1.5 to 3 hours
1 to 2 nights
6 - 12 months
A breast reduction, also known as a reduction mammoplasty, is a surgical procedure that aims to reduce the size of the breasts. It is important to have a good understanding of the surgery before you have the operation. This overview provides a short introduction to breast reduction surgery, preparation, and aftercare.
1.5 to 3 hours
1 to 2 nights
6 - 12 months
You may consider having a breast reduction if your breasts are causing you discomfort, or you are unhappy with the size and shape of your breasts.
A breast reduction can help to:
This procedure may also be done if the breasts are causing unpleasant physical symptoms including:
Your surgeon may suggest combining your breast reduction with an uplift, and/or nipple and areola reduction. Combining a breast reduction and lift aims to achieve a more aesthetically pleasing result.
When searching for a plastic surgeon to perform your breast reduction, make sure you choose one that is a member of either BAAPS or BAPRAS. BAAPS (The British Association of Aesthetic Plastic Surgeons) and BAPRAS (The British Association of Plastic Reconstructive and Aesthetic Surgeons) are the two leading societies for plastic surgeons in the UK. Surgeons belonging to these societies receive regular training which keeps their surgical and patient communication skills up to date.
We strongly advise that you check if your surgeon is a member of either BAAPS or BAPRAS before booking a procedure.
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Anyone unhappy with the large size of their breasts may benefit from breast reduction surgery. Although some patients choose to have this procedure done for cosmetic reasons, many choose to have it done to mitigate the unpleasant physical symptoms they experience because of heavy breasts.
Physical complaints caused by large breasts include:
A breast reduction can also be done for cosmetic reasons. For these patients, a breast reduction can address complaints such as:
Ideal candidates are physically and emotionally healthy before surgery. Pregnant or nursing people should not have breast reduction surgery. If you have recently given birth, you should wait 3 to 6 months before having breast surgery and ensure you are done breast feeding. Breast reduction surgery can impact or impede your ability to breast feed, so it is an important factor to consider before booking your procedure.
Optimising general health can increase suitability for breast reduction surgery. You can achieve this by doing regular exercise, reducing alcohol intake, eating a healthy diet, and stopping smoking or any nicotine use.
Breast reduction surgery aims to:
In many cases, breast reduction also includes breast uplift (mastopexy). Combining these two treatments can create a better aesthetic result. Whether or not your surgeon suggests including breast uplift to your treatment depends on how much smaller you want your breasts to be. Generally, smaller reduction amounts do not require a breast uplift.
Keep in mind your surgeon will be able to tell you during your consultation the specific details of what a breast reduction can achieve for you.
A breast reduction requires your surgeon to make incisions on each breast to remove breast tissue and skin. The type of incision your surgeon uses is separate to the technique they will use to remove the excess tissue. This means there are many different procedures your surgeon can choose from in order to get you results catered to your body and results you want.
Breast tissue contains ducts and glands that produce milk, so removing parts of this tissue may impact breastfeeding. Your ability to breastfeed after healing is determined by the methods your surgeon uses to remove the excess tissue, and the overall amount of tissue removed.
The incision technique used during surgery does not greatly affect breastfeeding, but it does determine the final appearance and shape of your scar.
Before surgery, you will have at least one appointment with your surgeon, generally called a consultation. During this appointment, they will decide the best way to proceed with your breast reduction surgery, including the best way to give you the results you're looking for.
There are many physical factors your surgeon will use to determine the best possible methods and techniques to use during your breast reduction surgery:
Either on the day of your surgery or during your pre-operative assessment for your breast reduction surgery, you must sign a consent form. This consent form is a legal document that signals you have given your surgeon permission to proceed with surgery and their overall treatment plan. Your surgeon and anaesthetist will meet with you when you are given this document and discuss its contents as well as the procedure. The surgeon and anaesthetist are also required to sign the consent form.
Before the surgery, your surgeon and you will decide which type of anaesthetic is right for you and your breast reduction surgery.
General anaesthetic numbs the entire body and places you in an unconscious state. It can take up to two days for you to recover from the side effects of general anaesthetic which include problems with memory and coordination. If given genera anaesthesia, you will need to have adult supervision for up to 24 hours after you are discharged from the hospital because of these after-effects.
Local anaesthetic is usually combined with intravenous (IV) sedation for surgeries like breast reduction. Local anaesthetic involves only numbing a small, localised part of the body where the procedure is performed. This type of anaesthetic causes far fewer side effects when compared to general anaesthesia, though patients have been known to hurt themselves while the drug is still working because they are unable to feel any pain. This is why it is important to move carefully and slowly for the first hours after any procedure that uses local anaesthetic.
On the day of your surgery, your anaesthetist will give you your anaesthetic, and you will be taken into the operating theatre for your breast reduction.
Your surgeon will begin by making incisions on each breast. The type of incision they use depends on how much excess skin you have.
Below is a list of incisions your surgeon may use during your surgery:
This incision is made around the full circumference of the areola. This is the least invasive incision type and can only remove a small amount of tissue. This is therefore the most appropriate incision type for breast reductions where only a small amount of tissue will be removed.
This incision cuts around the areola, and then down to the crease where the breast meets the torso. This allows more access to the underlying breast tissue compared to the donut incision type. Surgeons use this incision for breast reductions that remove a small or medium amount of tissue.
This is the most common incision used for breast reductions. The inverted-T incision allows for the greatest access to breast tissue and is most appropriate for breast reductions where a large amount of tissue will be removed.
After your surgeon has made the incisions, he will remove breast tissue to decrease the size of your breasts. There are three popular techniques commonly used in breast reduction surgery. Keep in mind that each of these techniques will affect nipple sensation and ability to breastfeed in different ways.
Tissue removal techniques include:
A pedicle is a surgical technique that aims to preserve the blood supply and nerve connections of areas of the body moved (not removed) during surgery. Keeping tissue connected to its blood supply gives it an advantage during healing and reduces the likelihood of complications like necrosis. Surgeons commonly keep the nipple and areola attached to a pedicle during breast reduction surgery to make sure they stay connected to their blood supply, nerves, and milk ducts while the excess breast tissue is removed. This allows for better preservation of nipple sensation and a higher likelihood of successful breastfeeding once the breasts heal, especially when compared to free nipple grafting.
The two most popular pedicle techniques are the inferior, and the superior as described below.
The nipple and areola are attached to a pedicle in the lower portion of the breast where there is a large nerve supply. This means breast tissue is removed from the upper portion and sides of the breast.
In combination with an anchor skin incision, this method is the most popular pedicle technique among surgeons. It is very useful for breast reductions where a large amount of breast tissue is removed.
The nipple and areola are attached to a pedicle located above the areola in the top of the breast. Keeping the nipple and areola attached to the top portion of the breast allows for tissue to be removed from the bottom and sides of the breast. This technique is most often combined with a lollipop incision.
The free nipple graft involves the surgeon removing the nipple, removing the underlying breast tissue and then stitching the nipple back on. Surgeons do not commonly use this method as there is poor preservation of nipple sensation and the ability to breastfeed is completely stopped.
After your surgeon removes the excess breast tissue, they will close the incision with stitches. Often drains will be placed in the breasts to reduce swelling. These will be removed after a few days. Once stitches and drains are placed, the chest is bandaged and the surgery is finished.
You will go back to the ward to recover from anaesthesia after your breast reduction. As this procedure is quite invasive, most patients will need to stay in hospital for one or two nights.
Your breast reduction procedure may also include a breast uplift. Surgeons often combine these two procedures to help achieve a better result. Choosing a highly skilled Medbelle BAAPS/BAPRAS surgeon will ensure you get the best results from surgery.
Your initial breast reduction consultation will normally last between 15 minutes to an hour. Your consultation time is your opportunity to be as honest and candid with your surgeon as possible. During your consultation, your surgeon will discuss a number of topics, including:
After your surgeon has taken your medical history, they will examine your breasts and may take confidential photos for your medical record. Finally, they will discuss your treatment options and whether or not your desires can be met.
When recommending treatment options, your surgeon will take into consideration the following:
Your surgeon will also talk through the risks and complications that are associated with a breast reduction. It is important that you are aware of these so that you are able to make a fully informed decision.
It is vital that you are honest with your surgeon about what you would like to achieve from your breast reduction. You should not hesitate to ask your surgeon any questions that you may have. Some questions that may be useful to ask are:
As with any surgery, a breast reduction procedure does carry the risk of complications occurring. It is essential that you are aware of all these risks before you go ahead with the surgery. The breast reduction risks and complications include:
Your surgeon will need to make incisions on your breasts during your reduction. This means that scarring is inevitable. The extent of the scarring will depend on the type of incision your surgeon chooses to use, and your skin’s ability to heal. Some patients may experience severe forms of scarring called keloid or hypertrophic scars. Patients who are likely to develop this are normally already aware of this.
You will experience some bleeding and bruising after your operation. This tends to be minimal and should decrease with time. In some cases however, the bleeding may become more severe. If this does happen, your breasts will feel very swollen and tight. You will most likely need to return to the operating theatre to have this treated. If your surgeon treats the bleeding promptly, it should not have a negative affect on your final results.
The breast reduction procedure may cause damage to the nerves in and around your breasts. This can lead you to feel altered sensations such as numbness or over-sensitivity in particular areas of the breast, especially the nipples. For most patients this is temporary, but in some rare cases it can be permanent.
Infection is a risk that comes with any surgical procedure. If you do develop an infection, it will most likely be a mild wound infection that can easily be treated with antibiotics.
If you experience any of the following symptoms of infection, you must flag them up to your surgeon:
There is also a risk that you could develop a blood clot after a breast reduction. If the clot develops in your legs, this is known as a DVT (deep vein thrombosis). It can also however, develop in your lungs and this is known as a PE (pulmonary embolism). If the PE is large enough, it can be fatal.
There is a higher risk of developing these blood clots for patients who spend a lot of time not mobilising after surgery. For this reason, it is is vital that you do not spend all day resting in bed. You must get up and take light, short walks around the house to help the blood in your legs to circulate properly.
After a breast reduction, the lower half of the breast tissue may naturally droop down into a “teardrop” shape while the nipples stay in their place. This may make the nipples appear overly high. The extent to which this happens depends on how much breast tissue there is, and how heavy it is. It is most commonly seen when an Anchor incision and inferior pedicle technique are used together. Your surgeon can correct this with revision surgery.
A seroma is a pocket of fluid that can develop after a surgical procedure. The pocket most commonly develops under or around the incision site. Small seromas may resolve on their own, whereas larger ones may require your surgeon to drain them. You may have drains put in after surgery to help drain fluid, reduce swelling and prevent a seroma developing.
During your breast reduction, certain areas of the your breast may lose t blood supply. If this occurs, it may cause the skin, tissue or fat in that area to die. This is known as ‘necrosis’.
If your surgeon chooses to use a free nipple graft technique for your breast reduction, there is a higher change of you developing nipple necrosis. This may result in the complete loss of your nipple. This is because when your surgeon removes your nipple from the breast, it loses its entire blood supply, making it more likely for the nipple to die. The risk of this happening also increases if you are a smoker.
It is also important to be aware that you may not be happy with the aesthetic result of your breast reduction. Many surgeons will not consider this to be a complication and will therefore not offer revision surgery free of charge. This is another reason why you must choose your surgeon carefully.
Choosing an experienced BAAPS/BAPRAS surgeon can help reduce the risk of all of these breast reduction risks and complications occurring.
It is important for you to prepare before you have your breast reduction. Preparing well for your breast reduction can also help you through your recovery period. Below are some breast reduction preparation tips that may be helpful for you:
You will not be able to drive straight after your surgery. It is therefore important for you to arrange for a family member or friend to help you get home safely after your operation. We also recommend that they stay with you for the first 24 hours after surgery, as you will still be recovering from the anaesthetic.
It may be really useful to get some household chores done before you go in for your operation. Taking the bins out, cleaning and doing a big grocery shop before your breast reduction will give you more of a chance to rest after your operation. It may be also be helpful to cook some meals and freeze them so that you do not have to worry about cooking either!
Try to place hard to reach cupboard items such as mugs, crockery and dry food on the kitchen counter. This will prevent you having to stretch to reach them, which can help your recovery as stretching can place strain on your incisions.
A breast reduction is quite an invasive procedure. It is therefore important that you rest well and do not exert yourself. You should therefore ask your family and friends to help look after young children and pets whilst you are recovering.
Sleeping on your back, in an inclined position for the first few days after your surgery can help reduce swelling and bruising. You can do this by having lots of extra pillows on your bed.
It may be more comfortable for you to wear clothes that fasten easily from the front in the initial post-operative days. This prevents you reaching up to pull clothes over your head, which places strain on your stitches. Straining your stitches can increase the time it takes your wounds to heal.
You will also have to wear a post-operative garment after your breast reduction. Your surgeon will give you specific instructions on which garment to wear, how tight to wear it, and how long you must keep it on for.
Maintaining a healthy diet will help you through your recovery. This includes eating food that is low in salt and sugar, having as many fresh fruits and vegetables as possible, and drinking lots of water and caffeine-free drinks.
Smoking, taking recreational drugs and drinking large amounts of alcohol can all have a negative effect on your recovery. It is essential that you stop smoking and using all nicotine products at least 6 weeks before and after your breast reduction. Smoking lengthens your recovery by delaying the time it takes for your wounds to heal. It also greatly increases the risk of infection.
It is very important to notify your surgeon of all the prescription and over-the-counter medications that you take. Certain prescription and homeopathic medications can increase the risk of complications occurring. Your surgeon will discuss your medications and recommend the best course of action to take.
As certain homeopathic medications can increase the risk of bleeding and bruising after surgery, we recommend you stop taking them at least 2 weeks before your operation. These medications can include:
Your surgeon will give you advice for your breast reduction aftercare and recovery. They will discuss the following topics:
After your breast reduction, you will most likely need to spend one or two nights in hospital. Before you leave however, a post-operative appointment will be arranged for you. This appointment will allow your surgeon to examine your breasts, remove any stitches that are not dissolvable and treat any complications.
In general, if you have an office job, you will need to take approximately 1 to 2 weeks off work after your breast reduction. If you have a job that requires more physical activity, you will need to take at least 2 weeks off. You surgeon will give you specific instructions on when you can return to work.
After you have your breast reduction, you will need to rest well and not exert yourself. You will need to start slowly when you begin exercising again. The general advice is as follows:
Avoid all sports and exercises for the first three weeks after your breast reduction. Even minor aerobic sports may increase swelling and bruising.
Three weeks after your breast reduction, you should be able to resume light aerobic exercises such as cycling. You should however be careful not to exert yourself too hard.
After 6 weeks have passed, you should be able to to resume all sports, exercises and heavy lifting again.
Each surgeon will have different advice about when it is appropriate for you to resume sports and exercise after your breast reduction. It is therefore very important to follow the advice that your surgeon has personally given you.
As you will not be able to drive immediately after your breast reduction, you must arrange for a friend or family member to take you home. It may take 5 days to 2 weeks before you are able to start driving again, depending on your surgeon’s advice.
Although scarring is inevitable after a breast reduction, there are a number of techniques that can help aid the healing of scars. These include:
You will be able to see an immediate change to your breasts straight after your operation but it may take 6 to 12 months before you can appreciate the full cosmetic appearance. It is therefore important to be patient!
Your Medbelle BAAPS/BAPRAS surgeon will give you specific advice regarding your breast reduction aftercare. It is vital to follow the instructions your surgeon gives you as this is specific to your recovery.
Make sure you research your breast reduction procedure well before you go in for your surgery. The following breast reduction FAQs may help answer some common questions:
Although possible, it can be quite difficult to get a breast reduction done on the NHS. It is often only offered to patients who are experiencing distressing symptoms. If you think you might be a candidate, you should speak to your GP first.
You should wait at least 3 to 6 months after a pregnancy before having a breast reduction. This is to allow enough time for your breasts to settle before you have your procedure.
As with pregnancy, you should wait at least 3 to 6 months after you have stopped breastfeeding before you have your breast reduction procedure.
As your surgeon is likely to remove some milk glands and ducts during a breast reduction, this can effect your ability to breastfeed post-operatively. Many women can still breastfeed after surgery, but this depends heavily on the tissue removal technique that your surgeon uses. Certain surgical techniques will have more of an effect on your ability to breastfeed than others. For this reason, it is very important to notify your surgeon if you are planning to breastfeed in the future.
Smoking, drinking large amounts of alcohol and taking recreational drugs can all increase the risk of complications occurring during and after your breast reduction surgery. Smoking in particular can increase the risk of developing infections and can also delay wound healing. You must therefore stop smoking at least 6 weeks before and after your procedure.
Most plastic surgeons will see you for an initial consultation for your breast reduction without a GP referral. Your surgeon may however, contact your GP to get details of your medical history.
You can also minimise the risk of complications by exercising regularly, reducing your alcohol intake, eating a healthy diet and most importantly, stopping smoking.
The effect that weight loss or weight gain has on a breast reduction depends on the amount of fat left in the breasts and the degree of the weight change. Any major weight changes will most likely have an effect on the final results and appearance of the breasts. It is for this reason that we advise that you reach your optimal weight before having your breast reduction surgery.
If you still have any questions that do not appear under these breast reduction faqs, give us a call and we would be happy to help you.