Breast Reduction

Excessively large breasts may inflict upon a patient both psychological as well as physical stresses leading to disruption in daily activity as well as social interactions. In such circumstances undergoing a breast reduction to removed excess breast tissue with resultant smaller, more manageable breasts may be a life changing experience.

It is important that you have realistic expectations when contemplating breast reduction surgery. If you find that your disproportionally large breasts are causing you physical problems such as back pain, neck& shoulder pain, skin irritations or are a hindrance to your physical activity, then you are a good candidate for a breast reduction. Alternatively you may have little physical symptoms but are frequently self-conscious of the size of your breast, find it difficult to find appropriately fitting clothes and feel your life would be easier if your breasts were smaller, then you may consider breast reduction.

During the evaluation expect to be asked about your reasoning behind wanting to undergo a breast reduction. You should be candid regarding the physical and psychological impact your large breasts have on your daily life. You should also be open regarding your expectations. Personal and family history of breast cancer will be discussed as well as your general health, use of regular medications and social habits such as smoking. An examination of your breast will include precise measurements, skin quality assessment and the position of your nipple. Your surgeon will then offer you his evaluation and explain what is safely achievable in terms of a breast reduction with your particular presentation in mind.

Prior to surgery you must carry out a number of test which include a complete blood test, a breast ultrasound but even better to have a breast mammogram carried out, including one after surgery for future reference. Breast reduction is usually carried out under general anaesthesia. There will be incisions around your nipple and most likely the lower aspect of your breast to allow removal of excess fat, breast tissue and skin as well as to lift the nipple to its new position. Rarely there may be a need to carry out a free nipple graft. This means removing the nipple and part of the areolar from its underlying attachments completely and transferring it to a predetermined elevated position. This is usually the case if you have extremely large and/or pendulous breasts. Following tissue removal the breast is reshaped and sutures are placed to hold it together. The skin is closed in layers and supportive bra is applied over wound dressings.

Breast reduction is a rather extensive surgical procedure and carries certain risks that need to be carefully weighed in before deciding if the potential benefits outweigh the associated risks. 

Aside from probable risks associated with general anaesthesia, as with most surgeries there is always a risk of bleeding, haematoma, poor wound healing, irregular scars as well as infection. More particular risks include temporary or even permanent changes to nipple sensation or complete nipple loss, irregularities in breast form and asymmetry of breasts. Other conceivable complications include seroma formation, DVT or pulmonary embolism, fat or skin necrosis –loss- and the potential inability to breastfeed in the future.

Due to any of the above a need may arise for future revisional surgery or hospitalisation.

You will stay overnight following surgery. There will be a drain –plastic tube- coming out of each side, which will collect excess fluid/blood. These are typically removed the next morning before discharge. Your breast will be swollen and will remain so for the first 2-3 weeks, the swelling subsiding gradually. Pain and discomfort typically does not last more than 5-7 days. Your surgeon will prescribe painkillers and any other medication deemed necessary for you. The supportive bra provided will have to be worn for 8 weeks. During the first two weeks you should avoid driving, lifting heavy objects or any sudden movements. Sutures are absorbable but the knots may need removing after two weeks. Exercise should be avoided for the first 6-8 weeks depending on your recovery. Following surgery you are expected to return to us for follow up visits after a week and then again at 2 weeks and 3 months.