What breast reduction is
Breast reduction removes part of the gland, fat and skin, then reshapes the breast to a smaller volume and lifts it. The areola is repositioned and usually made smaller.
Very large breasts, caused by excessive growth of the gland (breast hypertrophy) or, in extreme cases, gigantomastia, can cause chronic back, neck and shoulder pain, deep grooves from bra straps, irritation and infection of the skin under the breasts, and difficulty exercising or finding clothes that fit.
Who it is for
- women with chronic pain caused by the weight of their breasts;
- women with repeated irritation or infection in the fold under the breasts;
- women who cannot exercise because of their breasts;
- women whose breasts are out of proportion with their body;
- young women with gigantomastia, once breast development is complete.
Your weight should be stable before surgery. If you are planning a pregnancy, discuss the right timing at the consultation.
The consultation
The doctor assesses the size, shape and symmetry of the breasts, skin quality and the position of the areolas, and discusses the volume you would like. A breast ultrasound or mammogram is recommended before surgery, depending on age. The removed tissue is usually sent for histopathology.
How the operation is done
Breast reduction is done under general anaesthesia and usually takes two to four hours. The most common incision is anchor-shaped (around the areola, vertically down and in the fold under the breast); for moderate reductions, the incision around the areola and the vertical one may be enough. The areola stays attached to the tissue that supplies it and is moved higher. One or two nights in hospital usually follow.
Recovery
- First days: discomfort and tightness; drains may be in place for 1–2 days.
- 2–3 weeks: back to desk work and light activities.
- 6 weeks: a support bra is worn day and night; then sport resumes gradually.
- 6–12 months: the scars mature and the shape settles.
Many women say their back and shoulder pain is noticeably reduced after the operation.
Results
The breasts become smaller, higher and easier to live with. The result lasts, but pregnancy, breastfeeding and weight changes can affect it. Results vary from one patient to another.
Risks and things to know
- permanent scars, which fade over time;
- changes in nipple sensation;
- the ability to breastfeed may be reduced;
- slight asymmetry between the breasts;
- healing problems where the scars meet, more common in smokers and in women with diabetes;
- rarely, partial loss of the areola, especially with very large reductions.
