Breast Reduction

Women with very large, pendulous breasts may experience a variety of medical problems caused by the excessive weight, from neck and back pain and skin irritation, to skeletal deformities and breathing problems.

Bra straps may leave indentations in your shoulders and unusually large breasts can make a woman or a teenage girl feel extremely self-conscious. Breast reduction, technically known as Reduction Mammaplasty, is designed for such women.

Photos courtesy of Dr Barry A. Davidson, Boston

The procedure removes fat, glandular tissue, and skin from the breasts, making them smaller, lighter, and firmer. It can also reduce the size of the areola, the darker skin surrounding the nipple. The goal is to achieve smaller, better-shaped breasts in proportion with the rest of the body. 

Techniques for breast reduction vary, but the most common procedure involves an anchor-shaped incision that circles the areola, extends downward, and follows the natural curve of the crease beneath the breast. The surgeon removes excess glandular tissue, fat, and skin, and moves the nipple and areola into their new position. He or she then brings the skin from both sides of the breast down and around the areola, shaping the new contour of the breast. Liposuction may be used to remove excess fat from the armpit area.

In most cases, the nipples remain attached to their blood vessels and nerves. However, if the breasts are very large or pendulous, the nipples and areolas may have to be completely removed and grafted into a higher position (this will result in a loss of sensation in the nipple and areola tissue).

Stitches are usually located around the areola, in a vertical line extending downward, and along the lower crease of the breast. In some cases, techniques can be used that eliminate the vertical part of the scar. And occasionally, when only fat needs to be removed, breast liposuction alone can be used to reduce breast size, leaving minimal scars.

After surgery, you'll be wrapped in an elastic bandage or a surgical bra over gauze dressings. A small tube may be placed in each breast to drain off blood and fluids for the first day or two. You may feel some pain for the first couple of days — especially when you move around or cough — and some discomfort for a week or more. Your surgeon will prescribe medication to lessen the pain.

The bandages will be removed a day or two after surgery, though you'll continue wearing the surgical bra around the clock for several weeks, until the swelling and bruising subside. Your stitches will be removed in one to three weeks.

If your breast skin is very dry following surgery, you can apply a moisturiser several times a day, but be sure to keep the suture area dry. Although you may be up and about in a day or two, your breasts may still ache occasionally for a couple of weeks. You should avoid lifting or pushing anything heavy for three or four weeks.

Please ask your doctor for further information.