An expert insight into breast reduction surgery

Breast reduction surgery, or reduction mammaplasty, is a major operation that removes tissue, skin and fat from the breasts, followed by reshaping or uplifting of the breasts in some cases.

Here, Miss Philippa Jackson, renowned consultant plastic surgeon and certified cosmetic surgeon, provides a comprehensive insight into breast reduction surgery, including patient criteria and surgical techniques.

What criteria or factors determine a candidate's suitability for breast reduction surgery?

Suitable candidates for breast reduction surgery include:

• Patients who have realistic expectations
• Patients who are non-smokers, including no vaping
• Patients who have a BMI of 30 or less
• Patients who request a reduction in breast size, and don’t mind having scars on the breast around the nipple-areola complex (NAC) and on the front of the breast
• Patients who aren't fixed on breast size based on bra size
• Patients who accept trade offs - for example, being able to go smaller if they accept the increased risk of nipple loss or loss of shape that comes with it

Could you explain the surgical techniques commonly used in breast reduction procedures?

In breast reduction surgery, there are three key areas to consider: blood supply to the nipple, removal of breast tissue, and skin closure.

There are a variety of different surgical techniques available, which should always be tailored to each patient. These techniques will predict where the scars will be and what the residual breast shape will be.

Patients who undergo breast reduction surgery may either have a vertical scar reduction technique, or, an inverted T or anchor shaped scar techniques. It is possible to combine any nipple supply and breast tissue resection with these scar patterns.

Blood supply is very important. Thus, all surgical techniques are also designed to preserve the best blood supply possible during the operation.

Are there any long-term considerations patients should be aware of after surgery?

After breast reduction surgery:

• There are permanent scars on the breast
• The altered sensation of the breast and the NAC may affect sexual function
• Bottoming out is a risk because the skin naturally relaxes holding up the weight of the breast
• There’s no increased risk of breast cancer
• There’s an increased risk of recall after a mammogram because of internal scarring

Later on, the breasts will drop - we can’t predict when this will happen nor to what extent. Any weight change will also impact the breast’s appearance.

What are the potential benefits of considering the quality of life for patients after surgery?

Immediately after surgery, patients may see slow healing and fat necrosis, so it’s important to be fairly pragmatic and take a longer-term view. Importantly, patients who undergo breast reduction surgery should be aware that they won’t be able to go bra-less after surgery.

In terms of benefits, none are guaranteed, but there’s a potential improvement in quality of life after surgery.

This improvement may be due to various reasons, including:

• Finding it easier to buy underwear and clothing that fit
• Seeing an improvement in back pain
• Hopefully, feeling more confident

If you’re considering breast reduction surgery and you would like to consult your options, don’t hesitate to book an appointment with Miss Philippa Jackso via her Top Doctors profile today.