Breast reduction surgery also called ‘reduction mammoplasty’ is a surgery to reduce the size and weight of large heavy breasts. Women with large breasts may choose to have this surgery to reduce the discomfort associated with large breasts or to have a breast size that is proportionate to their build.
The effects of breast reduction surgery are that:
The surgery can be done at any age but it's advisable to wait until your breasts are fully developed.
If you have planned to have a child, you may want to postpone the surgery until after, as changes to breast tissue during pregnancy could affect your surgical results.
Types of surgical procedures:
The surgery is done under general anaesthesia and you may be discharged on the same day of surgery after you have fully recovered from the effects of anaesthesia.
The choice of technique will depend upon your existing breast anatomy, the type and amount of tissue to be removed, and the desired outcome.
Liposuction for Breast Reduction
The advantage of liposuction for breast reduction is that it is a shorter, less invasive procedure, with virtually undetectable scars on the breast and lasting results.
The best candidates are those who want a slight to moderate reduction in breast size, have good skin elasticity and little to no sagging to correct, and whose excess breast size is largely due to excess fatty tissue.
Vertical or “Lollipop” Breast Reduction
Patients who need a moderate reduction in breast size and have more sagging are good candidates for a vertical breast reduction. For this, two incisions are made - one is around the edge of the areola, and a second incision runs vertically from the bottom of the areola to the inframammary fold, or the crease beneath the breast. This incision pattern allows your surgeon to remove excess fat, skin and breast tissue and reshape the new smaller breast internally.
Inverted-T or “Anchor” Breast Reduction
The inverted-T breast reduction involves 3 incisions: one around the edge of the areola, one vertically from the areola to the breast crease, and one made along the crease underneath the breast. This technique allows for more tissue removal and reshaping. Your surgeon will typically use this approach if you need a more significant breast size reduction and/or you have more sagging or asymmetry to correct.
Preparing for breast reduction surgery
You will need to undergo a clinical examination and investigations to make sure that you are fit to undergo surgery. You will be asked to get a baseline mammogram before surgery.
Discuss your expectations for breast size and appearance after the surgery with your surgeon. He will examine and measure your breasts and take photographs of your breasts for your medical record.
Stop smoking well in advance of breast reduction surgery and inform your surgeon about any medications you are regularly taking as these might increase bleeding.
You will receive special instructions about not eating and drinking anything for 8-10 hours before surgery.
After the surgery
You need to have someone to take you home and be with you for the first 24 hours.
Your breasts will be covered with a gauze dressing or bandages. A tube might be placed under each arm to drain any excess blood or fluid. Your surgeon will prescribe medication for pain as well as antibiotics to decrease your risk of infection.
For the first days or week, your breasts will probably feel tender and sensitive. They might also be swollen and bruised. Your surgeon might recommend an elastic compression bra initially to protect the breasts.
While you may be permitted to have a shower a few days after surgery, you may need help getting dressed, as you will not have the full range of motion in your chest and shoulders at first.
Most patients feel ready to return to a desk job within 1 week, after they are no longer taking prescription pain medication. But you will need to limit physical activity for two to four weeks till the incisions heal.
Swelling and soreness may be felt after breast reduction and your new smaller breasts may therefore appear a little larger than you had expected. The breasts often heal at a different rate, so you may notice some asymmetry during the first few months of your recovery.
Risks and complications
Every surgery has its advantages and risks. The risks associated with a breast reduction surgery include the following:
Risks associated with anaesthesia
Risk of developing blood clots, cardiac or pulmonary complications
Asymmetrical position of the nipples
Breast contour and shape irregularity
Excessive firmness to the breast
Changes in nipple and breast sensation that may be temporary or permanent
Need for revision surgery