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Is breast reduction for you?
Breast reduction surgery is a technique to resize, reshape and lift the breasts. It is usually very well tolerated with pleasing results.
In breast reduction surgery, both skin and breast tissue are removed. In breast lift surgery, breast tissue is rearranged and skin is removed. There are many techniques depending on the amount of reduction required, the scar tendency, the chest or breast characteristics and surgeon preference. Each has advantages and disadvantages.
Preserving feeling & sensation
Contrary to popular belief, the nipple is not usually removed. The nipple is preserved on a pedicle of tissue that is moved to a new position. This helps to ensure the nipple and areola maintain their blood supply and nerve supply, and therefore, feeling and sensation.
It also means there is continuity of the breast ducts opening onto the nipple to allow for breast feeding. In very large reductions or when there are potential risks, the nipples can be removed and replaced as full thickness grafts.
Individual treatment plan
A full medical history is necessary to ascertain any risks associated with the surgery. A complete examination of the breast and axilla (armpit) helps exclude the risk of local pathology.
Measurements are taken of the chest and breast to adequately plan the procedure. The ideal amount of reduction and lift is planned.
Nipple positioning
The position of the new nipple is based on the junction of the breast and chest wall (inframammary fold), the position of the midpoint of the arm bone (humerus) and a set distance from the base of the neck. This is calculated based on chest size and patient height. These markings are repeated on the breast before the operation.
The cup size of a bra is only used as a very rough guide. This is because different bra manufacturers label each cup size differently. It is also not possible to predict the final size at the time of the surgery due to swelling, position changes and the use of injected local anaesthetic.
What to expect
Surgery is performed under general anaesthetic. Many surgeons choose to also use local anaesthetic. This reduces the general anaesthetic requirement, lessens bleeding or bruising and means that on awakening, the discomfort is minimized. Hospital stay is usually overnight. Plastic or silicone drainage tubes may be used. Dressings are firm and bulky to exert some pressure to help swelling and bruising. Generally the discomfort is reported as being less than anticipated.
Post-operative care
Recovery is usually rapid. Bruising and swelling often settles in the first few weeks. Activity can be increased from about two weeks. Light exercise can be restarted at about four weeks, grading back to normal by about six weeks. It is very important to care for the scar tissue. Massage and taping are encouraged. It takes scars up to two years to finally mature.
Significant weight gains or losses or subsequent pregnancies can affect the outcome. Any breast tissue that is removed is sent for pathological examination to exclude breast disease. A mammogram is suggested at six months after the procedure to establish a baseline pattern of the internal scar tissue. This allows comparison for later investigations.
Improvements
Many people report a decrease in breast, back or neck pain, an improved posture, a reduced heaviness in the breasts, an increased ability to exercise and an easier choice of clothing. This short introduction only covers some of the aspects of surgery. A full discussion with your surgeon is essential.