BREAST REDUCTION

What is a breast reduction?
A breast reduction is an operation aimed at removing excessive breast tissue and fatty tissue in order to leave the remaining breast in proportion with the rest of the body. The nipple is usually elevated and the shape of the breast improved.

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Women with large, heavy breasts may experience several health concerns related to their breasts such as back pain, neck pain, grooves in the shoulders from bra straps, pain in the breasts and rashes under the breasts. Women with arthritis of the spine and shoulders may have more symptoms than usual because of the added weight of heavy breasts. Some women are bothered by the psychological embarrassment of large breasts. In other situations, athletic, active women and women who are trying to lose weight are inhibited by the size of their breasts. Often, it is difficult and expensive to find clothes that fit.

Breast reduction can minimise or eliminate these problems. During the procedure, excess skin and breast tissue are removed and the breasts reshaped to be smaller and more attractive.

How is the operation performed?
The procedure is performed in a hospital under general anaesthetic. The operation usually takes three hours depending on the extent of each case. Usually only one night is required in hospital following the operation and you can return home the next day.

When can I return to activities?
Generally there is no great discomfort. There may be some tender spots but these are usually temporary. Usually at least one week is required away from work or normal activity.

Can I breast feed after the operation?
As a general rule patients having a reduction mammaplasty will be able to breast feed. Parts of the breast tissue are separated from the ducts in the nipple and problems may arise, or the milk output may be limited. However, as a note of interest, women with large breasts tend to have a low milk output so they might have problems breast feeding anyway. The surgeon may, in reducing enormous breasts, elect to graft the detached nipple higher, making breast feeding totally impossible.

Some patients may experience a permanent inability to breast feed after having the surgery. You should consider these factors seriously before deciding to undergo the procedure and talk them over with Dr Drielsma.

Are there any risks?
As with any surgical procedure, there is a small risk of complications. Surgery and anaesthesia is very safe and it is most unlikely you will experience any difficulty. However, there is a small chance that a minor complications such as bleeding or infection may occur.

Bleeding: There is a 2-3% risk of post-operative bleeding which may at worst require return to the operating theatre for drainage.

Infection: If infection occurs it will become evident within one week of surgery and may delay the healing process or result in the development of scar tissue. This may require treatment with antibiotics. In the unlikely event of infection, the ultimate result of the surgery may be adversely affected.

Scarring: Scars are an unavoidable drawback to the procedure, but typically quite acceptable to most patients. The incisions are designed so that the scars will not be visible while wearing normal clothing. The scars will be more obvious in the early months after surgery. These scars will continue to fade over the ensuing 12-18 months. Some patients may have a tendency to form thick or red scars (hypertrophic or keloid scars). These scars can usually be improved by a second operation if necessary.

Swelling and bruising: As with all operations, a degree of swelling and bruising will occur usually worst in the first 48 hours post-operatively. This has usually subsided by the end of the first week.

Sensation: Sensation of the nipple may be affected. It can be altered, being "lost", "made different", "sore" or it may even be "improved".

Blood Supply: The operation is planned in such a way to ensure that an adequate blood supply is maintained to the various remaining anatomical parts of the breast, such as skin, fat, breast tissue and nipple. At times, if the circulation is inadequate, tissue may die. This is not common, but is more likely in very large breasts or in patients with poor circulation. At times the desired size and shape may be compromised to help maintain an adequate circulation.

Anaesthetic: You will be receiving a general anaesthetic and your anaesthetist will be discussing with you possible discomforts following anaesthesia. Again, anaesthesia today is very safe and no major problems should be concerning you. Any questions you have regarding your anaesthetic would be best answered by your anaesthetist at the time of surgery.

General Information
Although every attempt is made to obtain symmetry and a natural shape, as with most women, there may be some difference in the final size and shape of the breasts or in the position of the areola and nipple and a small degree of difference must be accepted.

Should there be any questions regarding breast reduction, be sure they are answered in advance by Dr Drielsma. Well meaning friends are not a good source of information. Find out everything before proceeding with the operation - a well informed patient is a happy one.

Finally, there can be no absolute guarantee with any surgery. Remember the realistic aim of this operation is improvement, not perfection.

Please note: The above information mentions only some of the benefits and complications of a breast reduction. This information should not be regarded as a substitute for information and advice provided by Dr Drielsma during consultation.