Your Guide to Breast Reduction Operations

• Why would I choose to have a breast reduction operation?
• How much should I expect to pay for breast reduction surgery?
• Is breast reduction surgery available on the NHS?
• How do I choose a surgeon to perform my operation?
• The process: What to expect before, during and after surgery
• How soon will I see the results?
• How long will the effects of the surgery last?
• What are the risks and problems associated with breast reduction surgery?
• How can I reduce the chance of complications?

We are all familiar with the concept of breast enlargements, the tabloids and gossip magazines regularly talk about the latest celebrity to ‘go under the knife’ to get a pair of new, improved and ultimately bigger breasts. As a result, breast enlargement has become one of the most popular forms of cosmetic surgery, with patients ranging from the stars on the red carpet to the girl next door.

What isn’t as widely documented, however, is the operation that sits at the other end of the scale, breast reduction. Many women undergo surgery to reduce the size of their breasts, achieving equally life-changing results with similar benefits of increased confidence and self-esteem.

Why would I choose to have a breast reduction operation?

The size of a woman’s breasts is determined by a number of factors such as genes, weight and hormones. Although most women’s breasts are in proportion to their body size and shape, some women’s breasts are disproportionately large, which can cause general discomfort. The size and weight of the breasts can particularly be an issue for women who have small frames, as the imbalance can create problems.

The aim of a breast reduction operation is to reduce the size and weight of the breasts. There are many reasons as to why a woman would decide to have breast reduction surgery, including:

• Relief from backache and neck ache.
• Reducing the risk of skin irritation in areas where the breasts may droop and rub the skin.
• To make it easier to participate in high impact sports.
• To improve posture.
• To raise self esteem, many women report having being traumatised by lewd comments or teasing.

How much should I expect to pay for breast reduction surgery?

For most people, the cost of the surgery will naturally be a consideration, however, this shouldn’t be your main criteria when choosing a surgeon. The simple fact with cosmetic surgery is that, more often than not, you get what you pay for.

As a general rule, the amount that a surgeon charges is a direct reflection of their experience and seniority. Going for the cheapest option could simply mean that you are choosing a newly qualified, or inexperienced surgeon, and as a result, are more likely to run into complications. In the UK, the cost of breast reduction surgery varies from clinic to clinic, for an experienced surgeon it is reasonable to expect pay upwards of £3,500.

Some women may choose to have a breast reduction abroad to keep costs low. Although there are many qualified and experienced surgeons working abroad it is not always easy to find out their credentials as they won’t be governed by bodies such as the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS). This means it won’t be as easy as it is in the UK to differentiate between highly qualified and inexperienced surgeons.

Is breast reduction surgery available on the NHS?

In most cases, breast reduction surgery is a performed as a private procedure, because it is generally considered to be a cosmetic decision rather than a health related issue. As a result, breast reductions are not readily available on the NHS. However, if you suffer physical problems because of the size of your breasts or if you are affected psychologically, then your GP may refer you to the relevant physicians to confirm whether you qualify for an NHS breast reduction.

How do I choose a surgeon to perform my operation?

As with all surgery, the decision to undergo breast reduction surgery shouldn’t be taken lightly. When deciding on the clinic and surgeon who will perform the operation, the following tips may help:

• Do your research and, if possible, speak to other people who have undergone similar types of surgery. Recommendation can be a good way of getting a realistic opinion of a clinic.
• Don’t be afraid to visit several clinics and talk to them about their approach to breast reduction.
• Ask to see before and after pictures of previous patients.
• It is essential that you feel that you can talk honestly to your surgeon, as they will interpret exactly what you are expecting from the surgery.
• Check the levels of qualification and experience of the surgeon who will carry out the procedure.
• Follow your gut instinct. Breast surgery is incredibly personal, and ultimately you need to feel comfortable with the medical team.

The process: What to expect before, during and after surgery

Once you have made the decision to undergo breast surgery you can begin the process immediately. In most cases, the procedure will be as follows:

1. Consultation

Prior to the surgery you will have a thorough consultation with your chosen surgeon.

Here’s what to expect during the consultation:

• The consultation is your chance to discuss what you want to achieve and your surgeon will explain their recommendations to you. The surgeon will measure your body to determine the optimum size for you and evaluate your medical history and general health.
• X-rays or mammograms may also be taken and in some cases blood tests will be performed.
• The surgeon will then talk you through how they plan to perform the procedure.

2. Surgery

The medical team will have provided you with all the information you need to prepare you for surgery, including when you should refrain from eating prior to your operation.

The breast reduction surgery will be carried out under general anaesthetic. During the operation, fat, tissue and skin is removed from the breasts to reduce their size and weight. The breasts are then reshaped to a smaller size and the nipples are repositioned.

3. Recovery

After the operation you will need to take it easy for a week or two. Initially you will not be able to drive and it is essential that you refrain from reaching and lifting heavy items whilst your wounds are healing. Therefore, it is advisable to enlist help from friends or family to help you perform everyday tasks, especially if you have small children or pets. You should also consider taking some time off work whilst you recover.

You will be prescribed medication to ease any pain or discomfort following the operation. It is normal to experience some localised swelling and bruising after the procedure, the longevity and level of discomfort varies according to the individual but generally speaking, it won’t last much longer than around two weeks.

How soon will I see the results?

You should be able to see the difference in your breast size immediately following the procedure, especially if your size was greatly reduced. There will be some inevitable swelling in the first couple of weeks after the operation but once this has gone down you should be able to clearly see the new size of your breasts.

How long will the effects of the surgery last?

Breast reduction is permanent and your new breasts will remain in their smaller state providing that your weight remains stable. Once you have the operation, you won’t need to go back for any follow up surgery, unless you experience any serious complications.

What are the risks and problems associated with breast reduction surgery?

A breast reduction operation is a major procedure and therefore, as with all operations under general anaesthetic, there are risks involved.

Risk/problem	Explanation
General anaesthetic	Some people can experience a negative reaction to the general anaesthetic, namely in the form of a chest infection or thrombosis in the legs. Both of these risks are small and can be reduced further by stopping smoking and also coming off the contraceptive pill before the operation.
Infection	Infections can be caused from germs living in the breast ducts or if the wound becomes infected when the fat in the area dies from a lack of blood supply. These conditions can generally be treated with antibiotics, although in some cases this can cause the healing process to slow down and may result in more prominent scarring. Infections usually present themselves as excessive swelling or as an orange coloured fluid that drains from the incision. It is essential that you seek immediate medical advice and treatment for a possible infection.
Scarring	Occasionally, scarring on the skin around the areolas and under the breasts can stretch and become thick and red. In most cases this does settle down with time.
Changes in shape and texture	As this operation involves removing large amounts of breast tissue, it’s natural that the breasts can take a while to settle down after the surgery. They may initially feel lumpy, tender and swollen which is completely normal as it is an indication of the fat in the breasts dying off.
Skin folds	Another potential complication of a breast reduction operation is that the large amount of tissue removed can result in excesss skin folds around the scars, which may need to be removed in a further operation.
Nipples	There is a very small risk of loss of the nipple during the surgery, particularly if there is a considerable amount of reduction involved.

How can I reduce the chance of complications?

Smoking is one of the biggest factors in post surgery complications, as it can actually cause scars to widen and become more visible. It’s very important for your health and your recovery to stop smoking before a breast reduction operation. It is also worth seeking advice from your GP regarding coming off the contraceptive pill prior to surgery if you are worried about complications with general anaesthetic.

Your surgeon is there to look after you before, during and after your operation so if you have any worries at all then don’t hesitate to contact your clinic. For more information on the possible risks of breast reduction surgery visit the British Association of Aesthetic Plastic Surgeons.

Further Support

You can find out more about the breast reduction operations Stephen McCulley has performed here or contact us for more information.

Please also see related advice at:

• Breast reduction surgery information
• Reducing the risk of surgery