What To Expect During Your Consultation?
The success of the consultation depends on your openness and honesty in relation to what troubles you and your expectations of surgery. You will be asked questions about your health, desires and lifestyle. Different operations can be tailored to your needs and the potential outcomes and the risks and complications will be discussed with you.
A consultation regarding the risks and limitations of surgery will help you to choose a procedure that will meet with your expectations. There are many options such as liposuction only and different ways of placing scars. Often both the skin and the breast tissue need to be both lifted and reduced.
Preparing For Breast Reduction Surgery
The majority of breast reduction procedures require general anesthetic. Your health is a prime importance and any cosmetic surgery should be postponed if you are unwell for any reason. It is important that if anything changes with your health that you make contact with us. You should ideally stop smoking 6 weeks prior to surgery and stop taking aspirin, anti-inflammatory drugs and herbal supplements before surgery.
You may need preoperative tests prior to surgery, which we will arrange if required. You will generally experience discomfort following the surgery and should aim to be off work for at least 2 weeks depending on the type of work you do. It is important that you are at your ideal weight prior to breast reduction surgery and that your weight is stable. Results can alter considerably with weight loss and weight gain.
Breast reduction often takes between 1.5 and 2.5 hours and is usually done under general anesthetic. Breast reduction normally involves the placement of an incision around the areola and usually a vertical line from the areola down to the breast crease. Occasionally an incision is required along the breast crease also.
The excess breast tissue to removed and the breast reshaped. The skin is then draped over the new breast and the wounds are then closed with dissolvable stitches. Often liposuction is performed to reduce certain areas of the breast in order to give an improved contour. This is most often performed where there are perceived areas of irregularity. With every reduction there is also an element of lift and it is important to discuss the ideal size for you and your frame.
You will usually return to the ward within an hour following surgery and you will be encouraged to mobilize. You will usually not have drains in place and you will be able to eat, drink and mobilize as soon as the anesthetic wears off. You will feel swollen and have discomfort that will usually require analgesia.
You should wear a support bra and keep this in place day and night for at least 4 weeks. You may be able to go home the next day and should keep the wounds dry for the next week. You should arrange for someone to pick you up following surgery and have some support at home on discharge. You will be reviewed in clinic and the wounds checked at a week. You should avoid any strenuous exercise in the first couple of weeks and should continue to wear a support bra for 4-6 weeks after surgery. You will be able to resume light exercises after a week and normal exercise by 2-3 weeks.
You should begin massage to the scar once healed. The pictures (1-4) shows a lady who underwent a breast reduction / mastopexy and the appearance at a week and at 6 weeks and at 2 years. Bruising and swelling is often apparent through the initial weeks and redness and discharge are not unusual. It can take many months to years for the scars to fade.
Risks And Complications
The vast majority of patients are delighted with the procedure although common early complaints include change in sensation, bruising, swelling and there is often a slight difference between the two sides. Often there is slight oozing from the wounds over the first week and this is normal. Uncommon early complications include infection, hematoma, delayed healing, seroma formation and thickened scar. Nipple and areola loss has been described but is extremely uncommon.
Breast- feeding may be affected by surgery and if you have not completed your family you should consider this before proceeding. There are also uncommon risks of general anesthesia such as respiratory / cardiac compromise and deep vein thrombosis.
Sensation usually changes following breast reduction and the nipples may be hyper or hypo sensitive. It is uncommon to have permanent numbness but sensation can take a number of months to return.
With time breast tissue continues to age. This is particularly an issue with childbirth. It may be that further surgery to tighten the skin is required at a later date. With weight fluctuations the breasts can increase and decrease in size and the results can change with time. It is very rare for breasts to increase to a size where one would need a further reduction although this cannot be 100% guaranteed.
The scars following breast reduction can be red for a number of weeks / months after surgery and it can take some time before the scars start turning pink /purple and then start fading into a white line. It is unusual to develop abnormal scars and unusual to have irregularities requiring scar revision. Any revisions in the scars should not be considered for at least a year following surgery
The ability to breast-feed can be affected by breast reduction surgery and you should consider this before deciding on the operation.
Is Breast Reduction Successful
A breast reduction can give both functional and aesthetic improvements that can often improve quality of life. It is rare for patients to be unhappy with surgical outcomes and although there are complications that can occur these are very rare in Mr Ross’s practice.
Mr Ross has a less than 1% complication/ revision rate for breast reduction and patients regularly complete on line reviews regarding the successful outcomes of their breast reduction procedure. There are many examples of Mr Ross’s outcomes within the case series. When looking at these examples it is important to look at preoperative pictures that are similar to yourself of what can be achieved.
Implications For Mammograms And Screening
You need to be aware that 1in 10 women do develop breast cancer and if you find a discrete lump you should consult with your GP. If you find a lump or you are at an age to enter a breast-screening program you may be offered a mammogram. You need to tell the mammography service that you have had a breast reduction although it will not change your management.
Are There Any Alternatives To Breast Reduction
The only alternative surgical technique to breast reduction surgery as described above is perform liposuction only to the breast. Very occasionally this may reduce the breast enough that patients are happy with the outcome. Liposuction does not lift the nipple and does not alter the shape and patients need to discuss the pros and cons of this before considering it as an option.
Will My Breasts Grow Back After A Breast Reduction
Although it is possible for breasts to grow back after a breast reduction this is very unusual. There are certain medications that can lead to an increase in breast tissue. By far the most commonest reason for an increase in breast size following breast reduction is pregnancy and weight gain. For patients who have not completed their family it is important to consider the pros and cons of proceeding with a breast reduction as the chances of breast feeding are likely to be reduced slightly by surgery.
Mr Ross uses a superiorly based pedicle for the majority of his breast reduction surgeries and as such it would be possible to further reduce the breasts should this occur. Patients are advised to be at their ideal weight prior to surgery and be weight stable. If they have not completed their family to consider the pros and cons before proceeding.