What is Breast Reduction?
Breast Reduction is a procedure to reduce the size and bulk of the breasts.
Large breasts apart from causing social problems, can cause medical problems like back pain, skeletal deformities and breathing problems. They can also cause personal hygiene problems like a rash or recurrent fungal infections. Such women are candidates for Breast Reduction Surgery or Reduction mammoplasty.
Procedure for breast reduction is similar to mastopexy, but also involves removal of fat and glandular tissue making the breasts smaller, lighter and firmer.
There are 3 age groups of women seeking breast reduction:
- Young women aged 18 to 26 years who come because of social problems
- Women aged 35-45 years who have finished having their families and want to regain normal body contours
- Older women who gain weight after menopause.
Breast Reduction Procedure:
There are different techniques which have evolved over a period of time. Some of the most commonly used ones are:
1.Vertical Scar Technique:
is also called the ‘Short Scar Technique‘. This is a variation of the traditional reduction technique by restricting the scar to only the vertical limb and eliminating the need for the full anchor scar. In this technique and the variations to this technique, initially the lower pole of the breast is flat with more fullness in the upper part. This takes around 3 months to settle down. This method is good for moderate reductions.
2.Inferior Pedicle Technique
The classical method is one which gives an anchor shaped scar that goes around the areola and a vertical scar in the midline, inferiorly and extending on either side into the crease.
Liposuction also called “Scarless Breast Reduction” is done with the use of liposuction especially in young women, lot of fat is sucked out and only a skin reduction can be done thereby reducing the scarring. Good for minor to moderate reductions in fatty breasts. Though initially the breast sag more because they are now empty, over a period of time they shrink owing to the decreased weight and also decreased volume. Hence is it of better value in younger patients with good skin quality.
The procedure, which has been championed by South American surgeons in particular, is the “peri-areolar approach” or the “round block” technique. This procedure can only be used for breasts that require a mild to moderate reduction and where the nipple only needs to be raised approximately 6cms. It is an excellent procedure, reducing the scarring to just around the nipple without the traditional anchor shaped scars which actually run vertical and horizontal in the crease underneath the breasts. So in the smaller breast reductions, the vertical and horizontal scars are completely discarded, leaving only the peri-areolar incision.
In a large breast, however, the vertical and horizontal scars still need to be used. The breasts are still functional by maintaining the duct tissue to the nipple, as only around 20 to 30 % of the ducts and gland is sacrificed even in a formal traditional reduction. The nipple is not cut off and women may still be breast feed after the procedure, though in some cases it might not be possible.
is a more extensive procedure done in cases of extremely large breasts.
Here there is no function of the remaining breast tissue.
The nipple is taken away as a free graft and sutured back on after completion of the reduction and hence no function is retained.
Risks Of Breast Reduction
Scars are the most common problem after breast reduction. The scars are extensive and are visible, though proper care is taken to minimize them. If the procedure is done in younger individuals, after pregnancy and lactation, they might find that the procedure needs to be revised.
Breast feeding may be possible in most of the pedicled techniques but is some cases it may not be possible.
But overall, when done for the proper indications it is a very satisfying procedure providing a lot of freedom and improvement in the quality of life of patients.
Prepare for your Breast Reduction
- Make an initial consultation with your Surgeon. Discuss why you want the procedure done, Openly! We want to know why!
- Discuss any medications your taking with the surgeon.
- Discuss a procedure date and plan for work and holidays. Remember you need reshaping time of two –three months.
- Book your procedure date
- Pay your deposit to book your date (IMPORTANT) because then we know your serious and we get booked out very fast!
- Have your blood tests done and sent to your clinic for the surgeon to check over
- If you are above 30yrs of age, you will require a screening Sono Mammogram before the surgery
- The night before you will most probably be fasting so relax and follow your surgeons instructions
- Drink plenty of water and keep hydrated before your fasting period
- Get a good night’s sleep don’t be worried. You chose us to look after you!
- Shower and make sure you get to the center with ample time so the surgeon can prepare you for your marking and procedure.
- Download print and fill the consent form (link) and bring it with you.
- smoke for about two weeks before and three weeks after the procedure
- Drink alcohol or caffeine at least 48 hours before
- Take any blood thinning medications, such as Aspirin or Advil.
- Be nervous you are in safe and experienced hands!
- Be involved in high impact exercises or activities.
- Arrive at the clinic on time
- Listen to staff instructions
- Stay relaxed
- Settle into your day care room and take before pictures for reference
- Practice breathing – to relax this will prepare you for your pain management
- The surgeon will discuss the target areas with you before taking you into the day care center. He/She will explain any restrictions if there may be.
- Areas for fat removal will be marked with a surgical marker pen.
- The admin staff will go over your consent form and you make the payments
What happens during the procedure
- You will be taken into a clean and sterile OT environment with sterilized instruments.
- The surgeon and his team will check your detail whilst in the OT before the procedure.
- The pain management team will provide you with pain relief according to the treatment plan and the procedure will start.
- Your procedure will take place and finish within the allotted time.
- You will be able to see your extracted fat and measure the amount collected
- You will be moved back to recovery and you will stay till you have recovered fully, eaten something and you are settled.
- The team will look after you till you are ready to leave in the evening
- The surgeon will check up on you.
- You will be given prescription medicines and instructions for your fast recovery.
- walk around and be active as soon as you can on the same day of the procedure
- drink lots of water and be hydrated
- take a shower after removal of the dressing after 4 days from the procedure or as advised.
- Care of the suture line and nipples as advised.
- Come in for follow ups with your surgeon
- Use the creams and oils and meds as advised.
- Eat healthy
- be idle but don’t argue shout or fight.
- Drive first two days
- feel like you’ve had a big procedure and think you need ‘rest’
- drive or operate heavy machinery, lift heavy objects or strain within 2 days of your procedure
- smoke or drink alcohol
What happens next…
- Although breast reduction is a lifestyle procedure it is still a surgical procedure so along with rest and rehydration its imperative that you allow your body to heal in its own time
- the reduction in size noticed immediately but full & final results are seen after 3-4 months as tissues heal. So look after it just like anything else.
- Follow all after care procedures, you will be taught how to oil and massage the breasts to aid healing.
- Apply the scar creams to help the scars settle better
- After your complete healing period. We look forward to seeing you at your last check up, More body confident and happy!
Dr Surindher is a wonderful Doctor, who makes you feel important and who takes time to listen, which most doctors don’t do. Loved him from the first visit! Very professional assistance.