Breast reduction surgery: The complete guide

Breast reduction surgery, also known as reduction mammaplasty, is a common surgical procedure designed to alleviate the discomfort associated with overly large breasts.

Here, Mr Andreas Shiatis, renowned consultant plastic surgeon, provides answers to common questions about breast reduction surgery, including the consultation process, the procedure itself, and the expected results.

Who is a candidate for breast reduction surgery?

A candidate for breast reduction surgery often experiences physical discomfort or emotional distress caused by overly large breasts. Specific criteria include:

• Chronic persistent pain in the back, neck, and shoulders.
• Skin rashes or irritation under the breast crease.
• Physical activity limitation due to breast size.
• Self-consciousness or psychological distress about breast size.
• Poor posture resulting from the weight of the breasts.
• Shoulder indentations from bra straps.

Candidates should be in good overall health, not smoke, and have realistic expectations about the surgery’s outcomes.

What can I expect during the initial consultation?

The initial consultation is a crucial step in the breast reduction journey. During this appointment, the plastic surgeon will discuss your medical history, including any previous surgeries, medical conditions, and current medications. A physical examination will be performed to assess your breasts' size, shape, and skin quality.

In addition to these assessments, the surgeon will talk with you about your goals and expectations for the surgery. They will explain the details of the breast reduction procedure, including the techniques used and what to expect during recovery. Potential risks and complications of the surgery will also be discussed.

This consultation provides an opportunity for you to ask any questions or express any concerns you may have. It helps the surgeon determine the best surgical approach for your individual needs and ensures you are fully informed about the procedure.

How is breast reduction performed?

Breast reduction surgery involves the removal of excess breast fat, glandular tissue, and skin to achieve a breast size more proportionate to your body and alleviate discomfort.

The procedure typically begins with the administration of anaesthesia to ensure your comfort during the surgery. Options include intravenous sedation or general anaesthesia, depending on what is most suitable for you and the specifics of the procedure.

During breast reduction surgery, several small incisions are made on the breasts. The pattern of these incisions will vary depending on the technique used and the desired amount of reduction. This step is crucial for providing the surgeon with access to the necessary areas while minimising visible scarring.

Following the incisions, excess breast tissue, fat, and skin are removed to reduce the overall size of the breasts. The nipple and areola are repositioned higher on the chest to achieve a more natural placement. After repositioning, the remaining breast tissue is shaped to achieve a natural contour. This step is essential for ensuring that the breasts look symmetrical and proportionate to the patient’s body.

The incisions are closed with sutures, skin adhesives, or surgical tape, depending on the surgeon’s preference and the specifics of the procedure. Finally, bandages and dressings are applied to support the breasts as they heal, helping to minimise swelling and protect the surgical area from infection.

What techniques are used in breast reduction surgery?

Several techniques are used in breast reduction surgery, each with its own advantages and suitability depending on the individual case. Common techniques include:

• Anchor (inverted T) incision: Involves three incisions: around the areola, vertically down from the areola to the breast crease, and another horizontally along the breast crease.
• Vertical (lollipop) incision: Involves two incisions: one around the areola and another vertically down to the breast crease.
• Liposuction: Removes excess fat through small incisions using a thin tube (cannula) and suction.
• Circumareolar (doughnut) incision: Involves an incision around the edge of the areola.

The choice of technique depends on factors such as breast size, the amount of tissue to be removed, skin elasticity, and patient preference.

What are the potential risks and complications?

Potential risks and complications include infection at the incision sites, excessive bleeding during or after the surgery, and permanent scarring at the incision sites. You may also experience temporary or permanent changes in nipple or breast sensation, differences in breast size or shape post-surgery, and delayed healing of the incisions.

Surgeons take several steps to minimise these risks. We begin with a thorough pre-surgical evaluation to assess your health and suitability for the procedure. During the surgery, we use sterile techniques to prevent infection and employ precise surgical methods to minimise tissue damage. After the surgery, detailed post-operative care instructions are provided to promote healing.

When will I see the final results of my breast reduction?

The final results of breast reduction surgery will not be immediately apparent due to post-surgical swelling and bruising.

Initially, you will notice a difference in breast size and shape immediately after surgery, but swelling and bruising will obscure the final outcome. Over the span of 12 months, the breasts will settle into their ultimate position and shape as scars progressively fade and soften.

It's important to follow your surgeon’s post-operative care instructions and attend all follow-up appointments to ensure optimal healing and results and address any complications promptly.

To schedule an appointment with Mr Andreas Shiatis, head on over to his Top Doctors profile today.