Plastic Surgery & Reconstructive Procedures

Breast Reduction

Breast
  • About

    Breast reduction surgery reduces the size of the breast, with the goal being to achieve a beautiful, well-formed shape in the end.

    Ladies with large breasts may experience a variety of problems from the weight and size of their breasts, such as:

    • Chronic neck & back pains
    • Breathing problems
    • Severe skin irritations

    They may also experience psychological problems, including feeling too self-conscious that affect many of their daily activities.

    There are different methods of performing a breast reduction: minimal scar/short scar technique, inverted T technique etc. The latter to be discussed at the time of your consultation, as well as possible risks, postoperative courses and concerns.

    This procedure is performed under General Anaesthetic with usually one overnight stay in hospital. The projected initial recovery period is about 12 days.

    The results of a breast reduction are permanent.

  • Potential Risk

    Although uncommon, the following risks are particularly associated with breast reduction surgery. Other risks and complications can occur but are uncommon. Although good results are expected, there is no guarantee expressed or implied on the result.

    • Hematomas – Bleeding after surgery can cause a collection of blood under the skin & breast tissue, but is unusual. This may need further surgery.
    • Infection – The wound becomes red and painful. May need antibiotics or surgery to drain the infection.
    • Change in Nipple sensation – You may experience numbness or increase in sensitivity.
    • Delayed wound healing – Breakdown in the wound edges. It is even possible to have loss of skin or nipple tissue. This is treated with regular dressings until healed or in rare cases further surgery.
    • Firmness – can occur after surgery due to fat necrosis. More likely in patients with very large breasts. The size and shape may be altered. This may require biopsy or additional surgical treatment.
    • Skin scarring – All surgical incisions produce scarring. The quality of the scars vary from patient to patient. Hypertrophic scarring (abnormal enlargement and overgrowth of scar) may occur. Dog ears (elevated tissue at the edge of the scar) can occur.
    • Breastfeeding – About half of women will be unable to breastfeed after a breast reduction. This is unpredictable.
    • Seroma – A collection of the clear portion of blood within the tissue of the breast) May require drainage.
    • Breast asymmetry – Most women have some degree of breast asymmetry. Differences in breast and nipple shape and size may occur after surgery. In rare cases this may require additional surgery.
    • Breast cancer – The breast tissue can be sent to screen it for breast cancer at additional cost to you. There is a less than 1% chance that it may be positive. Discuss this with your plastic surgeon.
    • Unsatisfactory results – You may be unhappy with the size and shape of the breasts after surgery. Recurrent enlargement may occur.

    Any and all of the side effects and risks can result in:

    • Additional surgery
    • Hospitalization
    • Time off work
    • Expense to the patient

More information about precautions, preparations & planning before, on the day & after surgery is listed below.

  • Prior to Surgery
    • Stop Smoking (smoking increases the risk of a complicated recovery).
    • Achieve optimum weight prior to surgery.
    • Do not stop any of your routine medication unless specifically told to do so by the doctor.
    • Typically Aspirin, Ecotrin, St John’s wort, nonsteroidal anti-inflammatories and Arnica tablets and Omega fish oils should be stopped at least 1 week before surgery.
    • Cardiac patients on blood thinners for stents or those on Warfarin require specific instructions and this must be discussed 3 weeks in advance of surgery.
  • Recovery

    The combination of decreased activity and pain medication may promote constipation, so you may want to add more fruit and fibre to your diet. Be sure to increase fluid intake. Movicol may also be used as a stool softener.

  • Activities
    • Start walking as soon as possible. This helps to reduce swelling and lowers the chance of blood clots.
    • Avoid strenuous exercise and activities for 4-6 weeks.
    • Social and employment activities can be resumed in 7-14 days.
  • Incision Care
    • No soaking in the bath while sutures or drains are in place.
    • Avoid exposing scars to the sun for at least 12 months.
    • Apply Micropore to the incision lines for 3 months. Change every 7-10 days. Do not remove the tape every day as it will cause irritation of the surrounding skin.
    • Keep incisions clean and inspect through Micropore daily for signs of infection or oozing.
    • Incision areas must be massaged through the Micropore for the first 3 months.
    • ScarScience, Kelocote or Silderm can be applied from 6 weeks postoperatively, over the Micropore for another 6 weeks, and then on the incision directly for another 3 months postoperatively.
    • Support garments should be worn 24/7, and only removed for short periods while taking a shower. You should wear the postoperative bra day and night for 6 weeks, and thereafter for 6 weeks during the day.
  • What to expect
    • Discomfort will be maximal in the first 3 days, improving each day thereafter.
    • You may experience temporary pain, soreness, numbness, dry breast skin, swelling, discolouration and incision discomfort.
    • There may be a loss of nipple sensation, which should normalise in time (less than 5% of patients never regain nipple sensation).
    • Sagging or enlargement of breasts can occur with the ageing process, pregnancy and weight changes.
    • Scars will fade in several months to a year.
    • Breastfeeding may be possible after a breast reduction, but might be of insufficient volume to support the child.
  • Follow-up care
    • Drains will be removed when drainage is less than 50ml for 24 hours.
    • Most of the sutures are dissolvable in 6-8 weeks.
    • Any stitches will be removed in 7-10 days.
  • When to Call
    • If you have increased swelling or bruising.
    • If swelling and redness persist after a few days.
    • If you have increased redness along the incision.
    • If you have severe or increased pain not relieved by medication.
    • If you have any side effects to medications, such as rash, nausea, headache, vomiting.
    • If you have any drainage from the incisions or notice a foul odour.
    • If you have bleeding from the incisions that does not stop with light pressure.