Many women seeking breast reduction surgery do so because the weight of their breasts affects their posture, leading to neck and back pain. Some people simply want to have smaller breasts. It remains amongst the most common breast surgeries performed with some of the highest satisfaction rates. The breast may be thought of as three components: the skin envelope, the breast parenchyma and the nipple–areola complex. In breast reduction surgery varying degrees of resection of these components with repositioning of the nipple is carried out to reshape as well as reduce the breast size.
A wide variety of breast reduction operations are available, with various incisions and breast tissue reduction patterns. Each individual has different requirements and Dr Farhadieh will discuss, in detail, which would be most suitable to your needs. In general, there are two forms of incisions: the vertical incision and the ‘Wise pattern’ (inverted T). The vertical or minimal scar incision involves an incision around the nipple–areola complex and then straight down from below the nipple to the lower breast crease. The Wise pattern incision is similar, with the addition of a horizontal incision at the lower breast crease (so-called ‘inverted T’ incision). In general, very large breasts require this incision, whereas moderately large ones are amenable to the vertical incision.
During the surgery, the nipple and areola remain attached to the underlying breast and are moved to their aesthetically ideal position. The operation takes around 3 hours.
During your first consultation, Dr Farhadieh will review your medical history, and note any regular medications and allergies. You will be asked about your specific concerns and expectations, and your reasons for seeking breast reduction surgery. A physical examination will be undertaken and photographs taken as part of your confidential medical records.
Controlled weight reduction can be an enormous help in reducing perioperative complications, accelerating recovery and achieving a better overall surgical outcome. Smokers will be advised to cease smoking at least 3–6 weeks prior to surgery and to abstain for 3–6 weeks afterwards. Any medications, supplements or herbal remedies that may cause increased bleeding should be avoided for at least 2 weeks prior to and 1 week after surgery. Depending on your age, medical and family history, you may need to have a screening mammogram prior to surgery.
The surgery may be performed as a day, or more often, as an inpatient procedure when you should usually expect to be discharged the following day. On the day of surgery Dr Farhadieh will meet with you and mark the areas on your breasts where the incisions will be made. Any final questions will be addressed prior to surgery. Our anaesthetist will see you on the day of the surgery in order to discuss the anaesthetic procedure and pain relief options.
Immediately after surgery you will be taken to the recovery room and from there to the ward. Because local anaesthetic will have been injected into the surgical site during the procedure, the immediate postoperative period is usually relatively comfortable. Some discomfort may become apparent overnight, but this usually begins to subside over the course of the first few postoperative days. Sometimes you will have a drain inserted into the breast tissue during the operation; this will be taken out the next day.
The following day, after assessment by Dr Farhadieh, you will be discharged home, with instructions to wear a soft sports bra for the following 4–6 weeks. During the initial postoperative period, you may feel limited by general postoperative state, although you are encouraged to increase your mobility as soon as practical. Your postoperative review will be organized for 10–14 days following surgery.
During the initial postoperative 2 weeks your breasts may look and feel bruised. This will gradually settle and your breasts will gradually find their most natural position during the first 6–8 weeks. You should avoid stretching, heavy lifting and strenuous upper body activity during the first 6 postoperative weeks.
Complications may follow any surgery, including breast reduction surgery, but fortunately these are uncommon. Dr Farhadieh will discuss these at length with you during your consultation.
‘Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.’
Frequently Asked Questions
Is the surgery painful?
There is some discomfort associated with surgery. Most patients report a ‘tightness’, rather than pain, due to the excellent pain control regime we use, which includes local anaesthetic for the immediate postoperative period as well as powerful analgesics.
Will the shape of my breasts change during the recovery phase?
The breasts will not only heal during the first 6 weeks, but will also gradually find their natural postoperative position. Gravity, healing and surgery drive this process. The incision scars will fade over the first 12 months and will often be barely visible beyond the first year.
When will I be able to resume normal activity?
Within 2 weeks you will be back at work and be able to resume most normal activities. During the subsequent weeks you will return to your pre-surgery levels of activity.
Where will the scars be placed?
As part of the preoperative assessment Dr Farhadieh will discuss the positions of the incisions with you. The most common short scar technique involves an incision around the nipple with a vertical component extending towards the lower pole of the breast. The scars are not only camouflaged, but also fade considerably within the first 12 months after surgery.
What will my follow up include?
Dr Farhadieh believes that the relationship between doctor and patient is sacred and privileged. Our practice is based on compassion, honesty, transparency and, above all, patient welfare. We pride ourselves on making sure that you feel supported at all times. We will be available during all stages of your journey and will schedule short-, medium- and long-term follow-up appointments as part of our overall practice.