Large, heavy breasts can have a significant impact to quality of life in many ways. It is well recognised that physical symptoms such as neck pain, back pain and shoulder pain arise as a result of larger breast volume and weight. Psychological impacts are also significant, where patients may suffer lower confidence or self esteem and modify behaviors such as restricting clothing choices to loose fitting clothing and activities such as exercise. Unfortunately these problems usually worsen over time as the breasts age and further in those who have breast fed their children as the larger weight and volume causes the overlying skin to become stretched and the breasts become ptotic or drop, resulting in further weight distribution issues and increasing effects on the spine and can also lead to skin irritation due to sweating under the breast area which is not resolved despite regular washing and anti-perspirant use.
While some of these issues can be resolved by non-surgical methods such as weight loss and use of a supportive bra, an excellent treatment for larger breasts is breast reduction surgery, or reduction mammaplasty.
Breast reduction surgery aims to achieve three goals:
Planning for the procedure begins with your pre-operative consultation. During your consultation Dr. Chris Ahn will discuss what your goals for the operation are and how it would be best to achieve them. Risk factors for potential complications will be screened for and a clinical examination performed to assess your breast's size, symmetry and skin quality.
Although many patient's goals are simply to reduce as much volume as possible, this is not always the best solution. A well-performed redistribution of the breast tissues to a higher position on the chest wall can be just as important as the volume reduction itself and certain areas of the breast tissue will need to be preserved to be able to do this while restoring a good breast shape and preserving the normal anatomy, including the nipple areola complex. An overall estimate of the size reduction to be performed however an accurate 'cup size' measurement is not given as this is a somewhat arbitrary measure based on the difference between your chest circumference under and over the breasts.
The procedure is performed under general anaesthesia and typically takes 2-3 hours. Prior to your anaesthesia, Dr. Ahn will spend time marking the incisions to be performed on the skin and the area of breast tissue to be resected. Although there may be some variation in the skin incision pattern, the typical surgical incision line used is the inverted T or 'anchor' type scar. This scar enables superior control over the areas of skin to be reduced so that they can be tailored to your new breast volume and position while minimising the need for further revision as is the case in some less extensive scars such as the vertical 'lollipop' or peri-areolar skin reduction techniques.
Once the excess glandular breast tissue is removed, the remaining tissues that support and provide blood supply to the breast will be rotated up 90 degrees to lift and reposition the nipple higher on the chest. This maneuver redistributes the tissues to form an internally supported breast that enables lift without relying on external bra support. Once completed, the skin envelope is simply reduced and tailored to fit the underlying breast tissue shape without tension to enable healing with minimal risk of scar complications.
Depending on a number of factors your operation can either be performed as a day surgery or you may choose to stay overnight in hospital. As there is no muscle dissection involved in the operation, the procedure is generally well tolerated and although you may require some stronger pain relief in the first few days after your procedure, regular simple analgesics such as paracetamol or ibuprofen will deliver adequate baseline pain relief.
After the operation, you will be required to wear a post operative support bra for a number of weeks and attend follow up appointments with Dr. Ahn to check the progress of your wound healing and breast shape. Potential post operative complication include bleeding, seroma or fluid collections, wound infection or poor scarring and altered nipple sensation and will be monitored for and managed as required by Dr. Ahn and his team however you should be aware of the signs to look for and take an active role in monitoring your progress during your recovery period. Other post operative instructions including scar management, activity restrictions and return to work will be discussed depending on your own circumstances however in general you should expect a return to low activity work at 2 weeks and exercise at 6 weeks post operatively.
Breast reduction surgery is an excellent procedure that has a high patient satisfaction level. Problems such as neck and back pain can benefit from immediate relief after the procedure and many underlying problems of breast shape, size and symmetry can be addressed in a single operation. Dr. Ahn is highly experienced with this area and enjoys providing this service for his patients and sharing their experiences and outcomes. If you would like any further information or to arrange a consultation to see Dr. Ahn regarding breast reduction surgery, please contact us here.