In the breast reduction operation the aim is to reduce the size of the breast whilst at the same time lifting the breast and elevating the nipple to a more ideal position. The scars are placed in inconspicuous positions designed to be hidden when wearing a bra or bikini. The nipple is left attached to breast tissue to preserve its blood supply and retain its natural appearance. If the areola is too large, this too will be reduced at surgery.
Smokers have a much higher risk of developing complications. It is therefore advised that they should refrain from smoking for at least 6 weeks prior to and for two weeks following surgery. Smoking significantly increases the risk of wound infections and breakdown as well as vascularity problems with the nipple. Aspirin and anti-inflammatories should be avoided for a similar time period as they may promote bleeding. Patients on oral contraception (not HRT) should ideally stop taking the Pill for six weeks prior to surgery as there is a slight increased risk of thrombosis. During this period alternative forms of contraception are required.
The breast reduction procedure takes between two and two and a half hours and is undertaken under general anaesthetic. Before starting the operation when the patient is asleep the breasts are infiltrated with a dilute solution of local anaesthetic and adrenalin, not only to provide postoperative pain relief but also to reduce bleeding. At operation skin is removed as well as breast tissue. The nipple is elevated to a more ideal position. The locations of the incisions will have been discussed and marked preoperatively. The wounds are all sutured with self-dissolving stitches and dressings applied. Drains are inserted into each breast. The tissue that is removed is routinely sent for histological analysis.