The highlight of the procedure is to remove the breast fat, glandular tissue, and skin, to make the breasts smaller, lighter, and firmer. The surgeon makes the incision around the perimeter of the areola, vertically down from the areola to the breast crease and horizontally along the breast crease, like an upside down T which is commonly referred as inverted T or Anchor Incision. The nipple and areola are almost always left attached to their blood vessels and nerves. The skin from above the nipples is then pulled down to shape the new breast and a hole is cut for the new nipple and areola. If the breasts are particularly large, a Free Nipple Graft a very large and heavy breast. Wherein the nipples are completely removed and grafted to a higher position – this results in a loss of sensation to the nipple and areola.
The surgeons recommend two nights hospital admission
Duration of Operation
The procedure may take four to six hours.
Breast Reduction is done using General anaesthesia in which the patient is asleep for the surgery.
Pre Operative Care
Surgeons advised that patients to do the following prior to the breast reduction surgery to avoid post operation bleeding or any complications:
• Inform the surgeon of any allergies, all medical conditions, and any medication that the patient are taking (both prescription and non-prescription)
• Avoid aspirin and any medication containing aspirin or brufen for two weeks before surgery.
• Avoid smoking for two weeks as smoking can affect body’s reaction to the anaesthetic and slow down the healing process.
• Checkup for any major medical problems such as diabetes, high blood pressure, heart disease
During your consultation, you should discuss your expectations of the outcome of the surgery and listen to the surgeon’s opinion.
Post Operative Care
After Reduction Mammoplasty, the patient may experience some pain associated with the surgery. When the procedure is completed, a patient is advised of the following:
• Bandage and support garment. The patient breast will be wrapped in elastic bandages, gauze dressings and a surgical bra. A couple of days after surgery the pressure bandages will be removed. The surgical bra must be worn at all times for several weeks, until the swelling and bruising subsides, or until your surgeon advises you otherwise. You should only remove the surgical bra to bathe and to wash the garment.
• Surgical Drainage. A small tube may be placed in each breast to drain blood and fluids for the first day or two.
• Swelling and bruising. The extent of the post operative swelling and bruising depends on whether you tend to bruise or swell easily.
• Stitches and Wound Care. Most of the surgeons use non-dissolvable sutures which will be taken out after two weeks. If the breast skin is very dry following surgery, a moisturizer can be applied several times a day. Vitamin E cream is extremely effective and also helps the scarring to heal, however the suture area must be kept dry at all times, particularly after bathing. They may be red for months, and then slowly become fainter, eventually fading to thin white lines. The surgeon will try to ensure that your incisions as subtle as possible, however the patients are advised that the scars are extensive and permanent.
• Heavy lifting and strenuous exercise. For the first few months, it is important not to place tension on the wound by performing strenuous activities like lifting or stretching your arms above your head, as this may increase scarring by stretching the tissue. The patient will only be able to resume to regular activities after two weeks, although you should abstain from heavy lifting and strenuous exercise for several months.
• Recovery. Recuperation usually takes about two weeks. Most people are back to work after three weeks.
Risks and Complications
Risks are inherent to any surgical procedure. But do not worry, all precautions are taken by Plastic Surgery Phuket’s surgeons to avoid these risks.
Here are the most common risks of this surgery:
• Long and heavy Scarring
• Changes or loss of nipple sensation due to damage nerve and blood supply of the nipple
Breast reduction is recommended for women that have had children already and do not wish to have any more. Breast reduction does not increase the risk of breast cancer and indeed may slightly decrease the risk. Mammograms will still be possible after surgery.
Reduction Mammaplasty Vs Liposuction
Patients whose breasts are not too large, and the skin has good elasticity then liposuction may be an alternative. This is especially useful in women who wish to avoid scars. It is possible that this technique may preserve the ability to breastfeed. This technique has become the most common way to perform breast reduction on a patient who is about a DD size. An overly heavy breast which hangs low requires the conventional method of breast reduction.