WHY ARE LARGE BREASTS A PROBLEM?

Some women have problems with asymmetry (one breast much larger than the other) or have very heavy or pendulous breasts. Very large breasts can cause back ache, neck pain and irritation of the skin underneath the breast. It can be hard to find suitable clothes and comfortable bras and certain sports can be difficult. For some women having large breasts can make them very self conscious.

WHO CAN HAVE REDUCTION SURGERY?

Any woman with very large breasts that are problematic can be considered for a breast reduction. The size of a woman’s breasts will largely be determined by genetics but it will also be influenced by fluctuations in weight, pregnancy, breast feeding and hormonal changes. For these reasons, most surgeons advise that surgery is only undertaken when the woman’s breasts have reached maturity (i.e. best not performed on young teenagers) and the patient maintains a stable weight. You may be asked to lose weight to achieve a healthy BMI (body mass index) before surgery is offered.

WHAT IS INVOLVED IN THE OPERATION?

A breast reduction is usually performed under a general anesthetic and takes between 2 to 4 hours. There are a number of different techniques that the surgeon can use. There may be a scar underneath the breast, one around the nipple or even a vertical scar running down from the nipple to join the scar underneath. The choice of operation will be determined by the size and shape of the breasts before surgery and the size that is desired afterwards. You should discuss the options and the exact position of the scars with your surgeon before the operation. Excess skin, fat and breast tissue is removed and the position of the nipple may be moved permanently. Before the operation, depending on your age and fitness, you may have to undergo some simple health checks such as blood tests and a mammogram.

ARE THERE ANY COMPLICATIONS?

There are general risks associated with a general anesthetic such as aspiration of stomach content into the lungs which can cause serious illness or death. Therefore, to help prevent this it is mandatory that you do not eat or drink anything (usually 8 hours) preceding your surgery. Other risks include DVTs, (clots in the veins of the legs) which can break off and travel to the lungs, this is known as an embolus and although very rare, can be life threatening; especially in smokers. You will be encouraged to get up and walk around as soon as possible to reduce these risks. Problems with wound healing and infection can occur particularly in those who smoke and it is therefore advisable to stop smoking before the operation. In most cases the scars will fade, becoming hardly noticeable and would not be visible in normal underwear or swim wear. Scars vary enormously from one woman to the next and some people can have problems with red, raised and lumpy scars. There may be a permanent loss of sensation (normal feeling) in the nipple. After surgery, there may be some asymmetry and there may be further changes associated with future weight fluctuations and pregnancies.

WHAT HAPPENS AFTER THE OPERATION?

You will need someone to drive you home and stay with you the first 24 hours after surgery. When you come round from the anesthetic you will be heavily bandaged and possibly have drainage tubes in place. These assist in your healing process and should only be removed by your surgeon. You may experience some discomfort which should be alleviated by the pain medications. You may have dissolvable stitches but any permanent stitches that are used will need to be removed approximately 10 days after the surgery. You should expect lumpiness and tenderness for some weeks or maybe months after the operation.

WHEN CAN NORMAL ACTIVITIES BE RESUMED?

You will be advised to wear a supportive bra day and night and should not drive or undertake any vigorous activity for up to 6 weeks. Depending on your job, you should be able to return to work 2 to 4 weeks after the operation.

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