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BREAST REDUCTION
In a breast reduction the excess breast tissue and skin are
removed, leaving you with a scar that runs around each nipple
vertically down to the fold underneath the breast and then
horizontally in the fold underneath the breast. Depending on the
size and type of the reduction, sometimes there is no horizontal
scar.
The operation is long and takes approximately three hours to
complete. It is major surgery and we recommend that you take
things very quietly for at least a month after the operation,
and avoid any heavy exercise for six to eight weeks after
surgery.
There are potential complications with the operation, in
particular those relating to the scars, including the risk of
infection of the wounds, which would leave you with a scar wider
than that which is ideal. The scars settle over a period of two
to three months, to leave a fine line, though some scars become
red, raised and itchy, and remain so for approximately nine to
eighteen months after surgery. These settle to leave wide, flat
scars. The risks are approximately 4% in each case.
After surgery there may be a collection of blood underneath
the skin and breast tissue, despite the use of small tubes
(drains) inserted into the wound temporarily after the operation
to collect any blood. If this is the case, you may require a
return visit to the operating theatre for removal of the blood
clot.
The operation requires extensive undermining of the skin and
the movement of the nipple to its new height. The extent of the
operation may endanger the blood supply to the skin and to the
nipple. If this is the case, the nipple may have to be taken off
and immediately re-applied as a skin graft.
In addition, the extent of the surgical procedure may reduce
the sensation in the nipple or surrounding skin. This usually
returns close to normal over a period of two years. Whilst we
try to ensure that the breasts and nipples are symmetrical and
as equal in size as possible, it is likely that there will not
be an exact match after surgery. Whilst the operation reduces
the size of the breast, with ageing it is likely that the shape
of the breasts will change.
Please bear in mind that you may get increased discomfort in
the breasts with your period. This is normal. All the breast
tissue is sent to the pathologist for sampling. If any evidence
of malignancy is found in the breast you may require further
surgery and perhaps a mastectomy.
A breast reduction involves cutting into fat, which can then
die. The dead fat either appears as a sterile abscess coming
through the wound or as a tender lump underneath the skin.
Dressings may be required if this happens. If the lump remains,
this can have calcium deposited within it, which can show up on
an X-ray. It is, therefore, very important in the future that if
you have a mammogram performed, you must tell the medical staff
that you have had surgery to the breast in the past.
It is also inadvisable to be on regular Aspirin containing
tablets, rheumatic-type drugs like Nurofen or Brufen,or Ginkgo
Biloba, as these can cause bleeding. You should discontinue them
not less than 1 week before the operation. Smoking affects your
skin blood vessels and makes both bleeding after operation and
the risk of skin dying, more likely. If you are in doubt about
any of these points please consult us or your doctor.
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