Women may develop large breasts, also known as breast hypertrophy, as part of normal development, as a result of pregnancy or weight gain. For some women diet and exercise may reduce breast size, but for the majority of women breast reduction is the most reliable and effective method to reduce breast size.
Teenagers may also experience excessive breast growth during puberty as a consequence of a condition known as juvenile hypertrophy of the breast. With this condition one or both breasts may quickly enlarge causing breast asymmetry and/or the symptoms of large, heavy breasts. Despite their young age, such women are still eligible for breast reduction. Ultimately, breast reduction can be performed at almost any age after breast growth and development is complete.
Impact of Large Breasts
The physical and emotional impact of large, heavy breasts is often not appreciated. Symptoms of neck and back pain, shoulder grooving from bra straps, skin irritation under the breasts and unwanted attention, can have a profound negative impact on quality of life.
Women may also have difficulty with exercise and finding clothes that fit properly. For such women, breast reduction may alleviate all these issues. Many women come to Mr Karri for breast reduction in order to ease the physical pain that can be caused by large breasts. It is well recognised that breast reduction produces one of the highest patient satisfaction rates amongst all the surgeries in cosmetic and reconstructive plastic surgery.
Breast reduction, also known as reduction mammaplasty, involves removal of a combination of excess fat, glandular tissue and skin from the breast in order to reduce breast size to a appropriate size. Moreover, by reducing the weight of the breasts the symptoms associated with heavy breasts are alleviated.
The ideal breast reduction serves to reduce breast size so they are in proportion to the body, shape is enhanced, projection is improved and the nipple-areola complex is reduced in size and repositioned at a higher, more aesthetic position on the breast.
Breast Reduction Techniques
There are many breast reduction techniques but all have two fundamental components; skin-incision pattern and pedicle for the nipple-areola complex (NAC). Pedicle refers to the block of tissue left behind that provides blood supply to the NAC.
There are two types of skin incision patterns;
- Vertical scar – characterised by a scar around the areola and a vertical scar to the inframammary fold.
- Wise-Pattern (also known as ‘Inverted-T’ or ‘Anchor’) – characterised by a scar around the areola, a vertical scar to the inframammary fold and a scar in the inframammary fold.
Pedicles are named according to their attachment (or source of blood supply within) and include;
- Inferior pedicle
- Superomedial / medial pedicle
- Superior pedicle
For some large breast reductions, there may be a risk that the blood supply to the NAC may be compromised if the pedicle undergoes significant elevation/rotation. As such, the NAC may be transposed in the form of a skin graft and this technique is known as free-nipple graft.
During your consultation with Mr Karri, he will advise the most appropriate breast reduction technique for you, based on your breast anatomy and goals.
Procedure and Recovery
Breast reduction surgery is usually performed under general anaesthetic as a daycase procedure or with overnight stay. Immediately after surgery a supportive sports-bra will be fitted and you will be advised to continue wearing it for 4 weeks continuously. Swelling and bruising is expected but will resolve within a few weeks. You should arrange to have 2 weeks off work and plan to spend this time resting and recovering. Strenuous activity and heavy lifting should be avoided for at least 4 weeks. You will be given pain medication to ensure your comfort, although many patients report low pain scores after breast reduction.
Although the final result of breast reduction will not be apparent for a number of months, the benefits of the surgery will be noticed almost immediately. The reduced weight of the breasts and resultant freedom of movement can be enjoyed a few days after surgery.
As with all surgical procedures, breast reduction has risks that should be considered before a decision on treatment is made. Risks include;
Scar / poor scarring – breast reduction does leave permanent scars, although they are usually covered by a bra or swimsuit. In some patients the scars can remain red and raised for a variable period of time.
Wound-healing delay – small areas of delayed healing is common and eventually heal with the help of simple dressings.
Infection – very rarely an infection can arise which may require treatment with antibiotics or further surgery.
Haematoma – excessive bleeding into the breast can occur (known as a haematoma) and may require drainage. It is important that you you do not take any products containing aspirin, anti-inflammatories, blood thinners or vitamin E for 14 days prior to your operation as these medications can greatly increase the risk of bleeding.
Nipple-areola necrosis – rarely, the blood supply to the nipple or areola is interrupted leading to partial or total loss of the nipple or areola.
Loss of nipple sensation – although some women report nipple sensation gradually returning after several months, loss of nipple sensation should be expected.
Asymmetry – although every effort is made to ensure symmetry, there is always the risk of asymmetry.
Need for revision surgery in the future.
Risks of general anaesthesia, such as feeling sick and vomiting, deep vein thrombosis, shivering and sore throat.