Breast reductions and uplifts: what to expect

Breast reductions and uplifts are sometimes done due to cosmetic reasons. In the case of a breast reduction, this may be carried out to reduce back pain.

For women considering either of these procedures, it is recommended to read up on what to expect from these surgeries.

We spoke with the highly experienced senior consultant plastic reconstructive & aesthetic surgeon, Miss Judith Hunter, to find out what exactly these procedures can achieve. We found out information on the process of these operations, the risks and what aftercare is necessary.
 

What is the aim of breast reduction or uplift?

Breast reductions and uplifts – also called mastopexy - are different types of the same procedure.

Both cases change a droopy breast with a low nipple for an uplifted one with a higher nipple. This can only be achieved by placing scars on the breast. A breast reduction involves lifting the nipple, the nipple is kept alive on a column of tissue inside the breast, wedges are taken out of the breast skin and tissue to reduce the volume and reshape the breast. An uplift or mastopexy involves lifting the nipple in a similar way; it may only involve reshaping the breast not reducing the volume but tightening the skin around it.
 

There is always a scar all around the nipple. Depending on the shape and size of your breast to start with and what you are hoping to achieve, there are often other scars. There may be a vertical scar from the lower edge of the nipple to the fold underneath the breast and a horizontal one in the fold itself. These make an ‘anchor’ shape or ‘inverted-T’ scar. A mastopexy may be combined with an implant to enlarge, as well as uplift, the breast; this is called an augmentation mastopexy.
 

What to expect from the procedures?

A breast reduction or mastopexy is performed under general anaesthetic and takes 2 - 3 hours. A general anaesthetic means you are fully asleep. You must not eat or drink anything other than water for 6 hours beforehand. You can drink water only from 6 hours up to 2 hours beforehand. You will have a pre-op assessment, and occasionally, blood tests are taken.
 

A mastopexy may be performed as a day case, but usually, a breast reduction will be an overnight stay. Drains are usually used and kept in overnight. Miss Hunter will see you after the surgery, and usually, the drains are removed the following morning and you can go home. Your supportive bra will be fitted at the end of the operation, and you will need to continue to wear it for six weeks, day and night. You will be walking straight away afterwards. You should expect to take 1 - 2 weeks off work, and you will need to avoid heavy lifting or upper body work at the gym for a month.
 

You should also not drive during this time. Usually, we will arrange for you to be seen by the nurse for a wound check at one to two weeks after the surgery and I will see you then at around six weeks after the surgery.
 

What are the post-operative instructions?

You will be able to walk straight away, but you need to avoid excessive upper bodywork (as explained above) for one month. You can remove your supportive bra to shower but should otherwise wear it at all times, including sleeping in it at night.
 

You will be able to shower straight away - there will be dissolving sutures underneath the scars, which will be waterproofed with glue and covered with tape. After showering, pat the tape dry with a clean towel or dry it with a hairdryer in a cold setting. Do not remove the tape - we will do this at your first clinic appointment a week after the surgery.
 

Do not soak in a bath for a minimum of 2 weeks - the wounds need to be completely healed first.

Avoid swimming for six weeks. At your first clinic review, we will check the wounds and then retape them. At this stage, you can keep showering and drying as above. The tapes will then slowly peel off and can be trimmed if needed. Once all the tape has come off - usually at 2 - 3 weeks, and all the wounds have healed, you can start to moisturise and massage the scars. This can be done twice a day with any moisturiser that suits your skin. After six weeks, you no longer need to wear the bra at night and can be fitted for a normal bra, but it is advisable to avoid under-wires until three months after surgery.
 

What complications can occur due to a mastopexy?

There are some complications that, although they are rare, can occur specifically because of a mastopexy:

• asymmetry of the breasts
• seroma
• wound breakdown
• dog ears – pleats at the end of scars
• fat necrosis
• inability to breastfeed or difficulty breastfeeding
• changes in nipple sensation
• nipple loss or nipple necrosis
   

Aside from these, other complications can also occur from general anaesthetic (although there is a low risk), which can include:

• blood clots
• chest infections

Like any surgery, there is a risk of post-operative pain, infection or bleeding.
 

If you are considering a breast reduction or breast uplift, we recommend booking an appointment with a leading consultant plastic reconstructive and aesthetic surgeon such as Miss Judith Hunter. Visit her Top Doctors profile today for information on appointment availability.