Reducing Discomfort and Restoring Confidence
The size of a woman’s breasts is determined by a combination of factors, including genetics, weight and hormonal influences. Disproportionately large breasts can be responsible for psychological as well as physical issues. From a psychological point of view, dissatisfaction with breast size can increase self consciousness and anxiety. Physically, large breasts can cause back and neck pain, grooves in the shoulders from bra straps and rashes under the breasts. Other problems can include reduced clothing choice and discomfort during sport. Women sometimes also try to take postures to disguise or hide their large breasts, again leading to aches and pains from poor posture.
In the case where a woman is unhappy with the shape, weight or droop of her breasts, breast reduction surgery makes the breast smaller and improve the shape.
Types of Breast Reduction
The "Anchor" Breast Reduction
The most common type of breast reduction is the anchor or inverted T reduction. This involves and incision around the nipple, a vertical cut from here down to the crease under the breast (the inframammary fold), and a further incision in the inframammary fold. These incisions form a T or anchor shape.
Relocating the Nipple
A key part of this operation is the relocation of the nipple to a new position. In order to do this, the nipple remains attached on a ‘stalk’ of tissue (pedicle). Extra skin and breast tissue is then cut away. The skin and tissue that is left is reshaped into a smaller, higher breast and the nipple is positioned appropriately.
Is there an alternative?
The primary reason for considering a breast reduction is often the discomfort from large and heavy breasts. Alternative solutions to this issue can include wearing a properly fitted bra and lifestyle changes to lose weight.
What are the scars like?
The latest dissolving stitches are used to close the wounds as they provoke almost no inflammatory reaction as they are dissolved and therefore minimise any scarring. In a breast reduction, the scars run along the skin crease under the breast, with an additional scar running vertically from this fold to the areola (ring of colour around the nipple) which then curves around it.
They usually heal nicely with little redness and start to fade within a few weeks, but as with any scar it may take several months to look its best. In an absolute minority of patients the scars may become red and itchy and form hypertrophic (enlarged) or keloid (fibrous) scars. This may require treatment with silicone patches or steroid injections.
How painful is it?
The majority of the discomfort settles within 24 hours, during this time patients are in hospital and can have very powerful painkillers if necessary. Patients are offered a short course of painkiller tablets on discharge from hospital.
What happens after surgery?
Breast reduction cases are usually a one or two night stay. The wounds are protected with a soft dressing for two weeks after which time the dressings are removed in the clinic and patients can usually return to bathing or showering normally. At three months post-operatively a further routine follow up appointment is made to check that everything is healing well and post-operative photographs are taken.