Breast reduction is a procedure used to reduce the size of the breasts, reposition the nipple to a more appropriate location, and improve the shape of the breasts. This procedure is associated with a high satisfaction level.
Conduct of the Procedure
Breast hypertrophy is a common problem. Patients with breast hypertrophy can develop complications such as back and shoulder pain, difficulty in dressing, skin irritation, difficulty with physical activities, and decreased self-esteem.
The evaluation appointment is the moment where the patient can ask questions and have a physical examination.
A mammography and some other tests may be requested before the surgery. In general, the surgery is carried out when the patient is finished having children and her weight is relatively stable.
The procedure is a day surgery which lasts for about 2 hours and is carried out under general anesthesia. Three scars are to be expected: one around the areola, one vertical from the areola down to the underside of the breast, and one in the fold below the breast.
The volume of the breasts and the size of the areolas are reduced. Nipples are moved to the right place on the breast.
It is normal to feel some pain after the surgery, but it is generally of short duration (a few days). The patient will have her breasts covered by dressings, and showers will be allowed once they are removed. It is advised to rest in the days after the surgery, and then it would be best to gradually reach a certain level of exercise. Six weeks are necessary before strenuous physical activities can be resumed. Wearing a bra, ideally without underwires, is recommended for comfort.
The patient must see her doctor several times after the surgery to check for complications. A mammography may be requested after the surgery, usually six months after, if the patient meets the eligibility criteria for breast cancer screening.
Hematoma: A build-up of blood that may appear within a few hours to several days after the surgery. Although rare (less than 5% of all cases), in the vast majority of cases, another surgery is needed to treat it, and a temporary small drainage tube is installed as well.
Infection: two types are found. The first type, called cellulitis, is a superficial infection found around the incision. This infection is easily treated with antibiotics. The second type, called abscess, is an infectious collection. Another surgery is needed to treat it, and a temporary small drainage tube is installed as well.
Dehiscence: a wound disruption after a surgery. This complication is relatively common, especially after a major breast reduction. In general, dehiscence is a minor problem that has no consequences, only causing a few days delay in complete healing of wounds.
Asymmetry: may occur after the surgery, but it is often hardly noticeable. It is more frequent in patients in whom an asymmetry was already present before the procedure.
Fat necrosis: occurs when a part of the fatty breast tissue has died. This is a minor complication characterized by potential nodules which can be felt under the skin.
Nipple necrosis: the most feared complication by surgeons. It corresponds to the death of all or some of the cells in the nipple and the areola. It is extremely rare (less than 1 % of all cases). If necrosis occurs, various techniques can be used for reconstructing the nipple.
Decreased nipple sensation: may occur as a result of irritation of the sensitive nerves during the surgery. This is usually temporary. A permanent loss of sensation is extremely rare.
Scarring: any hypertrophic (thick) scar that occurs will be treated.
After the Surgery
Breastfeeding is possible after breast reduction. About one-third of women will find it easy to breastfeed, one-third will need supplements, and one-third will not be able to breastfeed at all. This is one of the reasons why it is recommended, whenever possible, to carry out this surgery when the patient is finished having children.