Breast Reduction

Breast reduction is a surgical procedure that aims to reduce the breast size and improve the shape and the nipple position of the breasts. Patients with large breasts might experience neck and back pain, bra strap marks, a rash in the breast fold, difficulty wearing clothes and finding the correct-size bra and low self-esteem.Most of the patients who undergo breast reduction report a significant improvement in their quality of life.

There are different techniques used in breast reduction. The procedure involves lifting the nipple into a better position and removing part of the skin and breast tissue to reduce and shape the breast. As a result, there will be a scar around the areola and a vertical scar running from the areola to the breast fold and this is known as a Vertical scar breast reduction. Sometimes Dr Vourvachis will have to add a horizontal scar along the breast fold and this is known as an ‘Inverted T scar breast reduction’. In patients with very large breasts, the nipple and areola might have to be removed and re-attached as a nipple-areola graft. If this is required, there will be lack of nipple sensation and inability to breast feed. Dr Vourvachis will have a detailed discussion with you about the various breast reduction techniques and the pros and cons of each and will help you decide the one that will give you a result that matches your needs and expectations.

It is recommended that you wait for a minimum of six months following pregnancy and breast feeding before undergoing a breast reduction, as your breasts will continue to decrease in size and if the breast reduction is performed too soon, then your breasts might become too small.

If you are taking any blood thinners such as aspirin, you might have to stop them one week before your surgery. If you are a smoker, you should refrain from smoking for at least 4 weeks before and 4 weeks after the surgery or until the wounds have fully healed. Similarly, you should avoid drinking alcohol at least 4 weeks before and 4 weeks after the surgery. You should check with your GP before discontinuing any of your regular medications.

The operation generally lasts about 3 to 4 hours under general anaesthesia. You might be able to go home the same day or stay for one night and be discharged the following day. If tubes (drains) will be used, they are usually removed the next day before leaving the hospital.

Scars vary in appearance between people and between different areas in the same person. Most of the time the scars heal well and become relatively soft within 12 to 18 months. Sometimes the scar can become thick, pink and lumpy and is called hypertrophic scar or keloid scar. Keloid scars are more common in people with darker skin colour. If these scars develop, they can be managed accordingly. Dr Vourvachis will have a detailed discussion with you about scar healing following surgery.

That depends on the time of your surgery. If the surgery is in the morning, then you will be asked to have a dinner the night before the surgery and drink only water in the morning, about 4 hours before the surgery starts. If your surgery is in the afternoon, then you can eat breakfast 6 hours before and drink water 4 hours before your surgery.. The anaesthetist will also inform you about the timings of your last meal and drink before your surgery.

You should buy two different-size sport bras prior to your surgery. Dr Vourvachis will choose which of the two bras fits you best. Immediately after surgery, you will wake up wearing a sports bra and you will have to wear it day and night for 6 weeks. After 6 weeks, you may start wearing a normal bra however, this may vary between patients. Dr Vourvachis will discuss with you the duration of wearing a sports bra.

It is unusual to send tissue for histological evaluation as it is very rare to find something abnormal in the breast tissue. In case of a family history of breast pathology, Dr Vourvachis will advise you to send tissue for histological evaluation. This will incur an additional cost.

The breasts will be covered with sterile dressings and the sports bra will be fitted on top of them. You will have to keep the dressings clean and dry until your first clinic appointment in 7 to 10 days following surgery. You can take a shower 2 days after the surgery and pat dry the dressings with a clean towel. If the dressings get wet, it is not a problem however, you should avoid getting the dressings in contact with water for a long time.

The risks associated with Breast reduction include discomfort, infection, haematoma (blood clot), reduced or increased nipple sensitivity, loss of nipple sensitivity, nipple necrosis, wound breakdown, delayed wound healing, fat necrosis, thick lumpy scar (Hypertrophic or Keloid scar), breast asymmetry, recurrent breast ptosis, need for further surgery. Dr Vourvachis will discuss with you in detail about the risks so that you are fully informed, even though it does not mean that any of those risk will occur from this surgery.

Three to four weeks after your operation you may begin gentle exercise, but strenuous exercise and work should be avoided for six weeks. You can sleep on your back or side but not on your front for up to six weeks. You can start driving after 2 weeks however, also check with your insurance to be sure. You should be back to your normal daily life activities at six weeks following the operation.

Cup sizes vary between people before and after surgery. It is not possible to guarantee an exact cup size however, most of the patients are happy with the final result. Initially the breasts are swollen and it can take up to six months for the swelling to disappear.It is important to maintain your weight following surgery, as this will ensure a longer-lasting result.

This depends on different factors such as the age and the body weight. If your weight increases, the size of the breasts will also increase. In young patients the breast may continues to grow after breast reduction due to hormonal changes and they may subsequently require a second operation. In women who go through one or more pregnancies the breasts may increase in size thus, requiring a second operation.

That depends on the patency of the breast ducts connected to the nipple and these ducts get cut during the surgery. Therefore, in most of the cases breast feeding is not possible following a breast reduction. Less commonly, women are able to breastfeed following the operation.

The majority of the patients are very satisfied with the final result and the significant improvement of their symptoms. Less commonly, patients develop bad scars and they are less satisfied with the result. The positive impact that breast reduction can have on the patient’s daily life activities can be very significant.