Reduction

These are extremely common procedures – more common than most people realise! A breast reduction usually involves a ‘lift’ at the same time. (As one is reducing a breast which is generally large and has some degree of ptosis, one automatically lifts same in the process of reduction.) The patient needs to be made aware of the consequences of breast reduction surgery, which could result is some scarring – this is usually a ‘fine line’ scar running around the nipple-areolar complex and extending in a vertical line down the lower part of the breast. There can also be a short horizontal scar in the inframammary fold, the length of which is usually dependant on the technique used and the size of the breast pre-operatively.

For smaller breasts, a short scar technique is usually performed. This is normally a circum-areolar and vertical scar. (Occasionally a 5 cm horizontal scar in the inframammary crease). Sutures are usually “dissolving” sub-cuticular (underneath the skin) Management of the scar is pro-active – and scar treatment is initiated irrespective of one’s expectations of resultant scarring. Keloid scars can, however, occur and patients need to be aware of this.

Often there can be some sensory change in the breast, although this is true of only a small percentage of patients.

Breastfeeding after breast reduction surgery is generally unpredictable. Some are able, whilst others unable, to breastfeed.

Smaller breast reductions are done as day case procedures, under local anaesthetic with conscious sedation, in my clinic at Driftwood, and patients go home the same day. Larger reductions may require overnight admission and these patients are usually then done at Constantiaberg Mediclinic. Drains are often used in these overnight cases and they are usually removed the following morning. Dressings are waterproof, covering the suture lines, with no bandages being applied. A surgical bra is usually fitted. The operative procedure is normally in the region of about two to two and a half hours, depending on the size of the breasts.

Recovery time – Most operative patients are encouraged to be up and about as soon as possible and, for the first week, I usually tell patients that they can continue to do normal household chores. After a week, I encourage them to resume their normal physical activities, provided these do not involve any jarring motions i.e. no jogging, horse riding, mountain biking etc. which would involve jarring of the upper torso. Patients may, however, commence hiking, walking or doing exercises that work on areas other than the upper torso.

Follow-up on patients is done a week post-operatively, when dressings are changed, sutures are trimmed and all is checked.

Patients may usually return to all physical exercises at about one month post-operatively.