Frequently asked questions regarding breast reduction surgery

What can breast reduction surgery achieve?
Will there be scars after breast reduction surgery?
How do I prepare for breast reduction surgery?
What happens when I come into hospital for breast reduction surgery ?
How will I feel after breast reduction? How quickly will I recover?
Is breast reduction surgery safe?
How do I arrange a consultation with Mr Hamilton in London regarding breast reduction?

What can breast reduction surgery achieve?

Breast reduction involves repositioning of the nipple and surrounding areola, usually at a higher, more youthful position, whilst at the same time excess breast tissue and skin is removed and the breast is carefully re-shaped. The vast majpority of ladies achieve a life-changing result following breast reduction. Mr Hamilton will be happy to discuss your goals and expectations from breast reduction at your consultation in London.

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Will there be scars after breast reduction surgery?

Yes. A variety of surgical approaches are possible and the exact details of any scars will be discussed with you at consultation. There is always a scar around the areola (the darker area outside the nipple) following repositioning of the nipple. For large reductions, the best correction is often achieved by adding a vertical scar from the areola to the crease under the breast and across the crease under the breast itself. In smaller reductions (or a lift combined with a small to moderate reduction) it is sometimes possible to avoid the horizontal scar across the crease under the breast. This is called a vertical scar technique and Mr Hamilton is keen to employ it in all suitable patients to minimise scarring. The scars fade over a period of months following surgery and the vast majority of patients find them highly acceptable.

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How do I prepare for breast reduction surgery?

Where possible, it is important to avoid aspirin or non-steroidal anti-inflammatory drugs such as ibuprofen (Brufen) and diclofenac (Voltarol) for two weeks pre-operatively. These drugs reduce the ability of the blood to clot and can make bleeding more of a problem during and after surgery.

Smoking can increase the likelihood of wound problems in this type of surgery and abstaining from smoking for at least 2 weeks preoperatively and postoperatively is a sensible precaution.

Patients taking the oral contraceptive pill should consider using an alternative form of contraception for a full cycle prior to surgery since the pill can increase the risk of thrombosis (clot) forming in the veins of the leg.

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What happens when I come into hospital?

You will be admitted to hospital on the day of surgery and Mr Hamilton will come to re-discuss the procedure and to plan and to mark the exact extent of the surgery. You will be seen by our consultant anaesthetist who will discuss the anaesthetic with you and answer any questions you may have.

How long does the a breast reduction operation take?

The length of the procedure depends on the extent of correction required. Typically, the surgery takes about 2 to 3 hours.

What does the breast reduction surgery entail?

With you asleep under general anaesthetic, local anaesthetic is placed in the area to be treated to reduce any postoperative discomfort. Mr Hamilton will then remove any excess skin and tissue in the breast, repositioning the nipple at the new higher level and re-shaping the breast. Occasionally a small drain connected to a suction bottle is placed in the wound to remove any fluid which might collect and reduce bruising. Very often, however, Mr. Hamilton does not find surgical drains to be necessary, allowing for a much more comfortable recovery period. A supportive dressing is placed over the breasts and our consultant anaesthetist will then gently wake you before you are returned to your room on the ward.

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What happens after the breast reduction operation?

Usually, after a relaxed night in hospital, you will be able to go home the following day. If drains are used, they will be removed the morning after surgery in the ward prior to discharge. Occasionally patients wish to stay another night but the majority prefer to go home the morning after surgery. We usually recommend that you use a sports bra after surgery to give extra support and comfort. Our nursing staff will help you into your sports bra before you go home. Sports bras are usually used for 4-6 weeks.

Mr. Hamilton will usually see you back in the consultation room 7-10 days after surgery to check that all is well and to reduce the dressing. Usually, only dissolving sutures are used, though some of these may need trimming when you come back to the clinic. Typically, you will be seen again a week thereafter at which stage dressings usually be dispensed with. A further follow up visit is planned around 3 months after surgery.

Is it painful?

Breast uplift causes a degree of discomfort but this is usually well controlled with the painkillers provided by our experienced consultant anaesthetist. On discharge home, patients are generally comfortable using mild painkillers such as paracetamol and codeine. Most patients find they are able to resume normal activities over a 1-2 week period.

How quickly will I recover?

If all goes to plan, normal activities can be resumed by about 2 weeks and most patients are back at work by 2-3 weeks. Vigorous sporting activities and gym work are probably best left until 4-6 weeks after surgery.

Will I be able to breastfeed?

Whilst some ladies are able to breastfeed after breast reduction surgery, it is probably best to assume that you will not be able to successfully breastfeed afterwards.

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Safety and Risks in breast reduction surgery

 

Is breast reduction safe? What are the risks?

The great majority of patients undergoing breast reduction in the hands of an experienced surgeon achieve good results with a rapid recovery. However, in a small proportion some complications are a possibility:

• Unfavourable scars – In some patients, especially those of Afro-Caribbean origin, scars can be thicker than expected or become raised. In the vast majority of cases, these settle spontaneously but occasionally other measures to improve the scar may be necessary. Most patients find that the scars settle well though all individuals are different and in some cases, scars can take many months to settle. Mr Hamilton will advise you on massage techniques to help speed up the rate at which the scars mature. Scars, of course, never disappear and some form of scar will always be present.

• Infection – fortunately, infection is rare in this type of surgery and the risk is minimised by careful surgical technique and the use of a dose of antibiotic before surgery commences.

• Nipple sensation – Most ladies find that there is some reduction in nipple sensation after breast reduction, though this tends to improve with time. Some permanent loss of sensation is seen fairly frequently, particularly in ladies undergoing very large reductions.

• Areola or nipple loss – Repositioning the nipple and removing breast tissue inevitably interrupts some of the blood supply to the nipple and surrounding areola. This introduces the risk of some of this tissue not surviving. Fortunately, the risk of this problem is very low, particularly when very careful planning and surgical technique is employed. The problem is more commonly seen in patients who smoke near the time of surgery.

• Haematoma – Rarely, small blood vessels in the wound may bleed after the surgery leading to a collection of blood under the wound (a haematoma) which needs to be released and washed out before resuturing the wound. If this problem arises, it is typically on the day of surgery and does not affect the final result.

• Occasionally, wounds can be little slow to heal and small dressings are occasionally required after surgery. If this occurs, it tends to be in the area of the “T-junction” where the vertical scar meets the scar running under the breast. Usually these areas heal of their own accord but on very rare occasions it can be necessary to resuture or revise this portion of the scar. This problem is, fortunately, unusual and more commonly seen in smokers.

• Significant surgery such as this carried out under general anaesthetic carries a small risk of postoperative chest infection (particularly in smokers) and of thrombosis of the veins of the legs (DVT or deep venous thrombosis) and the concomitant risk of clot moving to the lung (embolism). Patients wear protective stockings during and after surgery to help minimise the risk of DVT and embolism. Early mobilisation after surgery is an excellent way of reducing the risk we also use a compressive massaging device on the calf muscles in theatre to further reduce the small risk of this complication.

Summary

Breast reduction surgery is one of the most successful “cosmetic” surgical procedures and can make a real difference to the day to day lives of women who find their breasts too large. Mr Hamilton will be happy to discuss your goals and the surgical options at your consultation in his London clinic.

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