Breast reduction is considered by women with large, heavy breasts as they may experience several health concerns related to their breasts such as back pain, neck pain, grooves in the shoulders from bra straps, pain in the breasts and rashes under the breasts. Women with arthritis of the spine and shoulders may have more symptoms than usual because of the added weight of heavy breasts. Some women are bothered by the psychological embarrassment of large breasts. In other situations, athletic, active women and women who are trying to lose weight are inhibited by the size of their breasts. Often, it is difficult and expensive to find clothes that fit.
A breast reduction is an operation aimed at removing excessive breast tissue and fatty tissue in order to leave the remaining smaller, comfortable breast in proportion with the rest of the body. The nipple is elevated and the shape of the breast improved and made more attractive.
The surgery is generally performed on an outpatient basis. The procedure can be done with local anaesthetic and sedation or under general anaesthesia. The operation usually takes about 2 hours. There is no need for taping after the procedure and dissolving sutures are used so none need to be removed afterwards. Generally you will be able to go home 2 hours after surgery.
Some discomfort may arise from the stretching of the breast tissues, but it largely resolves within two to three days and is well-controlled with simple oral medication such as Panadeine. Showering is allowable 48 hours postoperatively.
Patients generally return to work within one week, but should avoid exertional activities over the 6 to 8 weeks required for bruising and swelling to resolve.
What about Complications?
Breast augmentation is an open surgical procedure that is associated with a low incidence of complications. At your consultation these will be discussed with you and you will be able to ask any questions you have about them.
Post-operative complications include blood accumulation or infection adjacent to the implant. Both problems occur infrequently, but can necessitate a second operation or temporary removal of the implant. Because implants are a medical device, they can fail at any point after implantation. This is uncommon, but may require implant replacement surgery.
Some patients develop a firm layer of scar tissue around their implants which can make the breast hard to the touch or painful. Called "capsular contracture," this can cause the breast contour to be asymmetrical and may require secondary procedures for improvement. Nipple sensation can be increased or decreased by the procedure though most women will experience some decrease in sensation around the nipple and outer breast which will be more noticeable in the few months following surgery but will improve with time. Most patients are able to breast-feed following augmentation.
The scar following breast augmentation is 6 cm long and sits under the breast in its crease. The scar will be reddened and more noticeable for 6 months or so but can be expected to fade dramatically over 12 to 18 months.
Breast Screening
Breast cause very little interference with the ability of mammography to detect early breast cancers. This is an important consideration that patients should discuss with a physician, particularly patients with a first-degree relative who has had breast cancer. All augmented patients need to inform their radiologists of their implants so the screening technique can be favourably modified.
Despite these limitations, approximately two million women are estimated to have undergone breast enlargement surgery. The overwhelming majority are satisfied with the results.
How important are psychological factors in relation to this procedure?
Emotional stability is the primary factor to be considered before any aesthetic surgery is performed. A "new body" does not guarantee a new life or solution to personal problems. It is mostly the mental attitude of the individual that determines a successful outcome. Breast augmentation can improve your appearance and renew your self-confidence. It is a procedure you do for yourself, not for anybody else.
General Information Should there be any questions regarding breast augmentation, be sure to get them answered in advance by Dr Drielsma. Well meaning friends are not a good source of information. Find out everything before proceeding with the operation - a well informed patient is a happy one.
Finally, remember the realistic aim of this operation is improvement, not perfection.
Beware of the pitfalls of shopping around for the cheapest costs for thisoperation as this often leads to disappointment with results. Often “packages “ that appear attractive use cheaper inferior implants and may involve unqualified or inexperienced operators.
Please note: The above information does not necessarily cover all of the benefits and complications of a breast augmentation. This information should not be regarded as a substitute for information and advice provided by Dr Drielsma during consultation.
The procedure is performed in a hospital under general anaesthetic. The operation usually takes three hours depending on the extent of each case. Usually only one night is required in hospital following the operation and you can return home the next day. Surprisingly little pain or discomfort is associated with the procedure. Usually 2 weeks are required away from work and return to normal exercise levels can occur in 6 weeks.
Can I breast feed after the operation?
Patients undergoing breast reduction will likely find breast feeding more difficult and in some breast feeding will not be effective.. This varies with the technique used and this will be discussed with you at time of consultation. Parts of the breast tissue are separated from the ducts in the nipple and problems may arise, or the milk output may be limited. However, as a note of interest, women with large breasts tend to have a low milk output so they might have problems breast feeding anyway.
Are there any risks?
As with any surgical procedure, there is a small risk of complications. Surgery and anaesthesia is very safe and it is most unlikely you will experience any difficulty. However, there is a small chance that complications such as bleeding or infection may occur. Scars are an unavoidable drawback to the procedure, but typically fade to be almost unnoticeable over 18 months or so and be quite acceptable to most patients. Sensation of the nipple may be affected. It can be altered, being "lost", "made different", "sore" or it may even be "improved".
Blood Supply
The operation is planned in such a way to ensure that an adequate blood supply is maintained to the various remaining anatomical parts of the breast, such as skin, fat, breast tissue and nipple. At times, if the circulation is inadequate, tissue may die. This is not common, but is more likely in very large breasts or in patients with poor circulation. At times the desired size and shape may be compromised to help maintain an adequate circulation.
Anaesthetic
You will be receiving a general anaesthetic and your anaesthetist will be discussing with you possible discomforts following anaesthesia. Again, anaesthesia today is very safe and no major problems should be concerning you. Any questions you have regarding your anaesthetic would be best answered by your anaesthetist at the time of surgery.
Asymmetry Although every attempt is made to obtain symmetry and a natural shape, as with most women, there may be some difference in the final size and shape of the breasts or in the position of the areola and nipple and a small degree of difference must be accepted.
Should there be any questions regarding breast reduction, be sure they are answered in advance by Dr Drielsma. Well meaning friends are not a good source of information. Find out everything before proceeding with the operation - a well informed patient is a happy one.
Finally, there can be no absolute guarantee with any surgery. Remember the realistic aim of this operation is improvement, not perfection.
Please note: The above information mentions only some of the benefits and complications of a breast reduction. This information should not be regarded as a substitute for information and advice provided by Dr Drielsma during consultation.
