By Dr Allen Rezai MD, founder of Elite Plastic & Cosmetic Surgery Group, Dubai, UAE, and one of UK’s leading specialists in Breast Surgery.
Some women have disproportionately large, heavy breasts, also known as mammary hypertrophy. In addition to their aesthetic effects, including difficulty wearing fashionable clothes, they often interfere with social or sporting activities. Large breasts also cause various symptoms such as back and neck pain and may predispose the woman to arthritis in these areas. Further, many women suffer with repeated skin infections in the fold beneath the breast. These women often benefit tremendously from a breast reduction.
Breast Reduction, also known as Reduction Mammoplasty, involves removal of excess breast tissue and fat to relieve the weight and make the breast more manageable. Excess skin is also removed during the procedure and the nipple areola is recentralized on the resulting breast mound to form a smaller more naturally shaped breasts. The resulting effect is not only more aesthetically pleasing, but can also be a significant functional benefit.
As with most surgical procedures, there are many options, depending upon the patient’s wishes, technical considerations and surgeon preferences.
Principally, there are two different scar patterns: the Anchor pattern and the Short Scar pattern. The Anchor pattern breast reduction utilizes a scar in the shape of an anchor. This scar encircles the areola, extends downward in a vertical direction to the bottom of the breast, and then extends side to side in the fold beneath the breast, known as the inframammary fold.
The Short Scar technique uses a scar that is in the shape of a lollipop. This scar encircles the areola, and then extends downward vertically to the bottom of the breast. There is no side to side inframammary fold component, and in that sense, the scar is shorter.
The Anchor shaped technique is suitable for patients with the largest amounts of breast tissue that needs to be removed. These patients generally are not good candidates for the shorter scar technique.
However, there is an alternative suitable for some younger women only requiring a moderate reduction in breast size. That is to remove the fatty tissue of the breasts via a modification of the liposculpture technique. Clearly, this avoids any of the significant scarring associated with breast reduction.
Breast Reduction is performed under general anaesthetics and may take anywhere between one to three hours Regardless of which scar pattern is used, the basic breast reduction operation is the same. Through the incisions, excess breast tissue and fat is removed. The nipple and areola remain attached to the remaining breast tissue, and this whole composite is shifted to its desired final location. The skin is shaped around the final breast mound, and the excess is removed. The final result is a smaller breast with the nipple and areola in a more centralized location.
Many women want to know what their final breast size will be. It is difficult to know the exact answer to this, as enough breast tissue must be left to support the blood supply to the nipple and areola complex. This varies from person to person. In general, though, breast reduction can achieve at least a two to three cup size reduction.
In a small proportion of women, the size of the breast reduction is simply too large to keep the nipple and areola attached to the remaining breast tissue. In these cases, the nipple and areola are removed as a graft, the reduction is performed, and then the nipple and areola are replaced back on the breast as a skin graft. This procedure is known as a breast reduction using a free nipple graft.
Following the operation the breasts are likely to be swollen and most women feel bruised and sore. Most surgeons recommend wearing a support bra for about four weeks after the surgery and most women are able to fully resume normal activity within four to six weeks.
As with all scars, the scars will fade over a period of time. In many women, they heal to form very faint white lines. However, it is important to remember that no surgical scar ever totally disappears. Most women consider the scarring of breast reduction to be a more than acceptable trade-off for the significant advantages of not having their large heavy breasts.
Although cosmetic surgery is amongst the very safest of medical procedures it is important to understand and accept that no surgical procedure is absolutely free from risk and the surgeon should explain these possible risks and complication in detail during the initial consultation. In particular, it is important for women considering breast reduction to understand that very few women are able to breast feed following the surgery, as the milk ducts are separated from the breast tissue during the operation.
For the great majority of women, the results of their breast reduction last for many years. Unless the operation is performed at a young age, it is very unlikely that the breasts will regrow. Excessive weight gain or pregnancy will alter the breast shape as in any other women. Further with age the breasts are likely to sag as normal. Breast reduction surgery is unique in that it can improve the quality of a woman’s life, in addition to producing a more aesthetic result.
Dr Rezai advocates a natural appearance, one in which the breasts look, feel, and move naturally. And at Elite Plastic & Cosmetic Surgery Group we utilize the shortest scars and least invasive approaches possible in order to achieve the best possible result.
Meeting up with a consultant plastic surgeon before you actually decide to undergo surgery is the preferred route for many reasons, not least amongst which is that you can avoid having any unrealistic expectations of the outcome of your operation.
At your first meeting with your Elite Plastic & Cosmetic Surgery Group consultant you will be able to:
- Discuss your needs and wishes in absolute detail
- Decide whether the operation you are considering is right for you
- Learn from your consultant what is achievable and, importantly, not achievable for you depending upon your precise circumstances. i.e. the likely outcome of your operation
- Discuss any concerns you might have about your operation
- Discuss the potential for any side-effects or complications related to your procedure
- View before and after photos of patients who have undergone a similar procedure
- Learn how you will need to prepare for your operation and what will happen afterwards
- Form an opinion as to whether your Elite Plastic & Cosmetic Surgery Group consultant is the right surgeon for you (the importance of feeling comfortable with your surgeon should not be overlooked)
- With many pre-operative consultations, a second meeting will ensure you and the surgeon have similar aims and expectations and you are fully aware of the implications of surgery. It will give you another opportunity to ask any questions you may have forgotten at the first meeting.Exceptional surgical results are paramount in our practice, so is maintaining the highest of professional standards and safety. We believes not only in educating each one of our patients as to what is available and appropriate, but also in formulating a customized plan for each person. Everyone has a slightly different physical anatomy, different lifestyles, goals, personal circumstances,
and differing viewpoints about plastic surgery. We believe that a truly successful result is not only achieving technical perfection, but also achieving the result that best fits your needs and desires.