Breast Surgery

Breast Reduction

Why have a Breast Reduction?

Large breasts can be the cause of very significant physical discomfort as well as self-consciousness for some women.

The main reason for a Breast Reduction, or Reduction Mammoplasty is that an over generous bust size can often be distressing or uncomfortable.

Many women who book a consultation are interested in finding out how Breast Reduction surgery could help relieve constant backache or shoulder pain.

Others talk of their sheer embarrassment about having a very big bust, and the effect that has on their self-confidence and even their personal relationships.

Looking after our appearance is not vanity. You should feel proud of yourself for having the courage to want to change something that you feel unhappy with.

Each individual breast reduction case is different, I will examine you and discuss the achievable reduction in size.

What is involved?

The operation involves excess tissue being removed and the breast itself reshaped.

I lift the breast tissue and the nipple into a higher, more youthful position, and remove excess skin and tissue to reduce the size of the breast.

Breast Reduction will also require the patient to understand, that there will be scars around the nipple accompanied by a vertical scar running down both the mammary crease.

An elastic bandage over a gauze dressing must be worn after breast surgery.

All breast reshaping is performed under general anaesthetic and will require a two night stay in hospital.

Breast Reduction Aftercare

After surgery

Immediately afterwards, expect to feel some discomfort. When the medical team feel you are ready you will be transferred to your room where you can relax in comfortable surroundings.

The next morning the pain will inevitably have eased considerably. Any remaining discomfort can be controlled by medication. Breast Augmentation requires a two-nights stay at the hospital so your immediate recovery can be closely monitored.

Your recovery

Recovery depends greatly on the extent of the procedure. Expect to feel sore and swollen for several weeks.

Strenuous activity should be avoided for 4-6 weeks. Although most of the bruising and swelling usually disappears within three weeks, some swelling may remain longer.

This procedure will leave scars that can be hidden by underwear, and can be expected to fade in most cases.

Post-op appointments

Post-operative follow-up is of paramount importance. Each patient undergoing Breast Reduction surgery will be given post operative appointments for wound management and suture removal. Post-operative instructions are vital and we consider it very important that you adhere to them. Failing to follow these guidelines and attend your appointments can adversely affect the outcome of surgery and put patient safety at risk. Following Breast Reduction the patient is asked to return on specified appointments and occasionally it may be necessary to return more regularly than those stated.

Breast Reduction Risks & Conditions


Smoking increases the risk of complications, particularly infection which may result in implant removal, and slows down the healing process. It has been shown that a smoking patient has ten times more complications than a non - smoking patient.

Smoking reduces the blood supply to the wound and can impede the healing process.

Each cigarette further constricts acutely the blood vessels. It is highly recommended to stop smoking completely 4 weeks prior to surgery and 2 weeks after; no nicotine patches or chewing gum are allowed. The risk of infection and complications in general slowly decreases if the patient stops smoking, but still remains higher compared to a non-smoker.

Haematoma (bleeding)

A haematoma is a collection of blood in the pocket of the breast. The risk is higher during the first 24 hours following any surgical procedure, but it can still occur at a later stage. In case of a major collection of blood it may be necessary for patients to return to theatre for a second operation to remove this collection, although extremely rare, excessive bleeding may lead to a blood transfusion and can be potentially a life threatening complication. In order to reduce this risk most patients will return from theatre with a small drain in place, which is removed prior to discharge. The risk of bleeding slowly fades in 3-4 weeks as the healing continues.

I recommend that you refrain from any heavy lifting and strenuous activity during this period.


Most patients will experience pain following surgery, especially if the implant is positioned behind the chest muscles. This certainly depends on the pain threshold of the patient.

Painkillers are given after the surgery to control the discomfort, a further supply is dispensed at the time of your discharge. It has been reported that pain may appear during this period and can become permanent, although this is a rare occurrence.

Patients may experience shooting pains, and burning sensation and itching, these are all symptoms of nerve bruising and will subside over the first month. Pain due to nerve damage (neuroma), is rarely permanent, but can be.


Patients with chronic depression may not be suitable candidates for cosmetic surgery. A letter from G.P or psychiatrist outlining a medical summary together with current medication may be required. I would also ask for their opinion as to your suitability for surgery.

Nipple Erectability

The ability of the nipple to become erect may be compromised after the surgery. This means that the nipple may not become erect in response to tactile and other stimulation. This condition can be permanent in rare circumstances.

Prominent veins

Prominent veins are often a sign of poor blood flow. After breast augmentation veins may appear or become more prominent permanently. This risk must be understood and accepted by the patient.

Skin and nipple sensitivity

Skin and nipple sensitivity may change after the surgery, ranging from total numbness to hypersensitivity and pain. This may last up to 6 months, one year or even longer. Nipple sensation may never return at the same intensity or quality and, in some cases, it is possible to experience total or temporary numbness of the skin or nipple after surgery as well as permanent hypersensitivity. The patient may feel numbness in the arms and fingers initially post-op this is temporary.

Swelling and bruising

Some swelling and bruising will be present after surgery. Usually this subsides in a few weeks, but can last some months post-operatively.


The scar may not be exactly in the mammary crease, but slightly above or below, and may not be perfectly symmetric with the scar on the other side. Breast Reduction will also require the patient to understand, that there will be scars around the nipple accompanied by a vertical scar running down the mammary crease.

The quality of the scar depends on the skin of the patient. For a few months it will be quite visible, but the tendency is to fade. Occasionally patients produce excessive scar tissue, it may be prominent (hypertrophic scar, keloid). This scarring is rare in Caucasian (white) patients, but slightly more common in non-caucasian patients. The scars can be tender and painful, especially during the recovery period, and may even become permanent.

Occasionally the scars on either sides may not heal at the same rate. A minority of patients may require scar revision under local anaesthetic several months following surgery.


A general anaesthetic carries risks that can be discussed with the Anaesthetist.

Itching, burning sensation

These symptoms are caused by nerve damage and will usually subside at 14 to 28 days.


In a very small number of patients, fluid builds up. Additional surgery may be needed to remove this fluid.

Nipple and flap necrosis

Lack of blood supply to the skin / tissue supplying the nipple. This complication may cause the nipple to die resulting in further surgery and permanent deformity.

Breast feeding

After surgery you will might be unable to breast feed.