Cambridge Plastic Surgery

Plastic and reconstructive surgery, hand surgery and aesthetic surgery

Medicolegal reporting

 

 

Breast reduction

Breast reduction surgery is an extremely effective operation that can be life changing. It is not appropriate for patients who are smoking.
Most patients report that the weight and size of their breasts contribute to back and neck pain, irritation in the skin of the infra-mammary crease, and reduced mobility. Most patients report that their breasts affect their choice of clothing. For some patients considering breast reduction surgery, their breast size can impede their choice of activity.
Patients over the age of 40: could potentially benefit from a mammogram before surgery. I would recommend that patients discuss this with their own general practitioner. Patients considering breast reduction surgery should have a healthy body mass index (of below 30, and ideally below 27).

The operation

I use either a vertical scar technique, or a “Wise” pattern technique, for larger reductions. All patients have a scar around the edge of the areolar and a vertical scar on the lower pole of the breast. Most patients have a scar in the infra-mammary crease. The nipple is supported on a “pedicle” which is superiorly and medially based. The surgery takes approximately 150-220 minutes and usually requires a two night stay in hospital.

Patients normally need to wear a sports-bra for 4 weeks after surgery. The hospital usually fits and supplies two appropriate sports bras.

Before Surgery

The same patient two-weeks after
breast reduction surgery

The risks

The risks include bleeding (requiring a return to the operating theatre) asymmetry, changes in nipple sensation, and tender or lumpy scarring. There is a small risk of blistering and delayed healing. Patients should presume that they will not be able to breast-feed after surgery.

The risk of deep venous thrombosis and pulmonary embolism is minimized by the use of thrombo-embolic stockings, and early mobilization of the patient after surgery (getting out of bed as soon as fit enough to do so with the support of the nurses).

The risk of sepsis after breast surgery is extremely low, however, any patient who develops a fever and feels unwell in the days and weeks after surgery, should seek urgent medical assessment and advice. (This could mean attending the emergency department of a local hospital.)

Patients who experience a rapid onset of calf pain, or shortness of breath in the weeks after surgery, need rapid assessment (usually best carried out by the emergency department of a local hospital) to exclude the possibility of a deep venous thrombosis (a clot in the calf veins) or a pulmonary embolism (a blood clot obstructing a lung blood vessel).

Return to activity

It is worth the time, effort and money, to get the best possible sports bra for you. To get the best results minimise any bounce for three months after sugery: this means that you should initially use either, an exercise bike, a road-bike, a treadmill (against a shallow gradient), or step-machine, before considering aerobics, tennis or running. Do not do any bench-press weights or abdominal crunch/curls for three months.

More information
Patients can find more information on the BAPRAS website: http://www.bapras.org.uk/public/patient-information/surgery-guides/breast-reduction

To make an appointment
please call 01223 550 881 or email: igrant@uk-consultants.co.uk

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