Breast Reduction & Breast Lift Reduction (Mammoplasty & Mastopexy)
Many women feel that their breasts do not match their overall body physique. Perhaps they experience discomfort because of large and droopy breasts or they are displeased with the changes to their breasts which come about through normal aging, after pregnancy or following menopause. Two surgical procedures are available in such cases, a breast reduction (reduction mammoplasty) and a breast uplift (mastopexy).
Although the goals of breast reduction and breast uplift are different, the procedures will be discussed together because the purpose of both is to create more youthful and naturally shaped breasts. In both cases this involves elevating the nipple/areolar from a lower, droopier position, to a more natural centering on the breast mound.
In a breast reduction, breast tissue and excess skin are resected so that the volume of the breast is reduced. In a breast lift only the skin is resected. In both procedures the nipple is elevated. If a patient perceives her breasts to be small as well as droopy, small breast implants may be inserted at the same time.
It is important to understand that no person is perfectly symmetrical from one side to the other, even before a surgical procedure. Every attempt will be made during surgery to minimise your side-to-side dissimilarities, but such differences are natural and always persist to some degree even after the most successful operation.
Here are some frequently asked questions about breast reductions and breast lifts.
Does cosmetic breast surgery influence the development of breast cancer?
There is no evidence that breast uplift or reduction surgery alters the possibility of developing breast cancer. It will still be necessary for you to examine yourself monthly for breast lumps and to undergo mammography as suggested by your personal physician. It is suggested that all patients 35 years of age or older obtain a mammogram prior to elective breast surgery.
Will I be able to breast feed after cosmetic breast surgery?
Although not all women are able to breast feed even before a breast operation, cosmetic breast surgery by itself should not rule out the ability to breast feed at a later date. With the breast upliftment procedure, no incisions are made within the substance of the breast. However, with a breast reduction, incisions will naturally course across breast ducts. The ducts immediately beneath the nipples are left intact allowing a patient to breast feed if this becomes desirable in the future. The larger the reduction, the more breast tissue is excised and this would therefore further decrease the chances of breast feeding.
Will I have bad scars?
The extent of surgical scars will be determined by the amount of tissue removed or the distance the areolus is uplifted. Traditionally, in addition to an incision around the areolus, a vertical incision extends from the areolus to the fold beneath the breast and another scar runs along the length of the fold.
How should I prepare for my operation?
As with all other elective procedures, you should avoid all anti-inflammatory agents including Ibuprofen, Voltaren and all aspirin products as well as excessive quantities of Vitamin E (the small amount contained in most multi-vitamin preparations is not harmful) for two weeks before surgery, as these inhibit the clotting mechanism of the blood and increase your chances of unnecessary operative bleeding.
You will be asked to stop smoking at least a month prior to surgery to maximise your body's ability to heal following the operation. This will also decrease potential complications associated with surgery.
It is imperative to make prior arrangements for transportation to and from the hospital and to have a responsible adult stay with you for the first 24 - 72 hours after the operation.
Will I be given a general anaesthetic and what care is necessary
after my operation?
The breast reduction procedure is performed in hospital and in most cases a general anaesthetic is employed to insure your comfort and safety. Today, many breast reductions and uplifts can be performed with newer techniques which allow limited incisions. These techniques would be discussed at your consultation.
Following the procedure a brassiere-like dressing will be applied and you will remain in the recovery room until you are awake and ready to return to the ward. Any tissue removed during a breast reduction will be examined by a pathologist.
You will remain in the ward for one to two nights and prior to discharge your drains will be removed and a clean dressing applied.
You are to leave the dressing dry and intact until your first post-operative visit to the rooms which will generally be five days following the procedure. During these five days you should limit your physical activity to avoid lifting or straining.
Following your first dressing change, you will be allowed to begin showering and to gradually increase your activity. Most patients find that it takes them about a week before they can function comfortably in the home or office setting, but that at least three to six weeks must pass before increased physical activity can be tolerated without discomfort.
Are there complications?
Although the majority of patients have very satisfactory results, your decision to have this operation must be made with an awareness of the possible risks involved. Even though they are actually very rare, complications may occur following any surgical operation. It is not possible to advise you of every conceivable complication but some of the possible complications include infections, bleeding, alterations in sensation of the nipple/areolar area or elsewhere over the breast mound, skin loss (including from the nipple/areolar area) which may delay healing or even necessitate skin grafts or other subsequent surgical procedures. Occasionally the incisions pull apart along the folds beneath the breasts or around the areolae. Should this occur, the area will be treated with a moist dressing and will almost always heal without the necessity for revisional surgery. Such a wound separation, however, will prolong the healing process.
As already mentioned differences in appearance from one side to the other are perfectly natural and will be present following the procedure as they were prior to any operation. Likewise, visible and occasionally unsightly scars are an expected outcome of such an operation.