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Breast Reduction

Reduction Mammoplasty (breast reduction)

The size of women's breasts may be determined by several factors, such as inherited genes, body weight and hormonal influences. They can, therefore, be a problem to some women early in adolescence or may not become uncomfortable until middle age following the menopause or the use of HRT. The problem of large breasts, however, may cause similar problems at all ages and these are chiefly backache, neck pain, grooves in the shoulders from bra straps, rashes under the breasts and the feeling of self consciousness. Because of the sexual nature of breasts the undue prominence may attract unwanted attention from the opposite sex, comments and sexual innuendoes. These can cause psychological distress to many women. One of the commonest complaints of women with large breasts is that it is very difficult to wear fashionable clothes and indulge in active sports, particularly in the summer months.

What is breast reduction surgery?

Breast reduction surgery is an operation to make the breasts smaller, by taking away fat, breast tissue and skin. The nipples are lifted and the breasts are reshaped to form smaller breasts.

Why have a breast reduction?

People have this surgery to make their breasts smaller and improve their shape. Some women have larger breasts than they would like. Big breasts can cause problems like back or neck pain, shoulder grooves in the shoulders from bra straps, and rashes underneath the breasts. Women are sometimes self-conscious about their large breasts and feel that they attract unwanted attention. Also, it can be difficult to wear some clothes or enjoy sports, particularly when it is hot.
If you are unhappy with the shape, weight or droop of your breasts, having them reduced can make them smaller and higher. If one breast is larger than the other, this can also be evened out. You may find that after a breast reduction you are more comfortable socially and personally.

What will happen before my operation?

You will meet your surgeon to talk about why you want surgery and what you want. The surgeon will make a note of any illnesses you have or have had in the past. They will also make a record of any medication you are on, including herbal remedies and medicines that are not prescribed by your doctor.
Your surgeon will examine your breasts, and may take some photographs for your medical records. They will ask you if you want to have someone with you during the examination, and ask you to sign a consent form for taking, storing and using the photographs. The surgeon will measure your height and weight to make sure that it is safe to do an operation. If you are overweight, pregnant or planning to become pregnant, your surgeon may suggest delaying your operation.

How is the surgery performed?

The operation involves first lifting the nipple into a new position, keeping it attached, and so alive, on a ‘stalk’ of tissue (pedicle). Extra skin and breast tissue is then cut away. The skin and tissue that is left is reshaped into a smaller, higher breast and the nipple is put back in place.
There are different types of reduction. The best type for you depends on the size of your breasts and how much of a reduction you want. The different types make different scars on the breasts. Whichever type of reduction you have, the scars should not be visible when you wear normal clothing, bras and bikini tops.

The anchor-type or inverted-T reduction (diagram 1)

This is the most common type of reduction. The cut starts around the nipple, travels straight down and then along the crease under the breast.

If your breasts are very large or droopy, your nipple might need to be completely removed and then stitched back on in a new position. Your nipple will not feel normal after this.

Diagram 1: anchor-type or inverted-T reduction


The vertical-pattern reduction (diagram 2)

The cut is made around the nipple and travels straight down, but with no cut underneath the breast. Though the scar is smaller with this type of reduction, the skin around it can look puckered. The vertical-pattern reduction is not suitable for very large breasts.

Diagram 2: vertical-pattern reduction