Your surgeon will always discuss with you and recommend the treatment that is appropriate for you. During the consultation, the surgeon will also explain the treatment, its results and benefits, the duration of the result and the frequency of repeating the treatment.

Breast Reduction

Having large breasts is not always the blessing it may seem. Women can feel very self – conscious and can become depressed about the size of their breasts. Large breasts can lead to numerous problems including back, neck and shoulder pain and grooves in the shoulders from bra straps, excessive sweating, rashes and infections under the breasts, difficulty participating in sport, unwanted attention and comments as well as difficulty in finding comfortable and attractive clothes to fit.

The size of a woman’s breast is partly determined by her genes – the inherited factors that also affect height and frame. It is also influenced by her weight and hormones. Some women develop particularly large breasts from early adolescence. Others develop them later in life, during the menopause or following the use of HRT (Hormone Replacement Therapy). For some women, large breasts are a source of physical and psychological discomfort.

Breast reduction is an operation where the excess fat and skin are removed from the breasts. The breasts are then reshaped to form smaller, more pert breasts, with the nipples being moved up to a natural-looking position. Breast reduction can also be effective in evening up the size of the breasts where one is much larger than the other.

CHOOSING TO HAVE A BREAST REDUCTION

Large breasts may appear droopy, with downward-pointing nipples. Breast reduction (reduction mammoplasty) may relieve many of the symptoms mentioned above. However, there is always some scarring on the breasts as a result of surgery. This will vary from person to person, and according to the type of incision (surgical cut) that is used. The surgeon will discuss the position of the incisions with the woman before the operation.

Before you decide on a breast reduction, you should consider the result you hope to achieve. Some women initially want a radical reduction in size, but this can affect the final shape and appearance of the breasts, so a more moderate reduction may be a better option.

Many women find that the benefits of breast reduction far outweigh the side effects. However, because a breast reduction is done, at least in part, for cosmetic reasons, it is especially important to carefully consider the risks.

Because breast size alters with bodyweight, you will be more suitable for surgery if your weight is stable. Your breasts won’t grow again after surgery, but they may still fluctuate in size if you gain or lose weight. If you are a younger woman, the surgeon will advise you to wait until your breasts have stopped growing before performing the operation.

As with breasts that have not been surgically reduced, some drooping will still occur, as you get older.

WHERE THE SURGERY WILL BE PERFORMED

The breast reduction procedure is performed in our Harley Street clinic.

TYPE OF ANAESTHESIA

The breast reduction procedure is carried out under intravenous sedation so there will be no pain and you will sleep through the operation.

THE SURGERY

Breast reduction procedure usually takes two and a half to three hours.

PREPARING FOR YOUR SURGERY

You will be given specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking and taking or avoiding certain vitamins and medicines.

If you smoke, plan to quit at least two weeks prior to the surgery and not resume smoking for at least two weeks after your surgery. Avoid overexposure to the sun before the surgery, especially on the abdomen, and do not go on an astringent diet, as both can inhibit your ability to heal. If you develop a cold or infection of any kind, it is important to inform the surgeon, as your surgery may need to be postponed.

You will need to arrange for someone to collect you after your surgery, as you will be unable to drive. It is also advisable to have someone to stay with you for a few days to help you out if needed.

In the week before, you should not take any medications containing aspirin (acetylsalicylic acid), since these products affect the blood clotting mechanism and therefore may lead to excessive bleeding during and after surgery, hence resulting in increased bruising. Taking high doses of Vitamin E preparations, eating large amounts of garlic and consuming alcohol can also produce the same result and should be avoided. If pain medication is necessary, we recommend you take ibuprofen/paracetamol.

It is in your own best interests to quit smoking, at least two weeks before and until two weeks after surgery. It is well known that smoking causes narrowing of the blood vessels, which leads to a decreased blood supply to the skin, thus slowing and interfering with the healing process. Be sure to inform your surgeon of any medications you take, as well as possible allergies including (drugs, latex, plasters and so on).

Your surgeon will decide whether preliminary examinations are necessary, such as blood tests, an electrocardiogram, or x-rays of the lungs. If this is the case, these tests should be performed several weeks before the surgery.

It is best not to wear any makeup when you come in for your operation, and to tie your hair back if possible. It is also best to wear a button-up top that does not need to be pulled over your head.

The operation will take place at our Dubai Healthcare City clinic under local anaesthetic and sedation (this is not a general anaesthetic). You may or may not be aware of what is going on but it will be totally pain-free. You will need to arrange for someone to collect you from the clinic as driving and using public transport are to be avoided for 48hrs after sedation.

YOUR BREAST REDUCTION OPERATION

During the procedure, the surgeon will make an anchor-shaped incision that circles the areola, extends downward, and follows the natural curve of the crease beneath the breast. The surgeon removes excess glandular tissue, fat, skin, and moves the nipple and areola into their new position. The skin from both sides of the breast is brought down and around the areola, shaping the new contour of the breast. Ultrasound liposuction may be used to remove any excess fat.

In most cases, the nipples remain attached to their blood vessels and nerves. However, if the breasts are very large or pendulous, the nipples and areolas may have to be completely removed and grafted into a higher position. (This will result in a loss of sensation in the nipple and areola tissue).

Stitches are usually located around the areola, in a vertical line extending downward, and along the lower crease of the breast. In some cases, techniques can be used that eliminate the vertical part of the scar. Occasionally, when only fat needs to be removed, Ultrasound liposuction alone can be used to reduce breast size, leaving minimal scars.

AFTER YOUR BREAST REDUCTION SURGERY

After your operation, you will remain in the clinic for 2 to 3 hours. You will have thick tape around your breast, which stays in place for one week. After the first week, you will need to return to our Harley Street Clinic to have the dressing removed, then return again after a further week for the removal of your sutures (stitches) by the nurse. You need to bring a support non-underwire bra to your first follow-up appointment, which you will wear for one month following your procedure.

ALL SURGERIES CARRY SOME UNCERTAINTIES AND COMPLICATIONS

Breast reduction is a very common procedure and relatively straightforward. However, as with any operation, there are risks associated with surgery and specific complications associated with this procedure. Post-operative complaints such as an allergic reaction to the anaesthetic, excessive bleeding during or after surgery, wound infection, developing a blood clot, are rare but can occur.

Specific complications of breast reduction include the scar becoming thick, red and irritable for a long time; rarely, abnormalities of the blood supply may result in loss of part or even all of a nipple. Breasts will always change shape slightly after the procedure, but occasionally the breasts may be more uneven than normal, or the nipples may not be level. Some women report that their nipples become oversensitive, undersensitive, or even numb. You may also notice small patches of numbness near your incisions. These symptoms usually disappear with time, but may become permanent in some patients.

GETTING BACK TO NORMAL

Although you may be up and about in a day or two, your breasts may still ache occasionally for a couple of weeks. You should avoid lifting or pushing anything heavy for three or four weeks. Your surgeon will give you detailed instructions for resuming your normal activities. Most women can return to work (if it’s not too strenuous) and social activities in about two weeks. However, you’ll have much less stamina for several weeks, and should limit your exercises to stretching, bending and swimming until your energy levels return. You’ll also need a good athletic bra for support.

You may be instructed to avoid sex for a week or more since sexual arousal can cause your incisions to swell, and to avoid anything but gentle contact with your breasts for about six weeks.

YOUR NEW LOOK

Although much of the swelling and bruising will disappear in the first few weeks, it may be six months to a year before your breasts settle into their new shape. Even then, their shape may fluctuate in response to your hormonal shifts, weight changes and pregnancy.

Your surgeon will make every effort to make your scars as inconspicuous as possible, but it is important to remember that breast reduction scars are extensive and permanent. They often remain lumpy and red for months, it gradually becomes less obvious, sometimes eventually fading to thin white lines. Fortunately, the scars can usually be placed so that you can wear even low-cut tops.

Of all plastic surgery procedures, breast reduction results in one of the quickest body-image changes. You’ll be free of the physical discomfort of large breasts, your body will look better proportioned, and clothes will fit you better.

If you have any further questions or queries about this procedure, please feel free to call and speak to either Dr Roberto or Dr Maurizio Viel or any of our nurses. Please note that it is necessary to attend a consultation prior to your operation, this is also the case with existing patients, it may also be necessary to have repeat blood tests.

To book an appointment for Breast Reduction, please call: 020 7636 4272