Throughout history, large breasts have generally been considered a sign of femininity highlighting a woman's ability to nurture. Yet a woman with significantly larger breasts than the aesthetic standard of her time may be seen as abnormal or deformed. In these cases there is no doubt, that large oversized breasts can be disturbing to a woman by causing a host of both physical as well as psychological symptoms. In the former these can take the form of shoulder, neck and back pain as well as cause distortion of posture and in more severe cases make breathing difficult. Large breasts can dominate a woman's appearance and make her look unbalanced and make exercise difficult or impossible to do. In psychological terms, ungainly stares and rude comments make sufferers even more self-conscious which leads them to wear loose clothing to disguise their imbalance.


Surgical correction to reduce the size of the breasts has been performed for many years and in fact the first true surgical reduction of a female breast was probably performed in 1669 in England by William Durston. Although the main aim of the surgery is to reduce the volume and weight of the breast, cosmetic enhancement to fashion a normal shape remains equally important. The techniques have been modified and refined throughout the years in order to improve the safety as well as the aesthetic results.

Before & After photos /slideshow/

Am I a suitable candidate for breast reduction surgery?

Only a consultation can assess this. During your consultation we will ask you about your general medical history including details about any previous breast surgery, and childbirth. While women of all ages can benefit, it's usually never performed before the breasts are fully developed. In addition, patients who plan to become pregnant should usually postpone the operation until after their family is complete. The reason is that if a pregnancy ensues following a breast reduction procedure, permanent re-enlargement may rarely occur. Thus any decision to perform a breast reduction operation prior to this must naturally be weighed and balanced against this risk and the benefits offered by this type of surgery.


If you are a smoker you will be asked to stop smoking well in advance of surgery. Smoking seriously constricts blood vessels and therefore decreases blood flow to a given area resulting in poor healing. Aspirin and certain anti-inflammatory drugs and other medications can cause increased bleeding, so you must avoid these.


If you are significantly overweight then planned preoperative weight reduction is encouraged but this alone does not necessarily rule you out for an operation. In fact many times the achievement of reduced breast size can become a stimulus for further planned weight loss.


Depending on your age you may be required to have a mammogram prior to surgery. This again will be advised at the initial consultation.

The operation

We are experts on Short Scar Breast Reduction and a pioneer of our own technique designed to minimize the scar and augment the upper pole of your breast (this is similar to what many of the new popular bras deliver through external means).

After the surgery

After you recover you will notice bandage dressings around your breasts and, depending on the technique used, the presence of drains. These are usually inserted under the wounds to drain any build up of blood or fluid that occasionally develops after surgery. Once the drainage is minimal (usually the next day) these drains are then removed. Your bandages are then readjusted and you are then instructed to wear a wireless sports bra for support.

Potential risks

Whilst it is true that when a Breast reduction is performed by a qualified plastic surgeon the risks are small, nonetheless, specific complications with this procedure can and do occur.


As in any procedure the risk of significant infection is always possible. This is minimized by careful surgical technique and the preventative administration of antibiotics both at the time of surgery and after. However despite these measures mild infection is relatively common and can occur around the incision sites, but usually subsides over a period of about 2 weeks.
Risks such as blood clots are rare. Early mobilization by moving around as soon after the surgery as possible reduces this considerably.


As mentioned earlier, swelling should be expected after this operation. When mild or moderate swelling is present, the body rapidly reabsorbs this. Very occasionally, increased bleeding can lead to more significant swelling and the development of a hematoma (a collection of blood under the skin). If this were to happen, surgical drainage to evacuate this would be required. Ultimately however this should not affect the final outcome.

Summary

We believe that both the Reconstructive aspects as well as the Aesthetic aspects to Breast Reductions have equal importance. One should expect relief of symptoms as well Aesthetic Balance.


Breast Reduction surgery probably has one of the highest satisfaction rates of all plastic surgical procedures. This is because women who had been burdened with the effects of overly large breasts for many years suddenly feel "liberated" and able to do things that were difficult or uncomfortable prior to surgery. In many ways these women feel they have been given a new lease of life and are thus able to approach many everyday matters with renewed interest and confidence.

We use a marking pen to draw on the breasts in order to determine the exact position and size of the newly operated breasts. Excess breast tissue, fat and skin are then removed, and the nipples and remaining underlying tissues are then moved to a new higher location, all in accordance with the preoperative markings. The suture line is situated around the nipple in its new position, and extends vertically downwards towards the under-breast crease.

Anesthesia,  surgery time, and hospital stay

Breast reduction is performed under general anesthesia and usually takes about 2 and 1/2 hours. This procedure can be performed on both an inpatient and outpatient basis. At the time of your consultation we will suggest which would be best for you.

For a few days after your surgery, you will probably experience some moderate degree of pain which should be well controlled with pain killers. The pain usually improves after the first 4-5 days.

After effects

Following surgery you will experience considerable swelling and bruising of the breasts. The bruising usually lasts about 2-3 weeks. While most of the swelling will have dissipated by this time, some subtle swelling may still be present for up to 3 months.


After surgery you may notice that the breasts feel quite firm and taut, particularly along the edges of the incision site. This will be as a result of the normal healing process laying down elements of scar tissue to facilitate healing. When this occurs, massage as instructed by your surgeon will speed up the recovery. It gradually resolves in time but may take a few months to complete.


You should expect the sensation to the skin in the nipples and surrounding skin to be reduced after surgery. This is as a result of surgical trauma to the nerves in the region. Although this usually recovers in a few months, permanent numbness may ensue.


It is normal for breasts to be slightly uneven and this is no exception in large breasted ladies. Although every effort is made to make the breasts symmetrical, it is not always possible to achieve this exactly. Breast reduction surgery is possibly one of the most demanding aesthetic procedures. It is imperative therefore that you always talk with your surgeon in order that he has a full and proper understanding of your wishes. Try to convey, as much as is possible, how little or large you would like to be following your surgery. This will minimize the possibility of having too little or too much removed.
Although the technique used by us ensures the best possible continuity between the breast and nipples thus increasing the possibility of breast-feeding after breast reduction surgery, this cannot ever be guaranteed.

Scars

Scars are not a complication but a normal event after any surgery. In Breast Reduction the scars are quite lengthy and may take many months or years to settle. You should always expect these to be red, raised, lumpy and even itchy to begin with but with time they should fade and flatten. This is the natural evolution of the healing process. However it is important to keep in mind that this may take up to two years to complete. Daily massage of the scars during this time period is advised to expedite and facilitate this process. You must understand however that no responsible surgeon will ever be in a position to predict any scars ultimate appearance. Although as mentioned, scars do fade and improve in time it is unlikely however that these could ever be characterized as being mainly only "hairline" in nature.

Downtime

A breast reduction is a relatively major operation and should always be respected as such. Don't try do too much too quickly. It is likely that a few weeks will pass before you feel yourself again. Remember variations do occur in the time individuals take to heal. As a guideline, although many people go back to light work duties by 10 -14days, others find it more appropriate to take a further 1-2 weeks to rest. Walking is helpful in the first 3-4 weeks as this improves the circulation and helps reduce the swelling, and the chance of blood clots developing. Heavy lifting or Strenuous activity is prohibited in the first 6 weeks after surgery. Overall common sense rules in the recovery period. If what your doing is uncomfortable then don't do it!