Breast reduction surgery – what does it involve?

Breast reduction surgery is a procedure that reduces the size of a woman's breasts. Women with larger breasts often experience problems, such as fitting into clothes and having trouble exercising without discomfort. Mr Navid Jallali, a top plastic surgeon, explains how breast reduction surgery is performed, the benefits and what happens during recovery.

Who needs a breast reduction?

A breast reduction, or a reduction mammoplasty, is a procedure carried out on women who have a condition called macromastia, or large breasts. There is really no defined size where a woman will benefit from a breast reduction, but mostly women that come to see me often complain that the size of their breasts is interfering with clothing. They find that particularly wearing or finding a bra is difficult, both in terms of size and also that their bra straps dig into their shoulders.

They also tend to have difficulty finding well-fitting clothing, because they may me slim but the size of their breasts is out of a portion with the rest of their body. Lastly, they may also have other physical symptoms in terms of an inability to be able to exercise.

The procedure itself is carried out under general anaesthetic. It takes around two and a half to three hours and most of the patients tend to go home the same day. In terms of recovery from a breast reduction, I use very light dressings and we have developed a particular technique where we stitch, glue and tape the wounds, and that means that most of the patients would be able to shower the day after the surgery and the dressings are then removed at two weeks. At that point, in most cases, their wounds have completely healed. The patients are then required to wear a sports bar for a further four weeks. After that they can go and get measured for a new bra.

What does breast reduction surgery involve?

There are lots of operations that are available in order to reduce the size of the breasts. After a full history and physical examination, I would be able to advise you in terms of which procedure is most suitable. From the simplest end of the spectrum, the operation can involve liposuction. We tend to use this in patients who do not need the breast position changing and who need small decreases in breast volume. This operation is also good in patients who have a tendency to form bad scars.

Most patients who want a breast reduction require a formal breast reduction procedure which involves an anchor shaped scar. The real advantage of this technique is that as well as actually reducing the size of the breast, it can also be combined with an uplift. The position of the nipple can be decided between myself and the patient.

What are the benefits of a breast reduction?

There are lots of benefits to having a breast reduction carried out and I generally tend to think of these as physical and psychological.

In terms of physical, the most obvious benefit is to have the size of the breasts reduced. I generally tend to agree with the patient prior to having the surgery in terms of which size they roughly like to be after the procedure. Most patients find that actually having large breasts has interfered with clothing and exercise, and reducing the size of the breasts allows them to actually wear normal clothes and to be able to do things, like going to the gym.

Other major advantage of having a breast reduction is that often because of the weight of the breast, the shape of the breast is not very attractive, and so by having a breast reduction a much more pleasing shape can be achieved. That shape is also important because most of the bras that are made, are made for a globally shaped breast and by achieving that with a breast reduction procedure, patients then find that it is much easier to find bras that fit them. In terms of psychological benefits, the social stigma is often removed and people find this much, much easier when they interact socially. Lastly, the other benefit, which is often unrecognised, is that breast reduction can also reduce the risk of cancer. We sometimes carry out these procedures in order to remove the breast tissue and this actually reduces the chance of developing cancer as there is less breast tissue available.

Dos and don’ts after breast reduction surgery

There are very few don'ts after this procedure. Most of the patients that are having a consultation for a breast reduction or considering breast reduction are often worried about severe pain after surgery. In fact, the procedure is very, very well tolerated and most patients have the procedure carried out as a day case. The dressings are very light and I have developed a technique which involves stitches, glue and a very, very light tape and that means that essentially patients will be able to shower straightaway. We generally recommend not to do any heavy lifting or exercise for two weeks after surgery.

In terms of do's, we generally tend to advise patients immediately after surgery to take some relatively light painkillers and to wear a sports bra for six weeks after surgery.

How can you reduce swelling after breast reduction?

Swelling and bruising are common things that patients worry about after having a breast reduction. In fact, both swelling and bruising are relatively rare after this form of surgery. There are lots of steps that we take to avoid bruising and swelling after a breast reduction operation. First of all, during the operation we tend to infiltrate the area with a local anaesthetic that has adrenaline in there, and that essentially reduces the bleeding postoperatively. This means that patients can have a light dressing after the surgery that fits easily under a sports bra. Patients are often then given good pain relief immediately after the surgery and this reduces the chance of coughing and pain afterwards and this again helps to stop swelling developing after the surgery.

In general, there will be some swelling within the first six weeks which is why we advise patients not to go and get measured for a normal bra straight away. After six weeks, most of the swelling has fully settled down.

If you are interested in having a breast reduction, make an appointment with an expert.