The breast reduction surgery procedure
A breast reduction surgery, just as with other plastic surgeries, can be divided into three phases – preparation, procedure and after cycle.
In medical terms the above three phases are known as preoperative, operative and postoperative phase. This page will describe what the first two of these three entail for breast reduction surgery.
Planning prior to a breast reduction surgery
Once you have decided to undergo a breast reduction surgery, you will book an appointment with a plastic surgeon. At the consultation with the surgeon it is very important that you have an honest discussion and that you listen to his/her opinions. Each plastic surgeon, as well as every patient, has different views on what is a suitable breast size and shape.
The plastic surgeon will examine and measure your breasts. He/she will also take photos to use as reference before, during and after the procedure. You will also discuss the factors that can affect the surgery such as age, point of departure (the breasts size and shape) and the skins character.
You should also discuss the areola and nipple reduction and relocation. Custom is to move it upwards and place it at the height of the crease under the breast pointing forward.
Your surgeon should describe the procedure in detail, explain what risks and limitations the procedure is associated with and make sure you understand what the scars will look like. As a patient it is important to understand that with a breast reduction one ”swaps” the large sagging breasts for more or less visible scarring on the breasts.
Preparations prior to a breast reduction surgery
You will receive thorough instruction about how to prepare for your breast reduction. These include information about how to eat and drink, rules of smoking, taking vitamins, medication and other substances. Tobacco and alcohol should be avoided for at least two weeks before and two weeks after a breast reduction.
In some cases you will need to undergo a mammography to make sure there are no medical hindrances that can affect the breast reduction procedure. (If there is no hereditariness for breast cancer then generally mammographies are performed on patients that are over 40 years old. With hereditariness the age is lower)
Generally one spends the night at the clinic after surgery and goes home the next day. As part of your preparations you will need to find someone who can pick you up at the clinic and assist you for a few days after surgery.
Surgical procedure for breast reduction
A breast reduction is performed under general anesthesia and takes about 2-3 hours to perform. There are several breast reduction methods. Normally the surgeon places an incision around the areola, down over the middle of the breast and then into the natural crease of the breast – a so called anchor-shaped incision.
Thereafter the breast tissue, fat and skin is removed and the areola with the nipple is shaped to the desired shape and transplanted to a new place on the breast. Then the surgeon takes the newly shaped skin and pulls it around the areola to shape new breast contours. When necessary the area below the arm pit is liposuctioned during the procedure.
The nipples are often still connected to their existing nerve and blood endings but if the breasts are very large and have a great overhang, the areola and nipple may need to be moved further in order to rest in a natural position on the breast. This increases the risk of impaired sensitivity and blood circulation to the areola and nipple.
The closing sutures are generally placed around the areola and into a vertical line down towards the crease under the breast. In some cases a breast reduction can be performed without the horizontal incision in the breast crease which reduces scarring. In exceptional cases it is possible to achieve a satisfactory breast reduction by merely liposuctioning the areas, which also minimizes the risk of scaring.
Once the incision has been closed a bandage is placed and the patient is moved from the operating theatre to a monitored recovery ward. In some cases the patient leaves the clinic the same day after a few hours rest, in others the patient spends the night.