Cosmetic Surgeons London

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Breast

Procedures

Breast » Breast Reduction

Why choose us for Breast Reduction?

Many ladies have breasts which are out of proportion to the rest of their bodies. The majority of these ladies suffer from many problems which interfere with their quality of life on a day-to-day basis and often do not seek help for a number of reasons. Here at Cosmetic Surgeons London help is available for all ladies suffering with the problems associated with large breasts. Breast reduction is a procedure to reduce the size of your breasts and change their shape.

Cosmetic Surgeons London offer corrective (revisional) surgery for failed breast reduction operations. Usually a correction after a failed breast reduction involves several operations and the best result is often not as good as a first time successful breast reduction. Therefore please choose your original plastic surgeon carefully!

Is breast reduction surgery for you?

  • My breasts grew after puberty and did not stop.
  • My breasts enlarged after pregnancy
  • My breasts were always different sizes
  • My breasts became different after surgery
  • My breasts have become droopy with time

If you answered "yes" to any of the above questions then you maybe suitable.

Problems experienced due to large breasts (macromastia or gigantomastia)

Physical
  • I get pain in the shoulders and neck area due to the weight on the bra straps
  • My breasts get in the way when doing physical activities
  • My breasts become sore and sweaty underneath and between them
Psychological
  • Attract unwanted attention: "men look at my breasts not at me"
  • I am unable to look good in clothes or find clothes to fit me

Where will the scars be after breast reduction surgery?

There will always be scars after you have had breast reduction surgery and the exact location of them will depend on which surgical technique is used. However, there are methods of minimising these. Always be sceptical if any surgeon talks you about scar-less surgery. One of the techniques used by your surgeon involves a scar that lies at the junction of the areola (the area around the nipple) and skin and then travels vertically down into the crease under the breast (infra-mammary fold). The scar resembles the shape of a lollipop. This technique is known as the "vertical scar" or "minimal scar" breast reduction and can be employed in suitable ladies. Your surgeon will decide whether this technique is suitable for you and depends on a number of factors such as patient age, skin quality and breast size. In circumstances where this is not possible there is an additional scar that joins the "lollipop" scar to lie in the infra-mammary fold. The scar therefore looks like an anchor or "inverted-T". The lower part of this scar is hidden beneath the natural lower curve of the breast. The scars fade over many months and you will be provided with excellent scar management advice. Here at Cosmetic Surgeons London we ensure that the most optimal technique will be used for your breasts and we aim to create soft, natural looking breasts which will improve your quality of life.

Will I be able to breast feed after surgery?

The answer often is yes. However, this is never a guarantee and the milk flow may be altered in some form.

You (the Patient's) Journey

Before the operation

You will have seen your surgeon on more than one occasion to fully answer all your questions. It is important to avoid medications, if possible, such as aspirin and non-steroidal anti-inflammatories (NSAIDs) e.g Ibuprofen (Nurofen), Sodium Diclofenac (Voltarol) for 1 week before surgery. These tablets may increase bleeding during and after surgery. It is advisable to stop smoking 4 weeks before and after surgery from both a wound healing and an anaesthetic perspective.

The operation

You will be admitted to hospital on the morning of surgery and your surgeon along with his consultant anaesthetist will come and discuss the surgical plan again with you and make some marks on your skin with pen. You will be required to have a general anaesthetic. The operation will take approximately 2 - 3 hours. Your surgeon will reduce the volume of your breasts, re-shape your breasts and lift the nipple to a more aesthetic position on your breast. All the stitches used will be dissolving in order to maximise comfort for you. Stitch removal may cause discomfort for some patients. Cosmetic Surgeons London always puts your comfort first. You will wake up with dressings in place before being taken to the ward. A drain may be used. In general, for a breast reduction you will stay in hospital overnight. You will need to have a friend or family member to drive you to and from the hospital and to look after you for the first 24-48 hours following surgery.

Recovery

You will experience some degree of bruising, swelling, and discomfort all of which improve by the day. Our consultant anaesthetist will prescribe you adequate medication to take home to alleviate any discomfort you may experience. You are encouraged to walk around the ward as soon as you feel up to it. It is important not to get the dressings wet after surgery and you will be advised on showering. Depending on your type of work, you may return to work between 7-14 days after your procedure. No heavy lifting or strenuous exercise for 6 weeks. It will take approximately 3 months before the swelling completely subsides and the final size seen. The scar will continue to improve for up to 18 months and you are encouraged to firmly massage the scar after 4 weeks. Your surgeon will see you 1 week after surgery at which point the dressings will be reduced and again at 2 weeks. At 2 weeks the stitches, which are dissolvable, will be trimmed flush with the skin so they cannot be seen. All dressings will be discarded at this stage. Your surgeon will closely follow your recovery to ensure you are able to resume normal exercising and activities. It is suggested you wear a sports support bra for 6 weeks.

In the majority of cases, our patients are extremely happy with their results and go on to lead transformed lives. There are some potential risks which you need to be aware of. All risks tend to increase in those patients who are overweight and smoke in the 2 weeks before and after surgery.

Safety and potential complications?

Scars

Scarring on the whole is not problematic. A scar will be visible but in the majority of patients fade with time. Certain individuals e.g. afro-carribean races and red haired individuals are at a higher risk of forming excess scar tissue (keloid or hypertrophic scars). Should these scars develop excellent advice and treatment will be provided by your surgeon.

Infection

This is an uncommon problem in breast reduction surgery. However, antibiotics are given during the operative procedure.

Nipple Sensation

Most ladies experience a reduction in the sensation around the nipples following breast reduction. Nipples can become over sensitive in some patients. In the majority of patients there will be some form of altered sensation.

Delayed wound healing

Occasionally some of the areas take longer to heal than usual. An area which tends to be affected in this way is the "T-junction" (where the vertical scar meets the horizontal scar in the breast crease) due to a number of reasons: the skin is thinner here, the entire breast weight places tension on this area during the course of healing. Treatment involves skilful dressing changes by the nurse and often this heals by its own accord.

Asymmetry

Rarely are anyone's breasts identical and often there are degrees of asymmetry. We certainly aim to create maximum symmetry.

Bleeding

Rarely, small blood vessels that have been cauterised during surgery open up afterward. This results in a collection of blood (haematoma) that needs to be removed. This involves a return to the operating theatre where the blood collection is washed out and the breast sutured back. There are no permanent side effects due to this and your ultimate breast shape will not be affected.

Areola and nipple necrosis

Rarely, part of the areola or nipple may lose its blood supply during the process where the nipple areola complex is moved. The risk of this is very low.

Fat Necrosis

After the operation, over the ensuing weeks tender firm areas may be felt in parts of the breast. These are referred to as fat necrosis and the majority of these smooth out over time.

Deep Vein Thrombosis (DVT)

Any general anaesthetic procedure is associated with a small risk of DVT which can potentially move to the lungs (Pulmonary Embolus). Here at Cosmetic Surgeons London we attempt to minimise this risk by the use of compression stockings before and after surgery, use of pneumatic compression devices during surgery and motivating the patient to mobilise as soon as possible after surgery.

Useful Sources of Information for Breast Reduction

Overall, ladies undergoing breast reduction are extremely satisfied with their eventual result and can continue to enjoy an improved quality of life after surgery.

Summary

Operation Time 2 - 3 hours
Anaesthetic General Anaesthesia
Nights in hospital 1 night
How much time off work? 1-2 weeks
When can I exercise? After 6 weeks

Cosmetic Surgeons London always puts your comfort and safety first!

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