and sore and there will be some swelling
- Pain is usually moderate and controlled with standard painkillers
- A drain will be placed in each breast that may stay in when you go home
- A supportive bra (non-underwired or sports type) is to be worn day and night for 2 weeks, then in the daytime for 6 weeks
- Walking is encouraged, but no heavy lifting or straining
After return home
- Socialising with friends at 1 week
- Return to office work at 2-3 weeks
- Driving at 2-3 weeks
- Heavy work at 4 weeks
- Under wired bra can be worn after 6 weeks
- Swelling and bruising up to 6-8 weeks
- Return to gym and strenuous activity 2 months
- Final result 6-8 months