Breast Reduction

Dr Jesse Hu
Consultant General Surgeon, Breast, Thyroid & Endocrine Surgery

What is Breast Reduction?

Breast reduction, medically known as reduction mammaplasty, is a surgical procedure aimed at reducing the size and weight of large breasts. The procedure involves removing excess breast fat, glandular tissue, and skin to achieve a breast size that is proportionate to the body.

The decision to undergo breast reduction is a personal one, encompassing considerations of physical well-being, aesthetic preferences, and lifestyle implications. It is typically pursued after conservative measures, like physical therapy or weight loss, have not provided sufficient relief from symptoms attributed to the size of the breasts.

Reasons for Considering Breast Reduction

People may consider breast reduction for a variety of reasons, encompassing both medical and personal considerations. Here are the primary reasons that lead people to contemplate this surgical procedure:

Physical Pain and Discomfort

The weight of overly large breasts can exert significant strain on the back, neck, and shoulders, leading to chronic pain and discomfort.

Limitations in Physical Activity

Large breasts can hinder the person’s ability to engage in physical activities, from daily exercises to specific sports, due to discomfort or physical limitation caused by their size.

Skin Issues

The constant friction and sweat accumulation under the breasts can cause skin irritation, rashes, and even infections, which can be mitigated by reducing breast size.

Difficulty Finding Suitable Clothing and Bras

Many with large breasts struggle to find clothing and bras that fit well, often leading to compromises on style or comfort.

Impact on Sleep and Daily Activities

The size of one’s breasts can make certain sleeping positions uncomfortable and interfere with routine activities, such as driving or bending over.

Posture Problems

The extra weight can lead to poor posture, contributing to long-term discomfort and spinal issues.

Benefits and Risks of Breast Reduction

Benefits

  • Alleviation of Physical Discomfort: Significant back, neck, and shoulder pain reduction.
  • Enhanced Mobility: Improved ability to participate in physical activities, contributing to a healthier lifestyle.
  • Better Fit for Clothing: Finding clothing and bras that fit comfortably and look flattering is easier.
  • Improved Skin Health: Reduced skin irritation and infections under the breast area.

Risks

  • Surgical Complications: As with any surgery, there is a risk of complications such as bleeding, infection, or an adverse reaction to anaesthesia.
  • Scarring: Scars are inevitable, though their severity can vary. Surgeons typically strive to minimise and conceal scars within natural contours.
  • Changes in Sensation: Some may experience changes or loss of sensation in the nipples or breast skin, which can be temporary or permanent.
  • Asymmetry: There is a possibility that the breasts might not be perfectly symmetrical post-surgery.
  • Impact on Breastfeeding: The ability to breastfeed may be affected, with some people unable to produce enough milk.

Preparing for Breast Reduction

The preparation phase for breast reduction surgery is crucial for ensuring a smooth procedure and optimal recovery. This typically involves:

The first step involves meeting with the surgeon to discuss goals, expectations, and potential outcomes. This conversation should also cover medical history, including current medications, past surgeries, and overall health status.

A comprehensive physical examination of the breasts is conducted to determine the best surgical approach. This may include measurements, photographs, and sometimes breast imaging studies.

Patients receive detailed instructions on how to prepare for surgery, including guidelines on eating, drinking, medication adjustments, and smoking cessation. Smoking, in particular, is discouraged as it can affect wound healing.

Some medications and supplements may need to be temporarily discontinued to reduce the risk of bleeding and other complications. This includes aspirin, anti-inflammatory drugs, and certain herbal supplements.

The Breast Reduction Procedure

Breast reduction surgery is a complex procedure that requires careful planning and precision. Here is an overview of how the procedure is generally conducted:

Anaesthesia

The surgery usually requires general anaesthesia, ensuring the patient is asleep and comfortable throughout the procedure.

Incision

There are several incision techniques used in breast reduction surgery. The choice of technique depends on the person’s specific anatomy, the extent of the reduction, and the surgeon’s preference. Common incision patterns include the circular pattern around the areola, the keyhole or racquet-shaped pattern with an incision around the areola and vertically down to the breast crease, and the inverted T or anchor-shaped incision.

Removal of Tissue and Reshaping

After making the incision, the surgeon removes excess breast tissue, fat, and skin. The remaining breast tissue is lifted and reshaped to improve contour and firmness. In some cases, liposuction may be used to remove excess fat from the armpit area.

Repositioning of the Nipple and Areola

For many patients, the nipple and areola are repositioned to a natural, more youthful height. The areola size can be reduced if necessary by excising skin at the perimeter.

Closing the Incisions

The incisions are brought together to reshape the now smaller breast. Sutures are layered deep within the breast tissue to create and support the newly shaped breasts; sutures, skin adhesives, or surgical tape may close the skin.

Postoperative Care and Rehabilitation

Following breast reduction surgery, a carefully planned postoperative care and rehabilitation protocol is essential for a smooth recovery and optimal outcomes. This typically involves:

  • Immediate Postoperative Care: Initially, patients will experience swelling, bruising, and discomfort around the incision sites. Pain medication can help manage these symptoms. Most surgeons will apply dressings or bandages and may also fit you with a support bra or garment to minimise swelling and support the breasts as they heal.
  • Drainage Tubes: If drainage tubes were placed during surgery, they are usually removed within a few days post-surgery during a follow-up appointment.
  • Activity Restrictions: Patients are advised to avoid heavy lifting and strenuous activities for at least 4-6 weeks. Walking and mild stretching are encouraged to promote circulation and prevent blood clots.
  • Follow-up Appointments: Regular appointments with the surgeon are necessary to monitor the healing process. During these visits, the surgeon will check the incision sites, remove sutures if needed, and address any concerns.
  • Wound Care: Instructions on caring for the incision sites and any signs of infection to watch for will be provided. Keeping the area clean and dry is paramount.
  • Support Garments: Wearing a support bra 24/7 is recommended for several weeks post-surgery to reduce swelling and support the new breast shape during healing.
  • Managing Scars: Scars are a normal outcome of breast reduction surgery. Patients will be advised on caring for their scars, including using silicone sheets or scar creams to minimise their appearance over time.
  • Physical Therapy: Some patients might benefit from physical therapy to improve posture and shoulder mobility, especially if they have experienced long-term discomfort before surgery.

Dr Jesse Hu

Consultant General Surgeon, Breast, Thyroid & Endocrine Surgery

Dr Jesse specialises in managing both benign and malignant breast and thyroid conditions, which also includes breast pain, breast lumps, breastfeeding problems, neck lumps, amongst others.

Her dual expertise in cancer removal and plastic surgery techniques expands the design of individualized treatments, leading to holistic patient outcomes.

Dr Jesse was part of the teaching faculties of both NUS Yong Loo Lin School of Medicine and Lee Kong Chian School of Medicine, where she teaches and mentors the next generation of medical students and trainee doctors.

  • Surgical training at NUS School of Medicine
  • FRCS (Fellow of the Royal College of Surgeons) Edinburgh, UK in 2014
  • Completed 2 Health Manpower Development Program (HMDP) fellowships at Oxford University Hospital, UK in 2016

Dr Jesse is recognized as an authority in breast cancer and thyroid surgery and a sought-after conference speaker.

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    Breast Reduction in Singapore

    Frequently Asked
    Questions

    How Long Does Breast Reduction Surgery Last?

    The duration of breast reduction surgery can vary depending on several factors, including the complexity of the procedure, the specific technique used, and the extent of reduction desired. Generally, the surgery takes about 3 to 5 hours to complete.

    This timeframe includes the preparation time immediately before the procedure, the actual surgical process, and the initial recovery period in the postoperative care unit. Patients can usually go home on the same day as the surgery, although occasionally, an overnight stay in the hospital may be recommended for monitoring.

    Will I Be Able to Breastfeed After Breast Reduction Surgery?

    Breastfeeding after breast reduction is possible, but it can be affected by the surgical technique used and the extent of tissue removed. Discussing your desire to breastfeed with your surgeon during the planning stages of your surgery is important.

    How Long Does It Take to Recover from Breast Reduction Surgery?

    Recovery times can vary, but most patients can return to work and normal activities within 2 to 4 weeks, with complete recovery and the ability to engage in strenuous activities after about 6 weeks. Complete healing and the final shape of the breasts may take several months to develop.

    Is Breast Reduction Surgery Painful?

    After the surgery, you will experience discomfort and soreness, which can be managed with prescribed pain medication. Most patients report that the relief from symptoms caused by large breasts outweighs the temporary discomfort of surgery.