Breast Reduction

As with any breast surgery, there could be a loss of nipple sensation or reduced capacity to breastfeed. If you are planning a breast reduction before starting a family, discuss this with your surgeon to minimise risk.

• Delayed healing or wound breakdown: occasionally despite everything progressing extremely smoothly during breast reduction surgery, and despite your initial dressings proceeding without incident, sometimes we find that at about 3-4 weeks after surgery there may be some problems with wound healing. It is more common in patients who smoke or who have a history of diabetes. Often this seems to occur when patients are not wearing their bra in an environment such as bathing or having a shower. Usually, no further surgery is required and often only a simple clean dressing needs to be applied to the wound until such time as it closes spontaneously. If the area of delayed wound healing is more extensive, we may need to take you back to the operating theatre to close this wound surgically.
• Smoking: because cigarette smoke constricts the small blood vessels within the tissue, smokers have a higher incidence of wound healing problems. In particular, smokers are much more likely to develop wound breakdown and have problems with the viability of the nipple/areola. For this reason, it is extremely important to stop smoking before the operation and for 6 weeks postoperatively.
• Fat necrosis: occasionally fatty tissue within the breast may be damaged during the surgery. Most often this is due to intermittent or transient damage to the blood supply to the fat. When this occurs, the fat may become firm or hard and may be transformed into scar tissue. Clinically we notice this area of scar tissue when it becomes palpable and may be felt as a small lump in the breast. With a better understanding of the blood supply to the breast, fat necrosis is now very uncommon. However, it still does occur, particularly in patients who smoke or in patients who are diabetic.
• Asymmetry: whilst every endeavour is made to ensure your breasts are exactly the same size and shape following surgery, occasionally your breasts will be slightly different to each other. If asymmetry is present it is usually very minor and can be corrected with a minor revision.
• Nipple ischaemia: although the newer techniques make complete nipple ischaemia extremely unlikely, it has been reported for this to occur following breast reduction surgery. The risk of nipple ischaemia is significantly increased in patients who are smokers. It is therefore strongly recommended that you stop smoking 4 – 6 weeks before the operation.
• Body image: altering your breast size will impact upon your body image. It is important that you discuss your ideal breast size at length with your surgeon.
• Bleeding and haematoma (bleeding into the tissues): this rarely requires a return to the operating theatre or a blood transfusion. Aspirin, as well as other non-steroidal anti-inflammatory agents taken up to 2 weeks prior to surgery, even as a single small dose, can increase the risk of bleeding. Multivitamins can also alter your bleeding. Patients on anti-coagulants need specific perioperative management.
• Firmness: excessive firmness of the breast can occur after surgery due to internal scarring. The occurrence of this is not predictable and additional treatment including surgery may be necessary.
• Deep venous thrombosis and pulmonary embolism: there is a small risk that blood may accumulate in the large veins in the lower legs and may clot once the patient starts to move and walk post-surgery. These clots may then move from the calf into the lungs where they may cause severe problems with breathing or occasionally death. The oral contraceptive pill and hormone replacement therapy can increase the risk of deep venous thrombosis. If you are taking such medication, you should discuss this with your surgeon and your anaesthetist prior to surgery.
• Risks of general anaesthetic / surgery: there are other rare risks associated with any general anaesthetic which you will be able to discuss during your consultation with your surgeon, and with your anaesthetist prior to your surgery.

What are the main reasons for having a breast reduction?

• You experience back, neck and shoulder pain due to the weight of your breasts
• Find it difficult to fit into clothing
• You have indentations from bra straps, caused by the large size of your breasts
• You have skin irritation beneath the breast crease
• You experience limited or restricted daily activity and exercise due to the size of your breasts
• You have low or poor self-esteem due to the size of your breasts
• You have experienced larger breasts after breast-feeding and pregnancy.

What is the recovery time for breast reduction surgery?

If you have a job which is not particularly physically demanding or a job in which you are able to minimise the contact hours you may return to work quickly, most patients are able to return to work within 3-4 weeks.

Important note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.