Breast reduction

Overview

The purpose of the surgery is to reduce the amount of breast tissue and skin covering the breast to make the breast smaller, improving its shape and position. The nipple is also moved into a new and higher position. It is rare for patients to suffer loss of sensation after the nipple is moved and in fact, some of my patients inform me of increased sensation following their surgery.

The vast majority of women who have breast reduction surgery are glad they have had it and are very pleased with the results.

Using a anchor shape or “Wise pattern” reduction. I don’t make people flat chested unless they a very clear that is what they want. Taking off too much volume can often leads to a broad flat breast. To get an idea of the change look at distance between the belly button and the bottom of the breast.

Click here for Breast reduction FAQs

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Standard wise pattern reduction but notice that the scars under breasts cannot be seen

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Using a anchor shape or “Wise pattern” reduction.

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In very large breasts

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Using a vertical scar or Lejour type reduction with some liposuction to the armpit folds

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Another standard wise pattern reduction

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A vertical scar reduction on a larger breast

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Using a anchor shape or “Wise pattern” reduction. I don’t make people flat chested unless they a very clear that is what they want. But in these following cases that was specifically asked for.

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Using a anchor shape or “Wise pattern” reduction. The scars are under the breasts are not easy to see.

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Breast reduction FAQs

 

Different Types of Breast Reduction Surgery

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There are several ways of performing breast reduction surgery. The main ones I use are the Wise Pattern reduction and the vertical scar reduction. They are both used widely and each has pros and cons.

Wise pattern (anchor scar) procedure

This is the standard breast reduction and gives good results for the majority of breasts (except the extremely large) It also has a better chance of preserving nipple sensation and also breast feeding is likely to be more successful after the surgery because more of the breast glands remain attached to the nipple.

The disadvantage is that it gives a scar that runs in the breast crease and the area under the breast where the “T” junction meets has a risk of being slow to heal.

Vertical scar reduction

The benefit of this operation is that the scar runs from the nipple to the bottom of the breast so it is shorter. The initial shape of the breast is flat at the bottom with the nipple pointing down and the skin around the suture line is wrinkled because of the “rouching” of the extra skin. This settles down at around 6 weeks although there can be some persistent irregularity.

The disadvantage is that breast feeding and nipple sensation are not so reliable and there is a need for the breast to settle into a good final position with flat scars and this is a little unpredictable.

The Operation and hospital stay Breast Reduction

The surgery is performed under general anaesthetic and takes about three hours. When you wake up you should be comfortable as local anaesthetic is used in the wounds and you will remain on regular analgesia (painkillers) for several days until you are effectively pain free. There will be dressings on your breasts. After the surgery you will stay in hospital for 1 or 2 days until it is safe to send you home. Surgical drains are used to prevent blood collection in the tissues and these are removed once they have settled.

What to expect from Breast Reduction

Breast reduction surgery makes an immediate and dramatic difference. There may be some discomfort for a few days. Normally 4-6 weeks after the surgery, you are beginning to return to normal. It may even be quicker than this. As said above, expect to feel washed out for several weeks after the surgery and to tire quickly although you will gradually return to your normal energy levels.

Your breasts will soften up over the first 8-12 weeks and assume their final shape.

Your nipple sensation may take some tme to return to normal

The majority of people who undergo breast reduction surgery are very pleased with the result and feel it makes a very positive change to their lives.

Cost of Surgery for Breast Reduction

from £6425 – This includes all required follow-up and in the unlikely event you require further treatment due to post-operative problems any further treatment is also included

After Breast Reduction Operation

Expect to feel washed out for a few days after the surgery and to tire quickly although you will return to your normal energy levels in a few weeks.

The sutures are all dissolving, but a one week follow-up will be given to make sure everything is OK. You will be provided with two soft bras (one to wear and one for the wash) to wear for the first few weeks after the surgery. I will personally see you at 1, 4 and 12 weeks and 6 and 12 months following surgery and more if required.

What are the risks of Breast Reduction surgery

I feel it is important that anyone having surgery with me is aware of the possible negative sides of surgery and understands the small but real risks. The following paragraphs cover what happens when things occasionally don’t go as expected.

Like all surgery there are risks of complications whoever does your surgery. It is important you are aware that many of the problems you may get after your surgery, if they are treated promptly, have no obvious effect on the final outcome.

It is unlikely your breasts are symmetrical before surgery and there may be a small degree of asymmetry after the operation. (If it is a big difference then a surgical correction can be discussed). All operations have a risk of bleeding. In breast reduction there is a small risk that a blood transfusion may be required (no more than 1%) or that there may be bleeding inside the operated breast leading to a collection of blood (haematoma), which needs to be removed under an anaesthetic (less than 2%). Infection is rare and antibiotics are given around the time of surgery to reduce the risk. Some people form bad scars (about 2%) and these can be troubling for a while although often respond to treatment over several months.

There may be some numbness of the skin, this will normally get better over a period of time but there is a small risk of small areas of permanent numbness.

Risks particular to breast surgery are problems with nipple sensation which may be lost or significantly reduced and breast feeding which may not be possible following the surgery. These problems can be permanent. There is a very small risk of the nipple not surviving (less than 1%) in its new location and this can require a reconstruction, which will not be a very good match for the other side.

Other problems include some wound breakdown in the wound under the breast which mostly responds to a period with dressings and a problem termed fat necrosis where some of the internal fat loses its blood supply and causes inflammation and hardness and occasionally an oily discharge. Again this responds in the main to dressings and has little if any impact on the final result. Between 10 and 20% of breast reduction patients have a need for prolonged dressings. You will receive medication to prevent blood clots and the anaesthetist will discuss the anaesthetic.

Some people may have long term pain or discomfort in the breast area.

All operations have a small risk of Deep Vein Thrombosis (DVT), chest infection and Pulmonary embolism. Death following elective surgery is exceptionally rare (1:250,000 in fit and well people)

As this is a surgical procedure to deal with appearance no guarantee can be given to the final appearance, but if we agree it is an unsatisfactory results correction will be offered at no additional cost.

What to bring to hospital

If you would like, bring a family member or friend. Bring some easy to put on bed wear, preferably with front buttons and your own clothes and toiletries and something to pass the time like books, puzzles or some music . The rooms have televisions and there is free Wi-fi.

What to look out for after you have gone home

Before you come into hospital, you will get a package that contains a set of post-operative instructions and a thermometer.

Watch out for redness, swelling, pain, discharge, opening of the wound, fevers, sweating and shaking. Whatch to see if your temperature is above 37.2C and you feel unwell or it is above 37.6C.

If any of the above are seen or any of the information of the instruction sheet call the numbers on the instruction sheet or the hospital you had your operation.

Things to Avoid

The following are medications or herbal medicines to avoid before surgery.

Please disclose all medications (including self prescribed and herbal and vitamin supplements) during the consultation. The following increase the risk of post operative problems.

Roacutane or other vitamin A skin preparations / aspirin / steroids / warfarin / clopidogrel / Brufen / alka-seltzer / Fish oil / Flagyl / anti-rheumatics-arthritics / blood thinners eg persantin / St John’s Wort / Aloe vera / Cimetidine / Vitamin E (>600mg/day) / Vitamin C (>1000mg/day) / alfalfa / arnica / bromelain / calendula / celery / chamomile / cloves / Evening primrose / garlic / ginger / ginko / goji berries / licorice / meadowsweet / diabetes medication / blood pressure medication / diuretics

Most fruit and pickles have aspirin like chemicals in them so avoid large quantities in the two weeks before surgery.

Please remember that if you have any questions or concerns to ask during one of your consultations. Writing questions down is sometimes helpful.

Driving

Normally you can re-start driving at around 2 weeks. You are fit to drive if you feel you are fit. I recommend you have someone take you to an industrial zone or supermarket car park late at night so you can attempt driving without risk to others. If you find you can drive without problems you are safe to go out on the road

Work

Depending on how physical the work you do is, you can start working from between 1 and 3 weeks.

If in doubt remember you can always ask for advice.

Exercise

At home rest is necessary for one week and any strenuous activity, bending, and lifting etc. is to be avoided. You can shower once your dressings are reduced after your first appointment.

Physical exercise more than a gentle walk should be avoided for the first least 3 weeks and then only undertaken if comfortable. After 3 weeks I allow swimming and cycling and more vigorous walking. After 6 weeks you can, if it is comfortable, return to full activities.

 

Bras

After surgery once the wounds and healed and it is comfortable an underwired bra can be worn. It takes around 3-4 months for the final size to be reached so buying a lot of bras early is not advisable