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Breast Reduction is a surgical procedure to reduce and re-proportion large breasts. Women with large breasts have a variety of symptoms including:

  • neck/back pain
  • bra-strap shoulder grooves
  • difficulties with exercise and clothes-buying

The female breast is a modified sweat gland, the prime function of which is milk production. Present at birth the bud grows during puberty, sometimes markedly, due to the hormones oestrogen and progesterone. It is usual to experience enlargement during pregnancy and breast-feeding and they diminish both afterwards and naturally with age – a process known as involution. Breasts are also influenced by general body habitus eg., obesity.

More questions about breast reduction?

+PRE-OPERATIVE CONSULTATION

As you must be fit for surgery a comprehensive consultation is required to not only assess your wishes, but fitness for what is a moderately long procedure. Fundamental are your aims and expectations. Any compromises will be explored and discussed in detail. Smoking must be ceased both before and after any operation. You must also declare all medications, particularly any affecting bleeding (eg., aspirin) or clotting (eg., oestrogens). You will be questioned about your breast health and any family history: with breast cancer now occurring in 1-in-8 a mammogram is recommended prior to surgery with any family history, specific concerns or age > 50 years.

+OPERATIVE PROCEDURE

Breast reduction requires general anaesthetic (GA) and an overnight stay to allow monitoring of the nipple-areolar complex (NAC) blood supply by the nursing staff.

Whilst an incision around the areola (‘periareolar’) will always be required, most require a vertical component too – the ‘vertical scar’ (or lollipop). In anything more than a small reduction, an incision in the under-breast crease will also be required This is known as ‘anchor-’ or ‘Wise-pattern’.

+POST-OPERATIVE ADVICE

Whilst normal light activities are recommended immediately afterwards strenuous exertion should be avoided and it will be 6 weeks before the gym. It is also be wise to arrange some help for a week or two if you have young children. There will be some discomfort, but you will be provided with analgesia and regular paracetamol is very effective: note that many strong painkillers can make you constipated.

There are procedure-specific instructions that should be followed for your benefit, but the dressing should be left dry and undisturbed until review at one week. Overall healing and recovery time is around 4 – 6 weeks.

+RISKS AND COMPLICATIONS

Breast reduction has an high degree of patient satisfaction, but like any operation carries the risk of potential complications, which are rare with modern techniques. Particularly important are your own expectations as to whether the operation can achieve the result you desire and at what cost of scarring and individual risks.