The way a woman feels about her breasts is very personal. It is
not easy to have to deal with teasing, unwanted attention, ill-fitting
clothes, uncomfortable bra straps or not liking the way her breasts
look. Oversized breasts or breasts that differ in size or shape from
one another, can cause backache, skin rashes beneath the breasts
and can be uncomfortable and difficult to live with.
Most women who ask for breast reduction surgery are those who have
fully developed breasts. Breast reduction surgery is warranted however,
in some younger women who have overwhelming problems with the size
of their breasts.
Breast reduction surgery involves removing excess skin, fat and
breast tissue from the breasts and reshaping them to give a smaller,
firmer and usually more youthful appearance. The nipples and areolae
are usually moved to a higher position on the newly created breasts.
There are various techniques for breast reduction, with different
and methods for removing and reshaping the breast tissue
and moving the nipples.
The extent of the scars depends on the size and shape of the breasts.
Most commonly, scars are placed around the nipple-areola and extend
downwards to meet a scar in the inframammary crease. Sometimes it
is possible to have a shorter scar. It is important to understand
the extent of the scar that is proposed in each individual and for
the woman to discuss this with her surgeon.
Scars after breast reduction or mastopexy
MASTOPEXY (BREAST UPLIFT)
Mastopexy is usually requested by women who have drooping of their
breasts after weight loss, pregnancy or loss of skin elasticity with
A mastopexy operation involves removal of the excess skin and relocation
of the nipple-areola onto a higher position on the newly created
breast mound. The resulting scars will be around the nipple-areola
and depending on the amount of skin that is excised, there may be
an extension of the scar downwards between the nipple-areola and
the inframammary crease and along that crease.
ESSENTIAL CONSIDERATIONS AFTER BREAST REDUCTION SURGERY OR MASTOPEXY
Breast feeding and pregnancy
It is uncommon (but sometimes possible) to be able to breast feed
after breast reduction surgery. This depends on the number of milk
ducts left intact after surgery and whether the nipple is still connected
to them. Breasts may normally enlarge by as many as 3 bra cup sizes
during pregnancy. This can still occur after breast reduction surgery.
Age and changes in body weight
Results from breast reduction surgery are best when patients are
at their ideal body weight when the surgery is performed, as any
subsequent weight changes will change the size and shape of their
breasts. Skin loses elasticity, breast glandular tissue involutes
(becomes thinner) and breasts may become droopy with age. Reduced
breasts will also change with age and when there is an alteration
to general body weight.
Screening mammography for the detection of breast cancer is currently
offered to women aged 50-64 years in the UK. Breast reduction surgery
will leave scar tissue within the breasts and it is important that
the woman informs the radiographer and doctor that she has had previous
surgery to her breasts. Breast reduction surgery does not increase
the risk for a woman developing breast cancer.
Nipple sensation is altered in about 15% of women after breast reduction
surgery. Sensation can be reduced, heightened or lost. These changes
in sensation can be temporary or permanent.
The enhancement of physical appearance can have immeasurable psychological
benefits to a woman in terms of confidence and self-esteem.
Scars from breast reduction surgery are permanent. Scars go through
a phase where they become firm before softening. Some scars become
red and wide but usually settle down with time to become less noticeable.
In a very small number of women, scars can become hypertrophic or
keloid. Hypertrophic scars are red and lumpy and take longer to settle
down. Keloid scars are those that become raised, wide, and itchy
and can grow beyond the original scar. Keloid scars are rare. Women
who have dark skin may have scars that have a deeper or lighter pigmentation
than their normal skin. Discussion of scar placement with the surgeon
before the operation is helpful.
Most women have some degree of asymmetry between their breasts in
terms of size, shape and placement on the chest wall. Breast reduction
surgery will attempt to address this but it is not always possible
to achieve perfect symmetry.
Symmastia is an uncommon naturally occurring condition. It may not
be corrected by breast reduction surgery alone.
While complications are uncommon after breast reduction surgery
or mastopexy, it is necessary for women to be aware of them and the
possible need for further treatment if they occur.
Infection can occur after any surgical operation. If it happens,
treatment usually involves antibiotics and rarely, a further operation
in order to clear the infection.
Bleeding or haematoma
As with any operation, there is a small risk of bleeding that can
cause pain and swelling. If a haematoma forms, a further operation
may be necessary to control the bleeding and remove the accumulated
fluid. This usually happens within the first week after surgery.
The nipple-areola is usually relocated to a higher position on the
newly formed breast mound in breast reduction surgery. It is left
attached to its original blood supply. Occasionally this blood supply
may not be sufficient in the new position. A further operation may
be required to replace it as a free
If the blood supply to the refashioned breast fat is insufficient,
some of this fat may die and cause a delay in wound healing. A further
operation to remove this tissue or repeated wound dressings may be
Women who are most pleased with the results of their cosmetic surgery
are those who have had it done for themselves rather than for anyone
else. It is important to find out as much as possible about all
the possible options when undergoing any surgery and to have a
thorough discussion with the surgeon about the complete process.
Cosmetic surgery can have immeasurable benefits to a woman in terms
of her self-esteem and confidence.