Breast Reduction

Surgical/Procedure name:
Reduction Mammaplasty

Common name:
Breast Reduction

Introduction

Also known as reduction mammaplasty, breast reduction surgery removes excess breast fat, glandular tissue and skin to achieve a breast size in proportion with your body and to alleviate the discomfort associated with overly large breasts.

In breast reduction, excess fat and skin are removed from the breasts. The breasts are reshaped to form smaller breasts and the nipple and areola are repositioned. Breast reduction can also be used to even up the size of the breasts where one is much larger than the other.

Breast reduction is not recommended for young women whose breasts are not yet fully developed or for women who plan to breast feed since the surgery may impair the ability to breastfeed. The surgery may also result in decreased feeling in the breasts or nipples.

The operation of reduction mammaplasty should not be confused with the so called "breast lift" or mastopexy procedure which is done for cosmetic purposes

Is it right for me?

Breast reduction surgery is a highly individualized procedure and you should do it for yourself, not to fulfill someone else’s desires or to try to fit any sort of ideal image.

Breast reduction is a good option for you if:

You are physically healthy

You have realistic expectations

You are bothered by the feeling that your breasts are too large

Your breasts limit your physical activity

You experience back, neck and shoulder pain caused by the weight of your breasts

You have regular indentations from bra straps that support heavy, pendulous breasts

You have skin irritation beneath the breast crease

Your breasts hang low and have stretched skin

Your nipples rest below the breast crease when your breasts are unsupported

You have enlarged areolas caused by stretched skin

Pre-Operative Care

The success and safety of your breast reduction procedure depends very much on your complete candidness during your consultation. You’ll be asked a number of questions about your health, desires and lifestyle. To eliminate the chance of post op. bleeding you should avoid aspirin and any medication containing aspirin for two weeks prior to surgery. You should also not smoke for 2 weeks prior to surgery as smoking can affect your reaction to the anaesthetic and slow down the healing process. Patients that suffer from hypertension must inform the surgeon prior to surgery.

Be prepared to discuss:

Why you want the surgery, your expectations and desired outcome

Medical conditions, drug allergies and medical treatments

Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs

Previous surgeries

Family history of breast cancer and results of any mammograms or previous biopsies

Your surgeon may also:

Evaluate your general health status and any pre-existing health conditions or risk factors

Examine your breasts, and may take detailed measurements of their size and shape, skin quality, placement of your nipples and areolas

Take photographs for your medical record

Discuss your options and recommend a course of treatment

Discuss likely outcomes of your breast reduction procedure and any risks or potential complications

Discuss the use of anesthesia during your procedure for breast reduction.

Risks and Possible Complications

The decision to have breast reduction surgery is extremely personal. You will have to decide if the benefits will achieve your goals and if the risks of breast reduction surgery and potential complications are acceptable.

Your plastic surgeon and/or plastic surgery staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks or potential complications.

The risks of breast reduction and breast reduction complications include:

Unfavorable scarring

Infection

Changes in nipple or breast sensation, which may be temporary or permanent

Anesthesia risks

Bleeding (hematoma)

Blood clots

Poor wound healing

Breast contour and shape irregularities

Skin discoloration, permanent pigmentation changes, swelling and bruising

Damage to deeper structures - such as nerves, blood vessels, muscles, and lungs - can occur and may be temporary or permanent

Breast asymmetry

Fluid accumulation

Excessive firmness of the breast

Potential inability to breastfeed

Potential loss of skin/tissue of breast where incisions meet each other

Potential partial or total loss of nipple and areola

Deep vein thrombosis, cardiac and pulmonary complications

Pain, which may persist

Allergies to tape, suture materials and glues, blood products, topical preparations or injectable agents.

Fatty tissue deep in the skin could die (fat necrosis)

Possibility of revisional surgery

You should know that:

Breast reduction surgery can interfere with certain diagnostic procedures

Breast and nipple piercing can cause an infection

Your ability to breastfeed following reduction mammaplasty may be limited; talk to your doctor if you are planning to nurse a baby

The breast reduction procedure can be performed at any age, but is best done when your breasts are fully developed

Changes in the breasts during pregnancy can alter the outcomes of previous breast reduction surgery, as can significant weight fluctuations

Recovery and Post Operative Care

When you wake after surgery you will be wrapped in elastic bandages, gauze dressings and a surgical bra. A small tube may be placed in each breast to drain blood and fluids for the first day or two.

The extent of the post operative swelling and bruising depends on whether you tend to bruise or swell easily. Every person is different. Application of cold compresses or ice packs will reduce swelling and relieve discomfort.

A couple of days after surgery the pressure bandages will be removed. The surgical bra must be worn at all times for several weeks, until the swelling and bruising subsides, or until your surgeon advises you otherwise. You should only remove the surgical bra to bathe and to wash the garment.

Usually, sutures will be removed in the first week. Sometimes the surgeon will use dissolvable sutures. If the breast skin is very dry following surgery, a moisturizer can be applied several times a day. Vitamin E cream is extremely effective and also helps the scarring to heal, however the suture area must be kept dry at all times, particularly after bathing. 

For the first few months it is important not to place tension on the incisions by performing strenuous activities like lifting or stretching your arms above your head, as this may increase scarring by stretching the tissue. You will need assistance to carry your groceries or hang your washing.

Your surgeon will try to ensure that your incisions are as subtle as possible, however it is important to remember that the scars are extensive and permanent. They may be red for months, and then slowly become fainter, eventually fading to thin white lines. In most cases the scars are positioned so that they would not be seen when wearing low-cut tops and dresses.

Recovery usually takes about two weeks. Most people are back to work within three weeks.

Recommended min length of stay in Thailand
14 days.