Breast reduction surgery is sought by many women to relieve the physical restrictions and painful strain on neck, shoulders and back caused by excessively heavy breasts -- a strain that can be so severe that it leads to chronic headaches, back and neck deformities, shoulder indentations, breathing problems, skin irritation and a variety of other medical problems.

Breast reduction surgery, technically called mammoplasty, is usually performed for physical relief rather than for cosmetic reasons. This procedure involves removal of excess breast tissue to reshape and lift the breasts. The results are smaller, lighter, better-shaped breasts that are in better proportion with the rest of the body.

What are the benefits?

Breast reduction is quite successful at reducing the weight of very heavy breasts, making it easier to enjoy an active lifestyle. Many women find that this surgery relieves chronic back, neck, and shoulder pain. The primary benefit of the operation is functional, but you also get a breast lift, which may enhance your appearance and improve your body image.

What will happen at the consultation?

During the consultation, you and your surgeon will discuss the changes that you would like to make in your appearance. Your doctor will explain the procedure, including what kind of anaesthesia he will be using. At this time, he will also ask about your medical history, and perform an examination. You should stop smoking 6 weeks prior to surgery and 2 weeks afterwards.

How is the procedure performed?

This procedure involves an anchor-shaped incision that circles the areola, extends downward, and follows the natural curve of the crease beneath the breast. Excess glandular tissue, fat, and skin are removed, and the nipple and areola are moved into their new position. The surgeon then brings the skin from both sides of the breast down and around the areola, shaping the new contour of the breast. In most cases, the nipples remain attached to their blood vessels and nerves. However, if the breasts are very large or pendulous, the nipples and areolas may have to be completely removed and grafted into a higher position. (This will result in a loss of sensation in the nipple and areolar tissue.)

How long does the operation take?

Breast reduction surgery generally takes about one to two hours per breast, depending on extent of the repair and the techniques being used.

How long do I have to stay in the hospital for?

Breast reduction is most often performed under general anaesthesia with a one to two day stay.

What can I expect afterwards?

Although the surgical incision for this surgery is quite large, it is placed in areas of the breast that are not too sensitive. In addition, due to the fact that the nerves to the breast skin have been stretched out by the weight of the breasts over a long time, the skin is less sensitive. Thus, the pain after surgery is usually easily managed with oral pain medications. Initially, there is discomfort in walking, getting out of bed, and any activity that causes the breasts to move. You may continue be sore for the first few days after surgery.

The stitches are dissolvable unless you have nipple grafting, when the sutures are removed from around the nipple after 5-7 days. Light activities can be resumed within a few days, although your chest will be sore. Routine physical activity and exercising (especially lifting, pulling and pushing motions) should be avoided for at least 6 weeks. This will help the scars to heal. Your doctor will advise you on the level of physical activity that is appropriate for you.

Some women experience random, shooting pains for a few months, especially around the time of menstruation. Expect some loss of feeling in your nipples and breast skin, caused by swelling. This usually fades over the first few weeks, but occasionally lasts a year or more.

What are the long-term results?

Of all plastic surgery procedures, breast reduction has the most immediate dramatic results. The chronic physical discomfort is gone, the body is better proportioned, and clothes fit better. Some women find that as much as they have desired these changes, they need time to adjust to their new body image. After this adjustment period, most women are very happy with the results.

What are the risks?

All surgery has some potential risks, including the risks of bleeding, reaction to the anaesthetic, and infection. In this surgery, serious complications are quite rare. In addition, small areas of infection or delayed healing in the incisions is not uncommon. There is also a possibility of developing small sores around the nipples, which can be treated with antibiotic creams.

Other complications include wound dehiscence, stretched or thick scars, infection ,bleeding, haematoma, skin necrosis, deep venous thrombosis, pulmonary embolism.

If you carefully follow all your surgeon's instructions both before and after the surgery, you can minimize the risks.

Some patients may experience a permanent loss of feeling in their nipples or breasts.

Rarely, the nipple and areola may lose their blood supply and the tissue will die. Cigarette smoking decreases blood flow to the skin and subcutaneous tissues (just under the skin) that carry blood flow and leads to an increased risk of the skin scabbing, and can lead to permanent scarring as well. Due to the length of time on the operating table, deep venous thrombosis of the calf veins is a small, but serious risk as clots may go to the lung. However, blood thinning injections are given to you during your stay to reduce the risk. If you are overweight, you may be more at risk.