Overly large breasts or even extreme breast growth (gigantomastia) can cause a number of physical and mental health problems. Both can be addressed with surgical breast reduction. The operation is typically combined with a breast lift, performed under total anesthesia and takes two to three hours. Patients typically stay in the hospital one to two days, avoid physical activity for a week, and return to their normal activities after four weeks. We also recommend wearing a compression bra for four weeks.
Breast reduction is appropriate for anyone who is unhappy with the large size and weight of their breasts. It is important to be in good health before having the operation. Breast reduction is indicated particular for women suffering from problems such as headaches, back pain, bra straps cutting into their shoulders, poor posture, and rashes and irritation under the breasts. It also offers relief for women who experience difficulties in their social, work or intimate lives due to their large breasts. Some women experience difficulty breastfeeding after breast reduction, so if you are considering pregnancy and breastfeeding you may wish to wait to have the procedure. Breast reduction can also resolve asymmetry of the breasts, where one breast is reduced and the other reshaped to match. This operation is not suitable for patients who have had breast cancer.
The first step involves consulting with the doctor to describe any problems you may be experiencing due to large breasts, assess skin elasticity and discuss the desired size and shape of the breasts. Next you will receive all the information you need on how to get ready for the operation, the operation itself, and the recovery period. At the consultation the doctor may also take photographs for your medical file. You will need to have an ordinary pre-operative examination as well as a mammogram before the operation. Make sure to inform the doctor of any contagious illness, however minor (cold, virus), in the three weeks before the operation. You should also inform the doctor of any medications and food supplements you take. Some people with large breasts experience skin problems such as irritation, rash and fungal or yeast infections under the breasts. These problems should be treated by a dermatologist before having breast reduction.
Please keep in mind that for some time after the operation you will be unable to lift heavy objects and take part in other activities engaging the pectoral muscles. We recommend arranging for help around the house after the operation, especially if you have young children at home.
Breast reduction is performed under total anesthesia and takes two to three hours. The surgeon usually places the incision around the areola and down, then along the crease of the breast, resulting in an anchor-shaped scar. Next the surgeon removes excess breast tissue, repositions the nipple and areola, and removes excess skin. The wound is then stitched shut with fine thread to keep the scar as unobtrusive as possible after the healing process is complete.
For the first few days after the operation the breasts are taped and covered with sterile dressing and bandages. Tubes may be placed in the wound to drain excess fluid. The doctor usually removes the drainage tubes the second day after the operation. At this point you can usually go home to continue recovering. Breast reduction does not involve a great deal of pain, but the doctor can prescribe painkillers if you need them. On the third day after the operation you can remove the dressing and gauze, leaving the tape on the wound and applying disinfectant to the breasts. You should then cover them again with sterile gauze and put on a non-wired compression bra. You can take a shower starting on the fourth day after the procedure. The tape and gauze can be removed after two weeks, although you will need to wear the compression bra for four weeks. We use dissolvable sutures, so you will not need to come in to have your stitches removed.
Starting 18 days after the operation, you can begin massaging the scar area. To perform the massage, press down with a finger and hold for about 30 seconds at each spot along the scar. Do this several times per day. The pressure massage helps a great deal with softening scar tissue, which takes about a year to fade. It is also a good idea to use the recommended scar gels and silicone bandages on the scars for that year. Make sure to protect the scars from direct sunlight during the summer months. Also keep in mind that as your breasts heal, their shape will continue to improve.
You should avoid physical activity for the first week after the operation. After that you can return to light office work, but continue to avoid engaging the pectoral muscles, such as by lifting heavy objects or small children. You can return to normal four weeks after the operation, although you should still wait at least an additional two weeks for particularly strenuous physical work.
Breast reduction is a surgical procedure and as such does involve a certain risk of complications. General complications include bleeding from the wound, infection, blood clots and excessive scarring. Complications specific to this procedure include potential difficulty breastfeeding in the future due to the removal of breast tissue and inevitable disruption of the milk ducts. Some patients experience loss of sensitivity in the areola and nipple. Usually this is temporary, and only in cases requiring extensive reduction of extremely large and hypertrophied breasts where the areola and nipple had to be moved as a transplant does the loss of sensitivity become permanent.
Breast reduction is permanent and brings relief from medical problems and improved self-image. However, the procedure cannot stop the effects of time and gravity, so the breasts may begin to sag again over the years. If this does occur, breast lift is a viable option.
