Why do people have breast reduction surgery?
There are many reasons why women have breast reduction surgery. Some have, what is also known as a reverse mamoplasty, because they suffer irritation caused by uncomfortably large breasts resulting in back and neck pain or soreness due to ‘cutting’ dress or bra straps.

Other women become unduly self-conscious as a result of their breast size and have feelings of depression caused by unwanted attention and comments. This could be made worse by the fact that it may be difficult to find comfortable or attractive clothes that fit. Ultimately most women who want breast reduction surgery are looking to improve their self-confidence and enjoy an improved body shape.

Realistic expectations
You must have realistic expectations about what breast reduction surgery can achieve for you. It will not change your personality or make people treat you differently. Everyone is individual and surgery will not transform you into someone else.

It is critical that you spend time thinking about what you want to achieve from surgery and talk about your hopes with your surgeon. Everyone’s skin and breast type is different and the surgeon will discuss what you can realistically expect to achieve.

What happens during consultation?
The surgeon will examine your medical history and discuss how you want the appearance of your breasts to be changed. Some women usually want a dramatic reduction in size, but this has a considerable impact on the overall appearance of the breast. It is likely that your surgeon will recommend a more moderate change.

The surgeon will also want to know why you want the procedure to gain a complete understanding of what you want to achieve from surgery. It is important that you are completely honest. There is always some scarring as a result of this type of surgery. The extent of this will vary depending on the individual and the positioning of the incisions.

Getting the most out of your consultancy
Often in cases where clients are unhappy with the results of surgery it is because they did not discuss their expectations thoroughly or were afraid to talk about the outcome or risks.

You have to make an informed decision before signing the consent form so make sure you ask plenty of questions. You want to feel relaxed and confident and completely understand what will happen during surgery.

You may want to know:

• About the surgeon’s qualifications.
• How many operations of your procedure are carried out each year.
• How you prepare for the surgery.
• What realistic results can be expected and when.
• How long the results will last.
• About the side-effects and possible complications.
• How long it will take to recover.
• About the extent of scarring and how it will change in time.
• What happens if anything goes wrong.

Preparing for surgery

• Avoid alcohol, aspirin, garlic and food oils a least a week before surgery as they can cause excessive bleeding.
• Do not eat or drink anything six hours before your general anaesthetic.
• The surgeon and anaesthetist need to know your medical history and if you are on any medication.
• You will be advised of any health checks or X-rays required before your procedure.
• Prior to surgery you will be met by your surgeon who will assess and discuss your queries.
• Try and give up smoking a couple of weeks before your procedure as it interferes with healing.
• Bring an overnight bag for your stay and leave your valuables at home.

What happens during surgery?
This depends on the type of procedure you require. However, in all cases you will be placed under general anaesthetic and treated as an inpatient.

Breast reduction involves the removal of excess fat and skin from the breasts through small incisions. The breasts are then reshaped to create smaller breasts and the nipples repositioned to complement the new size and skin shape.

The full details of the procedure and how long the operation takes will be thoroughly discussed with your surgeon.

After surgery

• Your first day is likely to be spent in a recovery room bed being cared for by nursing staff. Your surgeon will visit you and advise you when you can leave.
• The reshaped skin will have to be dressed and may have to be drained after surgery to speed up the healing process.
• Enjoy plenty of rest (you will feel more comfortable sleeping on your back) and avoid any energetic activities that raise your blood pressure.
• You should not drive for two days after the anaesthetic.
• If you have had a drainage tube inserted it will be removed within two days. Bandages are normally taken off after one to five days.
• Avoid alcohol, aspirin, garlic, food oils and smoking. All of these can interfere with the body’s healing processes.
• Any discomfort, bruising or swelling should be treated with a mild analgesic like Paracetamol. Do not use aspirin.
• Your breasts will feel tender for a several days and it is important that you restrict all arm movements (and not drive) during the first 48 hours to help the healing process.

Road to recovery

• Continue taking painkillers if you need them.
• Your breasts are likely to feel lumpy during the first few weeks or even months, but the sensation will settle.
• Do not be alarmed if one breast initially drops lower than the other. Both breasts will find their natural position in time.
• Depending on the type of operation you have, you may not be able to breast feed as the nipples will have been detached from the milk ducts.
• You will need to wear a bra or crop top night and day after the operation for at least 10 days. It should only be taken off when you shower.
• The dressing tapes must be kept in place for 10 days.
• Scars may initially appear noticeable, however in time they will take on the normal skin colour. The extent of scarring should be discussed at the consultation stage.
• Your surgeon will tell you when you can return to normal sunbathing activity.
• It is important to remember that your breasts will not grow again after surgery, but they will fluctuate in size if you gain or lose weight.
• Inevitably there will be some drooping as you continue to age.
• You must contact your doctor if you suffer from an abnormally high temperature, severe pain that is not treated with Paracetamol or if you experience severe bleeding.
• If you are in doubt about any of the post operative effects speak to your surgeon.

All surgery carries an element of risk
Most people believe that the benefits of breast reduction surgery far outweigh the risk. However before you sign the surgery consent form you should be aware of any possible complications and side effects.

Complications associated with any type of surgery include problems healing, the danger of infection and the potential formation of clots that may be life-threatening. Excessive bleeding or bleeding under the skin, known as a haematoma, may require a return visit to the surgery. Some patients may also have an allergic reaction to anaesthetic. In a minority of cases there may be a problem with fluid loss or an excessive build up of fluid that needs to be drained.

Deciding on breast reduction
It is important that you take your time to make an informed decision about surgery. Complications are extremely rare as this is a very common operation, however you must consider any potential outcome.

• After a successful operation you may feel sick due to the anaesthetic and bruises formed by the procedure may take several weeks to heal.
• There will be scars left by the incisions. Scars usually fade but do not necessarily disappear completely. This depends on your skin type.
• In some cases scars may be irritable and red for several months.
• You may lose a sense of feeling in the nipple and the numbness may extend to part of your breast.
• There is a chance that nipples may not be level and that your breasts will feel more uneven than before.
• You may experience some pain and discomfort for a few days and your breasts could feel tender and lumpy for some time after the procedure.
• In extremely rare cases abnormalities of the blood supply may result in loss of part or all of a nipple.

Complications are rare and depend greatly on individual circumstances such as a person’s health and skin type or the extent of the procedure. Your surgeon will be able to explain how the risks apply in your circumstances.