Breast Reduction

Breast reduction surgery is highly individual and there are several factors to consider. Breast reduction should not occur until breast development is complete and breast-feeding is no longer required. Smokers are at an increased risk of complications and so we would advise that you quit smoking prior to your surgery. Each patient’s situation is unique and will be discussed at your appointment.

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The technique that is most commonly used is called a Wise Pattern technique. This typically involves removing breast tissue from the lower, middle and outer portion of the breast and repositioning the nipple. This reduces the volume of breast tissue, whilst also producing a “lift”. It results in a scar around the nipple (circular), a vertical lower scar and horizontal breast fold scar (upside ‘T’ or anchor).

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The sutures are all dissolving, although there will be a few knots on the outside that will be trimmed 2 weeks post op. In order to improve scarring, Hypafix dressing is to remain covering the wounds for 2-4 weeks after surgery. It is critical to wear a sports bra continuously for the first 4 weeks post-surgery to relieve tension on the wounds.

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Risks

General complications from the operation include pain, infection, bleeding (haematoma), Deep vein thrombosis, and wound complications. Bilateral symmetry is the goal however this may not be possible, but the aim is to have both breasts looking as similar as possible. Symmetry may change overtime due to aging or changes in body weight.

 

Nipple necrosis is where the skin of the nipple has poor blood supply resulting in tissue death. This can vary from a small scab-like area to, in extreme cases, a black nipple. The management of this complication can be as simple as dressings and oral antibiotics, but is more serious cases could require surgical excision/debridement (in the operating theatre).

 

The “T-junction” is the point where the vertical scar meets the horizontal scar (bottom point of an anchor). This region notoriously has poor healing as it is where the blood supply as the furthest distance to travel and is under the most tension. If the wound breaks down in this area, it is usually managed with simple dressings and antibiotics. This may result in a thicker scar but is usually hidden in the breast fold.

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Post-operative care

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Post operatively expect to have a drain in each breast to help siphon fluid or blood. These are typically removed on the ward without pain on day 2 post-surgery. Hypafix dressings will be over the wounds and will need to remain dry and intact for two weeks. Most patients only require regular paracetamol for pain relief, however you may be given a small supply of strong pain-killers to use for severe pain at home.

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When discharged home it is critical that you wear your post operative/ sports bra all day (only remove when washing) for the first 4-6 weeks. This helps provide support, relieving tension on the wounds to improve scarring and reduce pain. You must refrain from any vigorous activity/exercise but I encourage being mobile to reduce the risk of DVT. Regular slow-paced walking is best until you have your first wound check at two weeks. Driving is best avoided for at least 1-2 weeks post op, depending on your recovery.