Breast reduction is usually performed for enlarged breasts (macromastia), but may also be indicated by:

• cystic breast infections (polycystic mastitis)
• back pain, neck pain, shoulder pain, breast pain, or headaches
• loss of sensation in the breasts, arms, or fingers
• sleeping problems or poor posture resulting from large breasts
• pigmented bra-strap groove
• striae (scarlike lines) on the breasts

Breast-revision surgery is performed while you are deep asleep and pain-free (using general anesthesia), in either an outpatient facility or in the hospital.

Incisions are made along the natural creases in the breast and around the dark pink skin surrounding the nipple (areola). A keyhole-shaped incision above the areola is also made to define the new location of the nipple. Skin is then removed from the lower section of the breast. The areola, nipple, and underlying breast tissue are moved up to a higher position. The nipple is moved and incisions are closed with stitches (sutures).

Alternative names    

Mastopexy; Mammoplasty; Breast size reduction; Breast lift; Breast lift with reduction; Breast lift with augmentation

Definition    

Cosmetic breast surgery is a surgical procedure to change the size or shape of the breasts.

Risks    

In addition to the general risks of surgery and anesthesia, there are risks of large scars with prolonged healing time, uneven position of the nipples, sensory loss , and inability to nurse a baby after surgery. The emotional risks may include feeling that the breasts look imperfect, or the desired reactions of others are not adequate.

Expectations after surgery   

The likely outcome from reduction surgery is very good. The appearance and lifestyle activities are significantly enhanced. Also, the pain or skin symptoms (such as striation) disappear. A special supporting bra may be required for a few months to reshape the breasts.

After a breast lift, a bulky gauze dressing is wrapped around the breasts and chest following surgery, or a surgical bra may be used. Pain is controlled by medication and will subside in 2 to 4 days. An overnight stay for breast reduction usually is needed to control pain and nausea. The dressing will be replaced by a soft bra within the first week, which must be worn for several weeks.

Generally within a few days the swelling and discoloration around the incisions will subside. There may be temporary loss of sensation in the breast skin and nipples after surgery. This condition will improve with time. Within 2 weeks of surgery, sutures will be removed.

Convalescence    

During convalescence, limit physical activities in order to prevent stretching of the scars. Some activity may be allowed in a day or two following surgery. The plastic surgeon will recommend a schedule for resuming your usual routine (usually about 8 weeks). To permit proper healing, avoid overhead lifting for 3 to 4 weeks.

Scars are permanent and often remain highly visible for a year following surgery, then fade to some degree. Every effort is made to place the incisions so that scars are as inconspicuous as possible, and the scars should not be noticeable even in low-cut clothing (incisions are usually made on the underside of the breast).

What is breast reduction surgery?
Large breasts can dominate a woman's appearance and make you look unbalanced and make exercise difficult or even impossible to do. Breast reduction is a procedure for reshaping exceptionally large breasts surgically to increase your comfort and satisfaction. Overly large breasts frequently have a considerable affect on self-confidence and can even affect personal relationships. The aim of surgery is to give you smaller, shapelier breasts that are in proportion to the rest of your body.

What does breast reduction surgery involve?
The most common procedure involves an anchor-shaped incision that circles the areola and extends down in a vertical line it will then follow the natural curve of the crease beneath the breast. Excess breast tissue, fat and skin are then removed and the nipples and remaining underlying tissues are then moved to a new higher location. The skin from both sides of the breast is then brought down and around the areola shaping the new contour of the breast and sutured.

How long does the breast reduction surgery take?
Breast reduction is performed under general anaesthesia and usually takes about 2 to 3.5 hours depending on each individual patient and the extent of surgery. The length of stay in hospital will be mainly determined by you, many patients are able to go home on the day of the surgery but some remain in the hospital for 1-2 days.

What will happen in the recovery period?
The breast will be bandage for support and can be removed a day or two after surgery but you will have to continue wearing a surgical bra 24 hrs a day for 1-2 weeks while the swelling and bruising subside. There will be considerable swelling and bruising of the breasts which usually lasts 2-3 weeks. Almost all the stitches used will simply dissolve but if there are any clips they will be removed after 5 days of surgery. The scars are quite lengthy and may take many months or years to settle. You will have follow-up visits in the months after surgery to check on your progress.

What is breast reduction surgery recovery time?
Depending on the individual patient recovery times will vary. You should be up and about in a day or two but your breasts may still ache occasionally for a couple of weeks. Most patients will return to work with 14 days but this is down to the individual. Avoid any strenuous activity for at least 6 weeks and limit your exercises to stretching and swimming.

What can I expect from breast reduction surgery?
Your expectations need to be realistic. Most patients are pleased with the outcome and find they have smaller, lighter, and firmer breasts. You will be freed from the physical discomfort of large breasts and your body will be better proportioned therefore in most cases giving a new-found confidence.