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Breast Reduction

Breast reduction is a surgical procedure designed to reduce breast size and weight by removing excess skin, fat, and glandular tissue.

The procedure is designed to rejuvenate the chest by enhancing the shape of the breast, lifting the nipple position and reducing the areola size. This results in younger looking, appropriately sized or smaller, uplifted breasts.

The procedure is best suited to those with disproportionately large or heavy breasts, causing back/neck and shoulder problems or those with postural changes (stooping), bra-strap grooving, skin irritation and rashes under the breasts. Large heavy pendulous breasts that only grow larger with age can severely restrict routine activities of daily living and exercise and lead to lower self-esteem and measurably poorer quality of life.

Reducing tissue mass and elevating the breasts on the chest wall improves or alleviates many of the physical symptoms associated with heavy or disproportionately large breasts.

Several surgical options are available depending on how much tissue needs to be removed, the desired shape and outcome and the downtime and scarring that can be tolerated.

Breast reduction using an anchor shape scar allows for large reductions of tissue, good control of excess skin and results in beautiful shaped breasts.

Single scar techniques with only the peri-areolar and vertical scar component are designed for more moderate reductions and rely on younger skin with more elasticity. The scars often take longer to settle since they extend past the breast onto the chest wall. This procedure is suited to younger patients with less pendulous or heavy breasts and more patience.

In all cases, excess breast tissue, skin, and fat are removed to reshape and reduce the size of the breast and lift the nipple-areola complex. Liposuction can be usefully added to remove excess axillary or back fat to improve the appearance of the whole chest.

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Breast Reduction

At a glance

Treatment

Frequently asked questions

If the size or weight of your breasts are restricting your lifestyle and you are prepared to accept scars and the potential loss of breast feeding, then breast reduction is a very high quality procedure that addresses the problem and rejuvenates the chest wall. Most candidates have completed their family and may/may not be peri-menopausal.

Very large breasts may require a less aesthetic procedure with ‘free nipple grafting’ or a revision breast reduction (through the same scars) if the breasts continue to grow or droop with age.

Be well-informed. Read around the subject, meet with as many doctors as you need to find someone you are comfortable with, someone you trust, someone who understands.

Take advantage of the consultation process – ask as many questions as you need, have as many consultations as required to firmly make up your mind and are committed to the process, not just the day of surgery. Bring along pictures of how you want to look/used to look, that’s a great starting point for discussion. Be realistic, sometimes a single procedure is not sufficient and  a combination of treatments (liposuction etc) may be required.

Be open and transparent about your medical history and prescribed, over- the- counter  (OTC) and ‘recreational’ medications.

Pre-op investigations such as mammogram or ultrasound may be required. We’ll advise you re compression garments, post-op pillows and anything else you may need

Set aside time for planning, prep and recovery. Surgery is a big psychological and physical stress. Don’t rush yourself. Don’t allow anyone to rush you.

It is a general anaesthetic procedure requiring a considerable amount of planning pre-op and tissue manipulation and suturing during the operation so it takes some time, approximately 3 hours.

You are laid on your back with arms out wide on the operating table and surgery performed with consideration for blood loss. Drains are rarely required. Each breast is operated on in turn with care taken to symmetrise and match the two breasts. It’s  a regimented surgical origami – removal of excess tissue,  some deft manouevres and shaping of the breast and repositioning of the nipples.

All sutures used are dissolving. Internal sutures lend support and shape to the breast. The superficial sutures  function to approximate the skin without tension.

Pain relief and antibiotics are given during the surgery

Rozina uses steristrips, a waterproof dressing then a compression garment as her preferred dressings.

The  form-fitting surgical bra has adjustable large straps and firm front clasps, to support the breast weight, reduce swelling and help with  pain relief.

You’re advised to wear the surgical bra for 3 weeks post-surgery, followed by a less firm sports bra for an additional 3-6 weeks. Underwire bras should be avoided during this time, to avoid rubbing against the healing scars .

Bruising and pain are expected for the first 1-2 weeks Prescription medication is provided but simple  over-the-counter pain relievers taken regularly are usually sufficient.  Most patients take at least a week off work, to rest and recover. You may feel sore and as if there’s pulling, stretching, or tightness in the area for up to  two weeks.

You can be back to normal activities within a few weeks, but it’s important to avoid strenuous activity or lifting heavy objects until after your six-week review. 

The full recovery period is usually 8-12  weeks, which is how long it typically takes for inflammation and swelling to reduce to a point that the breasts feel soft and natural. 

Because breast tissue is significantly manipulated during surgery, it may take over six months before all swelling subsides and the final results may not be apparent for 9-12 months

You will be under review and seen at 1 week, 6 weeks and again at 3 months.

Rozina will then invite you for a regular clinical +/- radiological review annually.

Breast reduction scars are very well positioned to be barely visible. They are placed around the areaola, down the centre of the breast and hidden in the inframammary fold. The scars are usually covered and flattened under a bra and are not therefore readily noticeable.

Scarsmature and  fade with time and after 18-24 months  you can expect a flat pale scar not easily  visible other than maybe at the peripheries of the lateral Infra-mammary crease. Dark skinned people may have more noticeable scars if they become hyperpigmented or raised.

Rozina will monitor and manage your scarring and provide silicone gels or sheets as necessary and is always happy to advise on any additional procedures to optimise scarring.

Sometimes large breasts can continue to grow after breast reduction surgery, in some rare medical cases, it can lead to rapid growth, mostly seen in younger women, that requires further or even ongoing surgery.

Pregnancy, hormonal changes, menopause, and weight changes  all continue to affect breast size and shape over your lifetime.

Since breasts are composed partly of fat, you may have an increase in bra size if you gain weight, moreso if you are post-menopausal since there is  less glandular tissue, more fat component.

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