Breast reduction (mammoplasty)

Breast reduction (also known as ‘mammoplasty’) is a surgical procedure to reduce the size of large or sagging breasts to more suitable proportions. The surgery involves removing excess breast tissue and skin to reduce the size of the breast. This surgery can help relieve the discomfort caused by large breasts and these can be both physical and psychological in nature, including:

  • back and neck pain
  • grooves on the shoulders from bra straps
  • rashes under the breasts
  • skin irritation
  • altered posture
  • inability to take part in certain sports
  • lowered self-esteem and/or depression
  • lowered self-confidence, especially when trying to find clothes that fit

While many people with larger breasts are content to live with their natural appearance, others choose to use the services of a breast or plastic surgeon to help improve the appearance of their breasts by undergoing breast reduction surgery. Should you be considering this type of cosmetic surgery, it is sensible to talk through your thoughts and feelings with a medical professional and explain your reasons for wanting surgery.

We would be very happy to arrange an initial appointment for you with a surgeon at your nearest Circle hospital, where you will be able to discuss the potential surgical options available to you and ask any questions you have.

There are a number of reasons a doctor may advise you not to have breast reduction surgery, including:

  • Childbirth: If you become pregnant in the future, you should be aware that it may not be possible to breast- after breast reduction surgery. The production of milk for breast feeding can cause the breasts to distend (enlarge or swell) more than normal, and this can stretch the skin as well as cause a break down of the fibrous tissue in the breasts that help to give them support.
  • Weight gain/loss: rapid weight gain and/or loss affects the size of your breasts. Much as a balloon that is inflated and deflated a number of times will become looser, the skin around breasts can become less tight through a cycle of weight gain and loss. Should you currently be overweight, you may be able to achieve a reduction in breast size by exercise and a healthier diet.

As you would expect, all Circle surgeons carrying out cosmetic surgery are suitably qualified and registered with the appropriate professional and regulatory bodies. They would be delighted to meet with you to discuss the suitability of breast reduction surgery for you, and to talk through the implications, things to be aware of and any alternative options available to you. Contact the team at Circle to arrange your appointment, at a time that is convenient for you.

Before the procedure:

It is always important to be fully aware of your reasons for choosing to have cosmetic surgery, and the dedicated cosmetic surgery team at Circle will ensure you have all the information you require about the procedure at every stage. Should you choose to have your breast reduction surgery at Circle, you will have an opportunity to discuss your choice with a plastic surgeon and they will be able to talk you through the choices available to you, explain the surgery they would advise and answer any questions you may have.

You will also require a physical examination, and this gives the surgeon the opportunity to determine the best surgical option for you based on the size and positioning of your breasts, nipples, and areolae, as well as the tone (firmness) of your skin.  

Depending on a number of factors, your doctor may arrange for you to have a mammogram before your surgery. This is an X-ray of the breast and a mammogram carried out in advance of surgery can be useful as a baseline for any further mammograms that may be required in the future.

If you smoke, it is strongly advised that you stop smoking before your breast reduction surgery and during your initial recovery at the very least as smoking can significantly slow the rate of healing.

The procedure:

The operation normally takes between two and three hours and is performed under general anaesthetic, meaning you will be asleep throughout the procedure.

There are various techniques that surgeons can use to perform this operation, and your surgeon will advise you which is the most appropriate in your case. Excess breast tissue and skin is removed through incisions (precise cuts) made in the lower part of the breasts. The surgeon will then reposition your nipples and reshape the skin to ensure your breasts are aesthetically pleasing. Once the surgery is complete, the incisions are closed with internal dissolving sutures. These sutures will usually dissolve within a couple of weeks.

After the procedure:

Once the procedure has been completed, you will be taken from the operating theatre into the Recovery Suite where you will be looked after by the Circle theatre staff until you are fully awake following the anaesthetic. Once you are fully conscious, and the staff are happy with your vital signs (blood pressure, heart rate, oxygen saturation levels etc.), you will be taken back by a porter and nursing staff to your private room to rest.

Throughout the day, Circle nursing staff will check your dressings and monitor your pulse, blood pressure and heart rate at regular intervals to ensure you are well and that your recovery is proceeding as expected. We appreciate that sometimes surgery can be an unnerving experience, and should you have any concerns at any time, day or night, you can simply press a button to call one of the nurses to your room. 

  • Drainage tube: Depending on the exact surgery carried out, you may have a small drainage tube inserted into your breasts. These tubes will have bottles attached to them and are there to drain away any excess fluid from your breasts following the surgery. These will be left in until the excess fluid has been drained and then safely removed before you go home.
  • Hydration: You may have an intravenous (IV) ‘drip’ in one of your arms to keep you well hydrated. Sometimes after an anaesthetic and an operation you will not feel like drinking much, so the IV drip is our way of ensuring you are suitably hydrated. Once you are able to drink suitable amounts of fluid, this drip will be removed.

Wound dressing: You will have wound dressings and a supportive sports-style bra (non-underwired) in place to ensure your breasts are held in the best position to aid and promote healing and recovery. The dressings will be regularly checked by your Circle nurse and replaced as and when needed.

You will be required to stay in hospital for one or two nights to ensure everything is healing as expected. Once you have been discharged back home, you will still need time to recover from the surgery, so it is important that you have planned additional time off work during this healing and recovery phase. The exact time you will need off work will vary depending on many factors, including the job you do, and your surgeon will be able to give you more specific advice.

Following any surgery, you are likely to experience some discomfort; this is completely normal and is to be expected. To help you with this, your anaesthetist will prescribe painkillers to help reduce any potential discomfort and you should take these regularly for the first few days in particular to help your comfort. Excessive pain can slow down your recovery from surgery, so it is important to discuss any unexpected or extreme discomfort with your Circle nurses as soon as possible.

Any surgery will take time to recover from and breast reduction surgery is no different. After a mammoplasty you may experience any, or all, of the following in the breasts:

  • Discomfort
  • Swelling
  • Bruising
  • Hardness
  • Pain or twinges.

These are all completely normal responses to breast reduction surgery and should subside after the first few weeks, although it may take up to 6 months for the shape of your breast to fully settle and for your scars to fade.

  • Driving: You should follow your surgeon's advice regarding how long to avoid driving but you certainly should not begin driving again until you are confident that you can safely perform an emergency stop without experiencing any discomfort.
  • Exercise: You will need to avoid strenuous exercise, heavy lifting, swimming and vacuuming for four to six weeks after surgery. (Although ‘vacuuming’ doesn’t officially qualify as exercise, we hope that you can use this as a good excuse to have a few weeks off doing any!)
  • Support bra: Your surgeon will advise you as to how long you will be required to wear your support bra and whether it is to be worn day and night. You must avoid wearing an underwired bra until you are informed otherwise, as this can affect the shape and positioning of your breasts as they settle over time into their new, optimal post-operative position and shape.

You will receive a post-operative telephone call from our Cosmetic Surgery Specialist Nurse one to two days after your discharge home. This is for them to assess your progress, healing and wellbeing. Should you have any queries or concerns, you will of course be able to discuss these with the nurse during the phone call.

You will also have a post-operative follow-up appointment arranged with your surgeon, where they will be able to determine your progress and give advice on when you can start to resume your normal activities. You should be aware that you will need to take two to four weeks off work, depending on your type of employment.

Breast reduction surgery is a commonly performed and generally safe procedure. However, all surgery carries with it an element of risk and it important you are aware of these.

General risks: Possible complications of any surgery can include:

  • an unexpected reaction to a general anaesthetic
  • excessive bleeding
  • developing a blood clot (usually in a vein in the lower leg, known as a DVT - deep vein thrombosis)

Specific risks following breast reduction surgery:

  • You may experience a change in sensation in different parts of the breast, including the nipple. These areas might have an increased or decreased sensitivity than usual. Any change in sensitivity is usually temporary but can last for up to six months. Occasionally this altered sensitivity can be permanent.
  • You will be left with visible scars following your surgery. Initially they will be red and slightly raised but will gradually soften and fade over the following months.
  • In some cases, it will not be possible to breast feed following breast reduction surgery.
  • Rarely, alterations in the blood supply may result in the loss of all or part of the nipple.

Circle Health offers fast access to a number of modern hospitals across the UK, all featuring state-of-the-art facilities, technologies and diagnostic equipment. At Circle, it is easy to book an appointment with one of our plastic surgeons at a time that is convenient for you.

If you are considering breast reduction surgery, or would like to discuss alternative cosmetic surgery options with a qualified and nationally-registered breast or plastic surgeon, why not book an appointment at your nearest Circle hospital? Our staff will be able to talk you through the options, advise you of the different procedures available to you, and answer any questions or concerns you may have. Contact the friendly team at Circle to arrange an initial consultation that fits your schedule.

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