Some women have great difficulty with their large breasts or uneven breasts, especially if they are out of proportion to their overall figure. Common symptoms and problems that women may suffer from include:

• Pain in the back, neck, shoulder and breast
• Inflamed skin under the breasts
• Difficulty undertaking physical activity owing to pain and discomfort
• A loss of confidence in their appearance

PROCEDURE

This is most often undertaken under General Anaesthesia, and usually takes two to three hours. The principle of Breast reduction surgery is to remove some of the tissue and skin from the breasts in order to reshape and reduce their size, and then lift the nipples to a more youthful position.

In small reductions, liposuction may be enough. Larger reductions commonly result in an anchor shaped incision around the nipple, extending downwards towards and along the breast fold.

There are several techniques that may be used, all with the common aim of protecting the blood supply to the nipple and areola during the process of removing the surrounding breast tissue and finally repositioning the nipple. In extremely large reductions, this will not be possible and there will be a need to remove the nipple and areola and reposition them as a graft.

The skin incisions and planned technique will be discussed with you in your pre-operative consultations, so you will know what to expect before your surgery.

RECOVERY

Temporary drainage tubes are normally placed for 24 hours, but occasionally need to be left in for a few days.

Depending on your type of job, you should plan to take one to two weeks off work and avoid high impact activity for six weeks.

It is advised that you wear non-underwired bras for 3 months.

RISKS AND POTENTIAL COMPLICATIONS

These will be discussed with you during your consultation, including the risks that may be specific to you if you have a significant medical history.

It is important to take your time and consider them carefully. You will have the opportunity to return for a second consultation to discuss them further, as well as any other queries you may have.

These include

• Bleeding
• Infection
• Seroma (tissue fluid collection in the breast)
• Asymmetry
• Wound breakdown and problematic scarring
• Change in nipple sensation (decreased or increased sensitivity)
• Decreased ability to breast feed
• Decreased blood supply to the nipple leading to partial or total nipple loss
• Decreased blood supply to fat cells leading to fat necrosis (discharge of fat that may persist for a number of weeks)

ALTERNATIVES

If you have not done so already, it would be useful for you try the following in the first instance, if applicable:

• Reducing your weight to a guideline body mass index of 27 or less. By doing so, some women find they do not need surgery at all. Even if your symptoms do not resolve entirely, and you do still want to consider surgery, then reducing your weight will help to reduce your risks of complications.
• Having professionally fitted underwear and clothing can improve your comfort and appearance, and you may find that this helps with breast-related neck and shoulder pain.

You can find more information on the BAPRAS website