Many women requesting this surgery are troubled by the heaviness and the droopiness of breasts. They may occasionally lead to other symptoms like: neck pain, upper back pain, shoulder discomfort and rarely skin infections under the breasts. It should be emphasised that breast reduction should not be considered as a shortcut to weight reduction. In fact, if the body weight is disproportionate to the patient’s height (the body mass index over 30) it is advised not to embark on a breast reduction surgery. Studies have shown that there is an increased risk of wound infection, delay in healing and other risks from the anaesthesia in such patients requesting breast reduction surgery. In appropriately selected and counselled patients this is a very rewarding procedure and the patients notice a significant improvement in their lifestyle and ability to choose and wear more appropriate clothing. It must be said that for some women who feel that their breasts are heavy, an appropriate bra fitting itself may remove the symptoms and they may never require an operation.
Breast reduction may involve reducing the breast tissue in addition to removing a proportion of the breast skin. There are multiple approaches to get this result. They also result in a differing extent of scarring but almost all of them will require the nipple/areola complex to be elevated to an appropriate position.
The two common techniques of breast reduction result in an inverted ‘T’ shaped scar or a ‘lollipop’ type of scar. The surgery is usually performed under general anaesthesia. The procedure may take between 2-3 hours. Patients usually stay overnight in the hospital and may or may not require a drainage tube further to the surgery. As most of the scars are placed on the under surface of the breast it is best to avoid under-wired bras for at least six weeks after the surgery. A supportive sports bra is usually comfortable but there are designer support garments available for this procedure.
For a few weeks to months after this operation, the breasts may appear slightly ‘top heavy’. With time – and the continuing effect of gravity – the breasts would gain some droop and come more close to a natural shape.
In a T shaped scar technique, the junction is likely to experience some delay in healing – requiring additional dressings. Heavy smokers carry a higher risk of this complication. It is best to avoid or minimise smoking for at least 2 weeks before and after the operation.
Rarely, the nipple/ areola may not heal well due to relative lack of blood supply. This usually occurs in women with excessively large / droopy breasts and in heavy smokers. Some women may also experience a lack of nipple sensation – most, however, regain this in a few months. Some may be left with a long term numbness of the nipples.