francois j duminy
Plastic & Reconstructive Surgeon
CAPE TOWN PLASTIC SURGEON CV
Breast Reduction - Conventional
What is Breast Reduction?
Breast Reduction is the Surgical removal of Excess Breast Tissue, Fatty Tissue and Skin from the breasts in order to leave the patient with smaller, firmer and more shapely breasts that match the rest of her anatomy in a more balanced way.
The tissue is removed in such a way as to leave the Nipple and Areola attached to the body by a bridge of tissue so that nerves and blood vessels to the nipple are preserved. This tissue bridge is called "The Pedicle"
Surgical Breast Reduction cannot be performed without making incisions. Incisions will always result in scars, but we aim to control those scars so that they develop into thin, soft and level lines that are unobtrusive.
1. A new feeling of freedom.
2. The ability to wear the clothes they have always wanted to wear.
3. Improved ability to exercise, take part in sports and control their weight more effectively.
4. “Cure” of upper and lower backache.
5. Improved pre-menstrual breast pain.
6. “Cure” of rashes in the breast folds.
7. Improved self-image leading to greater confidence and thus greater success in their pursuits.
Commonly general anaesthetic is provided for surgery and this carries possible dangers including Deep Vein Thrombosis and Pulmonary Embolism. The risk factor is low and is estimated to be 9 times less dangerous than driving in a motor vehicle.
Please note that in our practice it is now much more common to do Breast Reductions under Local Anaesthetic and Conscious Sedation. There are many advantages to this method.
At present you are free of scars, after surgery scarring is inevitable. Development of scars varies from person to person. Our aim is to finally achieve mature scars that are thin, soft, pale lines. To help you in this, please refer to our section on scar care.
Following this type of surgery, it is usually not possible for women to breast feed their babies and lactation should be suppressed. However, to postpone surgery for this reason is not always advisable as women with large breasts are often not able to feed successfully as they tend to have poor milk production and the baby is often not able to suckle easily when the breasts are too large.
Many patients experience either increased or decreased sensitivity in the nipple post surgery. In the vast majority of patients this returns to normal within six months
Post-operatively you will notice that the shape of the breasts is not normal but this will settle as gravity pulls the remaining tissue into its correct place.
At the end of the scar there may be a lump or irregularity. This is likely to be incorporated as the breasts settle. If it remains it is easily corrected at a later date by a small local anaesthetic procedure.
We try at all times to avoid complications by taking every precaution available to us and by employing meticulous techniques. Complications, however, will sometimes occur even in the hands of the most careful surgeon.
As with any surgical procedure the wounds may become infected which may prolong your stay in hospital for treatment which might include drainage, dressings and antibiotics.
A bleed may occur after surgery and it may be necessary to return to the operating theatre to stop such a bleed.
Pain is sometimes experienced in "patches" over the breasts. Occasionally there are firm areas associated with pain, this may be due to fat necrosis and it settles as the necrotic tissue is reabsorbed.
Sometimes very sharp pains of a very short duration occur. These pains are known as lightning pains and their occurrence disappears after a few months.
A very rare, but disastrous complication which we try to avoid at all costs is necrosis of the nipple. If the nipple loses its blood supply and dies, it may have to be removed. If this were to happen, the nipple would have to be reconstructed in the same way as is done when a breast is reconstructed following cancer surgery
How to Prepare for Surgery
Immediate Pre-Op Checklist
What you may expect while you are in hospital if you are choosing to have the procedure under General Anaesthetic
In the usual case, where there are no complications, you will spend 2 nights in hospital. You will be admitted in the morning before surgery.
The anaesthetist will usually also visit you.
A Private ward, if required, must be specially requested.
Surgery will take place when your turn comes and you will be in theatre for approximately two hours.
After surgery you will have well padded dressings over your chest and there will be special drains to ensure that no blood collects in the tissues. These drains will be gently and carefully shortened and removed by the nurses over the next two days.
Discharge from hospital will be two days after surgery once the drains have been removed.
After hospital - your Ongoing Responsibility.
You may have difficulty in driving and in picking up heavy objects such as children for 2 to 4 weeks.
Your breasts will need to be well supported post surgery and the best is a firm bra that fits well.
At first you should be able to use your old bras as the dressings will help to fill them.
After a week, try to obtain or borrow a bra with a larger cup than you will eventually require as the breasts will be swollen and possibly tender, later you can buy a bra that is the correct size for you.
The practice nurses would be happy to assist you in determining the correct size for you.
Sports bras provide very good support and are ideal for wearing over your underwired Bra.
Bra support, combined with the scar care regimen will ensure that you have the best scars possible together with a "new you" of whom you can be proud.
To get the most pleasing results you must give your body the best opportunity to recover.
Rest well, eat healthy foods and take special care of your breasts. We are always available to help with any problem.