Breast reduction
Throughout history, large breasts have generally been considered a sign of femininity highlighting a woman’s ability to nurture. Yet a woman with significantly larger breasts than the aesthetic standard of her time may be seen as abnormal or deformed. In these cases there is no doubt, that large oversized breasts can be disturbing to a woman by causing a host of both physical as well as psychological symptoms.
In the former these can take the form of shoulder, neck and back pain as well as cause distortion of posture and in more severe cases make breathing difficult. Large breasts can dominate a woman’s appearance and make her look unbalanced and make exercise difficult or impossible to do. In psychological terms, ungainly stares and rude comments make sufferers even more self conscious which leads them to wear loose clothing to disguise their imbalance.
Surgical correction to reduce the size of the breasts has been performed for many years and in fact the first true surgical reduction of a female breast was probably performed in 1669 in England by William Durston. Although the main aim of the surgery is to reduce the volume and weight of the breast, cosmetic enhancement to fashion a normal shape remains equally important. The techniques have been modified and refined throughout the years in order to improve the safety as well as the aesthetic results!
Breast Reduction surgery probably has one of the highest satisfaction rates of all cosmetic surgeries and reconstructive breast procedures. This is because women who had been burdened with the effects of overly large breasts for many years suddenly feel literally “liberated” and able to do things that were difficult or uncomfortable prior to surgery. In many ways these women feel they have been given a new lease of life and are thus able to approach many everyday matters with renewed interest and confidence.
Am I a suitable candidate for this cosmetic surgery?
Only a consultation can assess this. During your consultation Mr. Solomos will ask you about your general medical history including details about any previous breast surgery, and childbirth. While women of all ages can benefit, it’s usually never performed before the breasts are fully developed. This is because there have been cases reported where young teenage girls have had the operation only to find 2-3 years later that a significant enlargement occurs again(very rare). As a guideline, we normally wait until after the 18th birthday, although each situation is looked at individually and in more extreme cases the cosmetic surgery can be performed earlier. If you are a smoker you will be asked to stop smoking well in advance of cosmetic surgery. Smoking seriously constricts blood vessels and therefore decreases blood flow to a given area resulting in poor healing. Aspirin and certain anti-inflammatory drugs and other medications (discussed in DO’& DON’TS section) can cause increased bleeding, so you must avoid these. If you are significantly overweight then planned preoperative weight reduction is encouraged but this alone does not necessarily rule you out for an operation. In fact many times the achievement of a reduced breast size can become a stimulus for further planned weight loss. Depending on your age you may be required to have a mammogram prior to surgery. This again will be advised at the initial consultation.
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What does the operation involve?
Before going down to theatre, Mr. Solomos uses a marking pen to draw on the breasts in order to determine the exact position and size of the newly operated breasts. He will then show you approximately where the new reconstructed breast and nipple position will be. Excess breast tissue, fat and skin are then removed. During the operation, the nipples are preserved on a stalk of breast tissue and repositioned by moving them to a new higher location, all in accordance with the preoperative markings. So although a breast size reduction is performed, all patients will also benefit from a breast uplift as well. The nipple is usually positioned in a line level with approximately the middle part of your arm or your under breast crease. The suture line is situated around the nipple in its new position, and extends vertically downwards to the under-breast crease. Occasionally a small horizontal scar within the crease is also performed. However in general, Mr. Solomos’ technique avoids the older type of unsightly long anchor scars. Mr. Solomos will be able to discuss this with you at the time of your consultation and show you precisely where these will be situated. Finally some tapes, and a light dressing is applied over the suture lines following the plastic surgery. All sutures used are of the dissolving kind and will not need to be removed. You will also then be asked to wear a firm sports bra for support. Mr. Solomos does not use drains routinely. He has deemed these not necessary and has stopped using them for a number of years, without any adverse effects. Patients appreciate the fact that they no longer require any drains to be removed from the breasts after the cosmetic surgery.
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What type of anaesthetic is used and how long does the operation take?
Breast reduction surgery is performed under general anaesthesia and usually takes between 90 minutes and 2hours
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How long do I have to stay in hospital?
Most patients only require an overnight stay in hospital
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What happens after the cosmetic surgery?
Following this cosmetic surgery you will experience considerable swelling and bruising of the breasts. The bruising usually lasts about 2-3 weeks. While most of the swelling will have dissipated by this time, some subtle swelling may still be present for up to 4-6 months. After cosmetic surgeryyou may notice that the breasts feel quite firm and taut, particularly along the edges of the incision site. This will be as a result of the normal healing process laying down elements of scar tissue to facilitate healing. Occasionally small lumpy areas develop within the breast. This is called Fat necrosiswhere some small areas of fat cells within the breast tissue do not survive the trauma of cosmetic surgery and die as a result. In this process, the fat becomes hard before gradually softening over a period of weeks and months. When this occurs, massage as instructed will speed up the recovery. You should expect the sensation to the skin in the nipples and surrounding skin to be reduced after cosmetic surgery. This is as a result of surgical trauma to the nerves in the region. Although this usually recovers in a few months, permanent numbness in some areas may ensue. It is normal for any pair of breasts to be slightly uneven and this is no exception in large breasted ladies.Although every effort is made to make the breasts symmetrical, it is not always possible to achieve this exactly. Breast reduction cosmetic surgeryis possibly one of the most demanding aesthetic procedures. It is imperative therefore that you talk with Mr. Solomos so that he has a full and proper understanding of your wishes. Try to convey, as much as is possible, how little or large you would like to be following your surgery. This will minimise the possibility of having too little or too much removed.
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What kind of after effects should I expect?
Following surgery you will experience considerable swelling and bruising of the breasts. The bruising usually lasts about 2-3 weeks. While most of the swelling will have dissipated by this time, some subtle swelling may still be present for up to 4-6 months. After surgery you may notice that the breasts feel quite firm and taut, particularly along the edges of the incision site. This will be as a result of the normal healing process laying down elements of scar tissue to facilitate healing. Occasionally small lumpy areas develop within the breast. This is called Fat necrosiswhere some small areas of fat cells within the breast tissue do not survive the trauma of surgery and die as a result. In this process, the fat becomes hard before gradually softening over a period of weeks and months. When this occurs, massage as instructed will speed up the recovery. You should expect the sensation to the skin in the nipples and surrounding skin to be reduced after surgery. This is as a result of surgical trauma to the nerves in the region. Although this usually recovers in a few months, permanent numbness in some areas may ensue. It is normal for any pair of breasts to be slightly uneven and this is no exception in large breasted ladies.Although every effort is made to make the breasts symmetrical, it is not always possible to achieve this exactly. Breast reduction surgery is possibly one of the most demanding aesthetic procedures. It is imperative therefore that you talk with Mr. Solomos so that he has a full and proper understanding of your wishes. Try to convey, as much as is possible, how little or large you would like to be following your surgery. This will minimise the possibility of having too little or too much removed.
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Can I get pregnant and breast feed afterward?
Ideally it is best to have completed your family prior to having a breast reduction surgery. Patients therefore who plan to become pregnant should usually postpone the operation until after their family is complete. The reason is that if a pregnancy ensues following a breast reduction procedure, permanent re-enlargement may rarely occur. Thus any decision to perform a breast reduction operation prior to this must naturally be weighed and balanced against this risk and the benefits offered by this type of surgery. Although the technique used by Mr. Solomos ensures the best possible continuity between the breast and nipples thus increasing the possibility of breast-feeding after breast reduction surgery, this cannot ever be guaranteed.
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What are the scars like?
Scars are not a complication but a normal event after any plastic surgery. Even though in recent years the scars in breast reduction surgery, have become smaller, nonetheless the scars are still somewhat lengthy and may take many months or years to settle. However as the scars are around and below the nipples, these shouldn’t be noticeable even in low cut clothing or a bathing suit. You should always expect these to be red, raised, lumpy and even itchy to begin with but with time they should fade and flatten. This is the natural evolution of the healing process. However it is important to keep in mind that this may take up to two years to complete. Daily massage of the scars during this time period is advised to expedite and facilitate this process. You will also provided with scar reducing plasters in order to improve the appearance of your scars. You must understand however that no responsible surgeon will ever be in a position to predict any scars ultimate appearance. Although as mentioned, scars do fade and improve in time it is unlikely however that these could ever be characterised as being mainly only “hairline” in nature.
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Is it painful?
Our surgical understanding, the techniques and instrumentation have improved over the years and Mr. Solomos takes advantage of all these to deliver the best in terms of results. With these new techniques, pain is significantly improved compared to the surgery performed a few years ago. Therefore most ladies, who have breast reduction surgery with Mr. Solomos, complain or only mild to moderate discomfort after surgery. This of course should be well controlled with pain killers. The pain usually improves and dissipates after the first 4-5 days.
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What could go wrong?
Scars are not a complication but a normal event after any plastic surgery. Even though in recent years the scars in breast reduction surgery, have become smaller, nonetheless the scars are still somewhat lengthy and may take many months or years to settle. However as the scars are around and below the nipples, these shouldn’t be noticeable even in low cut clothing or a bathing suit. You should always expect these to be red, raised, lumpy and even itchy to begin with but with time they should fade and flatten. This is the natural evolution of the healing process. However it is important to keep in mind that this may take up to two years to complete. Daily massage of the scars during this time period is advised to expedite and facilitate this process. You will also provided with scar reducing plasters in order to improve the appearance of your scars. You must understand however that no responsible surgeon will ever be in a position to predict any scars ultimate appearance. Although as mentioned, scars do fade and improve in time it is unlikely however that these could ever be characterised as being mainly only “hairline” in nature.
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How many Breast reduction procedures does Mr. Solomos perform?
In accordance with the National Healthcare commission guidelines, according to the last five years (2002 -2006) of annual audit figures submitted to the Hospital of Highgate and BMI Hospitals in London, Mr. Solomos performed on average 30 breast reduction procedures per year. In the last 10 years he has performed over 300 breast reduction procedures.
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How long before I get Back to Normal?
With the more modern techniques Mr. Solomos applies to this operation, you should be able to get back to a routine fairly quickly. As a guideline, most patients with office based work can return to their duties after 4-5 days. Of course remember variations do occur in the time individuals take to heal. Others find it more appropriate to take a further 7-10 days to rest. Walking is helpful in the first 3-4 weeks as this improves the circulation and helps reduce the swelling, and the chance of blood clots developing. Heavy lifting or Strenuous activity is best avoided in the first 6 weeks after cosmetic surgery. Lower body exercise may be commenced after 14 days, with high impact aerobic type of exercises only allowed after 6 weeks.Overall common sense rules in the recovery period. If what your doing is uncomfortable then don’t do it!
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