Breast reduction patients make up some of the happiest patients in plastic surgery. They have often laboured for many years with large breasts that can be the cause of many health complaints, including back pain, shoulder pain and rashes or infections under the breast. There is also a psychological burden born by many such patients. They are often self-conscious about the size of their breasts, feel that they attract unwanted attention and find it difficult to purchase appropriate fitting clothing.
By Dr. James Southwell Keely, Cosmetic, Reconstructive and Plastic Surgeon
Prior to undertaking breast reduction surgery it is important to have a thorough discussion with your plastic surgeon about your breast health and general health. It is prudent to perform a pre-operative mammogram so as to establish a baseline of the inner appearance of the breast, as all that will change after the surgery.
Enlargement of the breasts is caused by an increase in the volume of breasts fatty tissue and/or breast glandular tissue. As the breast enlarges the skin is stretched and in turn the nipple slowly descends towards the bottom of the breast. Accordingly the goals of breast reduction surgery are to reduce the size of the breast in all dimensions and to reposition the nipple into a more youthful location.
Prior to surgery a patient should aim to achieve a stable body weight. Weight fluctuations after surgery will affect the size of one’s breast. After surgery there may be a reduction in nipple sensitivity, or a paradoxical increase in nipple sensitivity. It is best to have completed your family before undertaking the surgery although it is possible to breast feed after breast reduction.
There are many different breast reduction techniques. The best technique for any given patient is the one that will fulfil their individual needs. From a patient’s perspective the techniques can be subdivided based on the final appearance of the scars, namely a scar that runs around the areola only (peri-areolar scar), a scar that runs around the areola, then down towards the crease under the breast (vertical scar) and lastly a scar that runs around the areola, down towards the breast crease then along the crease itself (inverted-T scar or anchor scar). The peri-areolar scar involves the least scarring, the vertical scar is medium in terms of scar burden and the inverted-T scar involves the most scarring. In general, the larger the size of the reduction, the more scarring there will be.
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