Breast Reduction

Breast Reduction Surgery

What is Breast Reduction Surgery?

Large breasts are a problem for many women and can also be for some men (gynaecomastia). In addition to the cosmetic implications of larger than normal breasts, the functional problems can frequently be debilitating. These can include back and neck pain, skin problems underneath the breast and difficulty exercising. Social embarrassment and depression can result from the public attention that comes with having large breasts, forcing patients to avoid being seen in public.

In some patients there is a marked difference between the breasts and the correction of this difference can be addressed with breast reduction surgery on one side only.

There are many different methods of breast reduction, all having in common the elevation of the nipple to a higher position, the reduction of the volume of breast tissue, with the ‘trade off’ of a degree of scarring on the breast.  Scars are created around the nipple areola disk, and in a vertical line from the nipple to the fold beneath the breast.  In some cases these are the only scars required.  In larger breast reductions, where there is a correspondingly larger amount of skin to be excised, a further horizontal scar may be required beneath the breast.  It is only in extremely large breasts that the nipple skin is removed completely and re-positioned as a skin graft.

Whilst some patients can breast-feed following breast reductions, there is frequently a reduction or loss of this breast function. Careful consideration should be taken if surgery is contemplated before a family has finished growing. Mr Eccles generally advises waiting between 6 months and 1 year after pregnancy and breastfeeding before considering a breast reduction.  During this time the breast gland tissue will usually become smaller.

How long will I need to stay in hospital?

The surgery usually lasts between two and three hours and surgical drains are usually necessary to prevent blood collecting within the breast after surgery. When Mr Eccles is happy that the drainage volume has reduced to an acceptable level (usually after a day or two), the drains are removed and you can be allowed home.

How long does it take to recover after breast reduction surgery?

Although there is some minor discomfort after breast reduction surgery it is not usually painful. There will be some bruising and swelling of the breasts. This has most often settled by two weeks when it should be possible to return to work. Following surgery your breasts will be covered with light dressings which will remain in place for about a week.  The breast is supported by a bra, either supplied by the hospital, or a bra of your choice.  Some 7-10 days after surgery, dressings will be removed and the wounds inspected.  The stitches used are mainly dissolvable.

How long does breast reduction surgery last?

The results are usually life long but, as breast tissue is affected by hormonal manipulation, weight gain and ageing, further procedures may be necessary if a patient’s situation changes.

Commonly asked questions.

1. Complications – As with any surgical procedure there is the possibility of complications which, fortunately, are rare.  Occasionally, a collection of blood can occur within the breast and, if significant within the first 24 hours, may require a small general anaesthetic procedure to remove the blood.  Blood transfusion is not usually required after breast reduction.  One in ten patients will notice alteration in sensation of the nipples following breast reduction.  This is quite commonly seen in the first 3 months after surgery, but for many patients spontaneous recovery takes place.
2. Scars – Delayed healing in scars on the breast or around the nipple may take place.  This is more common in large breast reductions. Very rarely the nipple may partially or completely breakdown after surgery.
3. Breast tissue quality – Lumpiness in the breasts can be seen after surgery and is often associated with internal scar tissue or fat necrosis.  Fat necrosis occurs due to loss of the blood supply to areas within the breast tissue.
4. Late complications – Minor asymmetry of size, volume or shape between the two breasts and the nipple area is not uncommon, as it is difficult to predict how each breast will heal. However, only occasionally do patients require later adjustments.
5. Breast size – It is important to discuss with Mr Eccles the sort of breast size you might seek after breast reduction.  The goal is to achieve a satisfactory breast reduction for each patient and what might be a B or C cup for one person is different for another.  Initially, there is swelling of the breast and the final judgment of new size should not be made for some 6 months.  Subsequent weight changes may have an influence on breast size.
6. Exercise – During the first few days following surgery it is important to balance rest with gentle activity.  You will need help at home for a few days after surgery.  After 2-3 weeks of gentle convalescence most patients are able to return to work.  Vigorous activity should be avoided for up to 6 weeks.