Very large breasts can be burdensome and cause a number of medical problems, including back and shoulder pain, an inability to exercise, poor posture and sometimes rash. Epworth Plastic Surgeon Dean Trotter explains what you can expect during the reduction procedure.
Why might you get a breast reduction?
In most cases the aim is to reduce back, neck and/or bra strap pain, improve your ability to exercise or for hygiene reasons, rather than improving appearance. Breast reduction surgery has one of the highest satisfaction rates of any surgical procedure and most patients will be very pleased that they underwent surgery.
How is the reduction performed?
There are several different techniques, but in general the breast tissue is reduced, along with the overlying skin. The breast tissue is then reshaped to provide a better breast shape and the skin tailored to that new shape.
Depending on the size of the reduction, this may result in a scar around the areola, with or without a vertical scar down the front of your breast (vertical breast reduction) and possibly another in the fold below your breast (‘Wise’ pattern breast reduction – the scar looks like an anchor). Some techniques also involve liposuction; however, it is unusual that liposuction alone will be an adequate technique of breast reduction.
All breast reduction techniques will have some form of scar that you will need to accept before deciding to have surgery.
What should I know?
As with any operation on the breast, there may be complications including bleeding, infection, asymmetry, slow wound healing, anaesthetic complications and deep vein thrombosis or pulmonary embolus.
Usually with breast reduction the nipple and areola are lifted from a lower position on the breast to a more ideal position. This means that blood and nerve supply to the nipple and areola may become compromised. Very rarely, this results in failure of the nipple and areola to survive the operation.
More commonly there is some reduction or even loss of feeling in the nipple following breast reduction. Up to one-third of women will experience this.
The other issue related to the nipple is that the ability to breastfeed may be affected. Not all women are able to breastfeed, so it is hard to determine exactly if a breast reduction will interfere with breastfeeding. Some women are unable to breastfeed following breast reduction, others can but have to supplemental feed, and others have normal breastfeeding ability.
If a patient’s body mass index (BMI) is higher than 30, their risk of complications increases significantly and they will likely not be considered for a breast reduction procedure.
Finally, smoking interferes with wound healing and for this reason smokers are not usually candidates for breast reduction surgery.