The size, shape and proportion of the breasts have a profound impact on how a woman perceives her femineity and also self-confidence. Overtly large breasts can cause great physical as well as emotional distress. Disproportionately large breasts can lead to strained neck, altered posture, pain due to bra straps, irritation and rashes to the skin fold beneath the breasts and social embarrassment among others. If a woman has large breasts that cause such discomfort and it interferes with her day-to-day life, she should consider a breast reduction surgery also known as reduction mammaplasty.
Breast reduction is the surgical procedure to remove excess fat and glandular tissue from the breast while reshaping and lifting them while maintaining the aesthetic proportions. Most women who undergo breast reduction for the right reasons are generally satisfied with the ultimate outcome. However, it is a major surgery and all factors must be taken into consideration before you choose to undergo this procedure. It should be done only by a board-certified Plastic Surgeon.
Benefits of Breast Reduction Surgery
More proportional and aesthetically shaped breasts- Large breasts tend to hang and look disproportionate to the rest of the body. Breast reduction is a plastic surgery procedure that achieves breasts that are more aesthetic, proportional and attractive.
Decreased neck and back strain, improvement in irritation and rashes beneath the breast folds- After breast reduction the breasts are smaller, lighter and more comfortable. This definitely causes an improvement in the discomfort associated with large breasts leading to a great deal of satisfaction post breast reduction surgery.
Better comfort while performing physical activities- Without heavy breasts hanging from the chest it becomes much more comfortable to perform several physical activities like running, cycling, playing outdoor games. This leads to a sense of general wellbeing.
Improved self-confidence- More aesthetic and proportional breasts means you can wear clothes of your choice; social embarrassment is decreased leading to an improved self-confidence.
When to Plan / Timing of the breast reduction
Breast reduction can be planned at any age once the breasts are fully developed. If pregnancy is planned in the near future, it is advisable to undergo breast reduction after cessation of breast feeding as post pregnancy changes to the breast could affect the ultimate result.
Preparing for the procedure/ consultation
Once you have decided to undergo breast reduction surgery fix up an appointment for consultation with a Plastic Surgeon. Discuss in detail what are the problems faced by you due to the large breasts and what are your expectations and concerns regarding the procedure.
The doctor will take a detailed medical history, examine the breasts and axilla for any lumps, measurements will be taken to determine the exact cup size. Some pre-op photos will be taken to exactly plan the course of the surgery and for a post-op comparison. The surgery, post op recovery, scars will be discussed in the consultation.
Investigations will be done to determine the fitness for surgery. Ultrasound or Mammography of the breast will be done to rule out any undetected lumps. Diabetes and hypertension will need to be well controlled pre procedure. Smoking will have to be stopped at least 2 weeks prior to the procedure. Certain blood thinners will need to be stopped pre-op.
Types of Surgery
Depending on the size of your breasts one of these three procedures will be planned.
- Liposuction: If the size of the breast is moderately large and a significant reduction is not desired only liposuction can be planned. Significant reduction cannot be achieved with liposuction. The post-operative recovery is much faster and return to work is earlier. There will be only a few 5mm incisions used to suction out the excess fat from the breast, so scars are also hardly visible.
- Vertical Reduction: This is the most common type of breast reduction for moderately large to large breasts. Breast tissue is retained on a medial, superior or inferior pedicle and all the excess is excised. The wound is closed in a vertical scar and stiches are also there around the areola. There is no scar in the breast crease, only a vertical scar from areola to just the crease. There is no scar above the areola. With the vertical reduction a good amount of reduction can be achieved along with uplifting the breasts and making them much more youthful.
- Inverted T shaped Reduction: For very large breasts, vertical reduction cannot achieve adequate reduction, hence a reduction with an inverted T scar is preferred. Breast tissue is retained on a medial or superior pedicle. All inferior and lateral excess is excised along with skin excess. Final wound closure is like an inverted T with a scar form areola to crease and a horizontal scar along the crease. There is no scar above the areola. Good uplifting and good reduction can be obtained with this procedure.
Liposuction may be used in combination with the other procedures to achieve a better and symmetrical result.
The procedure
Once you decide to undergo a breast reduction procedure after the detailed consultation, all tests needed for fitness will be carried out after which a suitable date will be decided for surgery. You will need to be admitted and requisite fasting will be advised before the procedure is carried out. Pre-operatively the surgeon will also do the markings so that all the incisions and excisions are precise and the desired result is obtained. The procedure is done under General Anaesthesia. Post operatively there will be bandages and there will be some pain for which appropriate medication will be administered. You will be mobilised the next day. Discharge is usually on the 2nd day once you are comfortable. Dressings are changed on either the 2nd or 3rd day and specialised supportive garments are given.
Recovery/Getting back to routine life
In about 7-8 days the pain, swelling settles and you will start to feel more comfortable with the new and renewed you. The doctor will advise you when you can start showering. If you are comfortable, you can join back to work in 7-10 days. Heavy exercises should be avoided up to 1 month post-operatively. Doctor will call you for follow up till the wound settles.
As the post-operative discomfort settles you will start noticing decreased neck and back strain. Confidence will improve gradually as you embrace the new shape. Most women are very satisfied with the decision to undergo breast reduction surgery.
Problems/Complications
Some of the problems or complications that are associated with breast reduction surgery are:
- Swelling and bruising: some swelling and bruising is common after this procedure, but sometimes it may be troublesome and take more time to settle.
- Infection: Wound infection may happen in a few instances. Sometimes it is localised and settles with antibiotics and dressing. Very rarely infection may be more and may need minor procedures to allow it to settle. If you notice some redness and pain more than expected then contact your doctor to rule out infection.
- Delayed wound healing: Sometimes a part of the wound may gape and take longer to heal and need dressings longer. With proper management this usually settles.
- Scars: There will be scarring post the procedure. They may be more visible earlier but they fade over a period of time. In case the scar becomes hypertrophic or thick, take the advice of your doctor to help improve the scar.
- Asymmetry: if the procedure is properly planned and proper pre-op markings are done this rarely ever occurs. If there is some asymmetry that you are bothered by, consult your doctor to get it corrected
Breast reduction is a blend of surgical skills with art to achieve proportionate, aesthetically shaped breasts that add to the feminine appeal. Dr Eulalia D’Souza is a Board-Certified Plastic Surgeon who has an eye for the art and can help you with achieving what you desire with a breast reduction surgery.