Breasts reduction

A breast reduction is done to prevent or get rid of bothersome physical conditions caused by very large and too heavy breasts. However, one must expect the surgery to leave noticeable scars on the lower part of the breasts. It is impossible to predict what the long-term results will be because of different factors such the tissues natural loosening, pregnancies, the use of birth control pills, breastfeeding, weight gains or losses. The surgery can improve the patient’s every day life by giving her self-confidence, solving clothing problems and making physical activities easier.

A beast reduction helps relieving pains and aches caused by excessive weight (back pain, shoulder aches, neck pain). It also helps relieving skin irritations and solves clothing problems that patients with heavy breasts have. It also makes it easier for sports. A mastopexy or breast lift is on the other hand, a cosmetic surgery. In both cases, the surgeon improves the shape and symmetry of the breasts.

In Quebec, the Régie de l’assurance maladie (Health insurance) covers this type of surgery if proven medically necessary, in this case, causing a functional disorder. If it is the case, a minimal amount must be removed. The surgeon must scrupulously respect this constraint (moreover, the “Régie” requires the concerning documents) If not, the surgery is proven of a cosmetic nature and it is the patient who will assume all expenses.

A bleeding can sometimes occur during or after the surgery. It is therefore necessary to avoid taking any anticoagulant drugs (aspirin, anti-inflammatory drugs) two weeks before and a week after the surgery.

If you are taking drugs, you must inform your doctor on the preceding visit of the surgery. Also remember that smokers are at higher risks.

The surgery is usually done under general anaesthesia. Before proceeding, the surgeon draws the resection contour line on the breast, which is a guideline to delimit the quantity of tissues to be removed.

The procedures include the resection, the breast reconstruction and the suture. The diameter of the areola is often decreased. The scars usually have the shape of a reversed T, and there is a scar around the areola as well. Some surgeons make different incisions (they will, of course, let you know the type they will be using before the surgery). The incisions are covered with adhesive plasters (diachylon); the chest is wrapped in bandages, and this, for a few days. A small drain may be placed on each breast, which will be removed a few days later.

At first, you must avoid strong movements of the arms. Sleep on the back or slightly on the side, you will be more at ease. Activities can gradually be resumed, without exaggeration however. When will you be able to return to work? To pass the vacuum cleaner? To do housework? To lift your child up? To drive a car? To take a shower? To wear a bra? Here are as many questions to which your surgeon will be delighted to answer.

Generally, one should not raise the arms higher than the shoulders during the two following weeks of the surgery and it is necessary to wait from 4 to 6 weeks before doing sports.

A none-metal supporting bra should be worn for a whole one month after the surgery.

The bruises usually disappear after two or three weeks. A temporary numbness of the nipples can sometimes take a few months before vanishing (it rarely is permanent).

At complete healing of the scars, not before, the breast takes its form and its final position. In many cases, that can take at least a year. If ever the scars have an unsightly look, it can be possible to touch them up. Your surgeon will explain you how.

As with any surgical procedures complications may occur. Although not very frequent, these risks exist nevertheless. Here is a list of possible complications.

Bleeding – During the first days, it is normal to see blood spot on bandages. The weeping of the wound will gradually stop. A more important bleeding must be attended to.

Infection – Infection can occur following any surgery. The multiple breast canals hold bacterias that can sometimes cause an infection. The majority of the infections are local, and one must prescribe an effective treatment (sometimes with antibiotics). A more serious infection can involve a circulatory reduction (slow blood flow) and causes greater puffiness (which can cause to partially re-open the wounds)

Skin or nipple loss (necroses) – A circulatory reduction can cause a necrosis of the skin or fat tissues. The partial loss of a nipple is rare, the loss of a whole nipple, or both, even rarer.

Scars – These two types of surgeries necessarily involve the formation of permanent scars. They are usually acceptable, but the weight of the operated breast exerts a strong tension on all the scars. Those can therefore widen with time or, in certain cases, become thicker and painful (but this is rather rare).

Asymmetry – It is impossible to obtain a perfect symmetry of the shape, volume and position of the areolas and breasts. For women a perfect and natural symmetry is extremely rare. A minor touch-up can prove to be useful after the complete recovery.

Breast-feeding – A breast reduction can refrain breast-feeding. It is more likely that the quantity of milk is insufficient.

Pulmonary trombophlebitis and embolisms – it is the developing of blood clot in a vein and that can lodge it self on the lungs. This risk is inherent to any general anaesthesia. The risk is however very low.

Others:

  • Fat necrosis.
  • Loss or reduction of sensitivity of the nipples.
  • Possible augmentation of the breast volume after surgery.
  • Nipple discharges.
  • Retraction of the nipples.
  • Cysts.

For more information

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