Breast Reduction

What is a Breast Reduction Really?

Lifting the breasts and removal of excess breast tissue, creating a breast size and shape that fits the rest of the body.

At what age can breast reduction surgery be done?

15 plus, when breast growth has been stable for one year. Surgery requires parental consent, if under the age of legal consent.

ENLARGED PTOTIC BREAST (LEFT) AND IDEAL BREAST (RIGHT)Surgical Technique

In very large breasted women who have completed childbirth and breast feeding or who do not mind losing the ability to breast feed, the nipple and areola can be removed and replaced as a free nipple-areolar graft after reducing the breast. This helps to prevent ‘fat necrosis’ or hardening of the breast after surgery as well as also avoiding the risk of an impaired blood supply to the nipple-areola if it were to remain attached. INFERIOR PEDICLE SIDE VIEW BEFORE AND AFTERIt also provides a very secure shape with fewer tendencies to “bottom out” after surgery. Nipple sensation is lost and the projection and color of the nipple and areola is also affected.

The most common technique used in breast reduction is the ‘inferior pedicle’ technique that preserves the connections of the nipple to the breast parenchyma or gland thus allowing breast-feeding. Breastfeeding is still not a foregone conclusion since large or hypertrophic breasts may have poorly functioning glandular tissue (parenchyma). The quoted figure in the scientific literature is that 50% of these women will be able to lactate after breast reduction surgery The ‘inferior-pedicle’ procedure is suitable for most large breasted young women. In most cases the nipple needs to be elevated by more than 6 cm; although this is not a requirement. The ‘inferior pedicle’ technique is also suitable after the menopause and gives a more INFERIOR PEDICLE FRONT VIEW BEFORE AND AFTERnatural nipple-areolar appearance than the free nipple graft technique described above. The ‘inferior pedicle’ technique results in an anchor shaped scar. Patients are more likely to have sensation in their nipples after this kind of surgery.

The second most common method is the ‘superior pedicle’. This is more suited for moderately enlarged breasts in which the nipple is 5-6 cm below its final postoperative optimal level. This procedure moves the nipple-areola complex (NAC) on glandular tissue from above, rather than below. An ellipse of skin and gland is removed in the midline part of the lower breast. The NAC remains attached and nipple sensation may be preserved. The ability to breast-feed is usually lost because most of the attachments between the parenchyma and the NAC are divided. This kind of procedure has the advantage of a stable breast shape without the risk of ‘bottoming-out’ over time. The scar is ‘lollipop-shaped’, being around the NAC and SUPERIOR PEDICLE SIDE VIEW BEFORE AND AFTERthen extending downwards to the crease below the breast. In the breast auto-augmentation technique, the ellipse of parenchyma in the lower breast is preserved and used to ‘augment’ the hollow upper half of the breast.

Philosophy
Large breasts are uncomfortable and unsightly. They put stresses on the shoulders and the upper back. Exercise is difficult and large breasts can be an SUPERIOR PEDICLE FRONT VIEW BEFORE AND AFTERembarrassment, especially for school –age girls. Surgery to reduce them gives an attractive shape that can improve posture and sense of well-being as well as overall quality of life. See Testimonials and Ulrika Johnsson’s story.

Surgical time and recovery
Surgery takes about 3-4 hours. All stitches are under the skin and are absorbable. The patient can go back to work in 7-10 days.

Related procedures
Liposuction under the arms to define the outer curve of the breast.

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