Breast Reduction

Female breast size is determined by several factors, including genetics, body weight, and hormonal influences. Breasts can also be affected after giving birth, resulting in an undesirable change in the breast shape and size. Unfortunately, larger breasts can often be associated with a variety of problems, ranging from self-consciousness and inconvenience (especially if you are particularly sporty, or if you struggle to find flattering, well-fitting bras and clothes), through to more serious discomfort. This can include a backache, neck pain and skin irritation such as rashes under the breasts. There are also issues that arise such as an inability to take part in certain sports or exercise due to overly large breast size.

Many women desire to have a breast reduction after giving birth when the breast begins to sag lower than before. However, many women have breast reductions prior to having children and are concerned about the ability to breastfeed after surgery. During the procedure, care is taken by your highly skilled surgeon to retain connections between the remaining breast tissue and the skin, in order to preserve breastfeeding capability.

We offer breast reduction for men to treat Gynaecomastia, which is a common condition that causes the male breasts to become enlarged. This can be caused by hormone imbalance, obesity, old age or puberty, or it can occur naturally without reason. Gynaecomastia can cause men to feel self-conscious, and the treatment for this is an excellent way to regain that confidence and have your desired chest.

The surgery for men is performed in a slightly different method, with the focus on avoiding visible scars, and often liposuction alone is adequate to create the desired results. We also offer Nipple Reduction for men who suffer a condition called 'Puffy Nipple'.

This is not a simple answer, because surgeons have different requirements, not only with the bras they recommend but also with the dressings beneath. It will also depend somewhat on the exact procedure performed.

The wounds are generally closed with stitches under the surface. These dissolve over a few weeks. You may have a strip dressing or reinforcement paper strips over or along the wound. Then there is variation. That may be the sum total of dressings or there may be gauze and stretchy Mefix paper dressing covering the wound and also supporting the breasts.

Finally, the garment. Some surgeons do not use them at all. In fact, many at the Cadogan Clinic will advise that you bring in or buy later a normal sports bra without wire support. The alternative is the lycra bra, made specifically for breast surgery of which there are many types. The team will fit the one most suitable for you and your surgery.

There is one other lycra dressing, occasionally required, and that is a stretchy strap worn across the upper breast to hold the implant low.

The sports bras or lycra garments will be worn day and night for 3 weeks or more and then during the day for a longer time, particularly during sporting activity.

One cannot guarantee that sensation will not be altered by breast surgery, but it is rarely a problem. Clearly, if a breast has been removed, any reconstruction will have very limited feeling, but this is not usually uppermost in the patient’s mind.

Patients with very large breasts often never have significant feeling in the nipples and in the event that sensation is reduced after reduction surgery, it is unlikely to be missed. The degree of reduction is dependent on the technique employed. This is something to discuss with your surgeon.

The breast lift, or mastopexy, is less likely to affect sensation as most nerves to the nipple are not touched.

Although breast augmentation with implants or even fat grafting does little to endanger nerves to the nipple, the skin and underlying nerves are stretched causing temporary numbness and rarely recovery is delayed or absent. We may find some loss when we test for sensation, but it is rarely enough for patients to complain.

Due to our specialism in liposuction, it is possible in some cases to perform breast reduction using liposuction techniques only. This technique is often known as ‘scarless breast reduction’ since the incisions required can be made in less prominent positions, such as under the arms, where they cannot been seen.

More typically, however, following traditional techniques you should expect a small degree of scarring. There are different techniques for breast reduction and the scars created will depend on the technique employed, as well as the patient in question and the size of the breasts being reduced. Most commonly you should expect some scarring around the nipple, across the bottom of the breast fold, and a vertical scar linking the nipple scar to the breast fold scar giving rise to the so-called ‘inverted T’ or anchor pattern.  Some surgeons prefer to perform the operation omitting the breast fold scar giving rise to the ‘vertical scar’ reduction.  Not everybody is necessarily eligible for this and it tends to be used for not such large breasts.

Regardless of which technique you undergo, Cadogan Clinic is able to provide each and every one of its patients with access to one of London’s most advanced scar minimization and prevention teams following their procedure. Our nurses have decades of experience and will provide you with the tools and techniques to support your healing process as effectively as possible.

General advice is to take two weeks off work following breast reduction surgery, since swelling is greatest during this time and it is advisable to give wounds time to heal.  During this period it is advisable to keep physical activity to a minimum or drive. It is, however, advisable to mobilise as soon as possible after breast reduction surgery.

If stitches need to be removed, this is generally carried out at about two weeks after the operation.  At this stage dressings are removed and women are encouraged to wear comfortable crop tops or sports bras for support until any swelling and discomfort has resolved, after which they can start wearing normal bras in their new size – this may take a few weeks longer.

Massage and moisturizing are a vital process of breast reduction aftercare and expert advice will be given on the best techniques from our dedicated team.

Breast reduction is usually performed under general anaesthetic as a day case procedure, meaning advanced sedation techniques are employed to enable you to recover more quickly after surgery and return home on the day of your procedure.

Whilst there are several breast reduction techniques, each essentially involves reducing a proportion of the breast volume via excision and reshaping the breast mound such that the nipple is lifted into a more normal position, while preserving the blood supply to the elevated nipple and areolar complex. The overall effect is a more ‘pert’ breast hanging in a more regular position.

Your surgeon will explain his or her preferred technique at your consultation and where the incision is to be placed accordingly.

All breast reduction techniques require an incision that will result in a scar that will likely be red and slightly raised in the weeks and months after your procedure, before fading completely.

Scar visibility can, however, be greatly impacted by the quality of the surgeon you choose, as well as the level of aftercare you receive. In the hands of a skilled surgeon the scar can be positioned very discreetly, whilst an expert scar minimization team can provide you with the tools and techniques to enhance the healing process. For example, scar the appearance can be reduced by regular moisturisation and massage techniques, all of which our dedicated team will advise our patients in the days following your procedure.

Due to our specialism in liposuction, it is possible in some cases to perform breast reduction using liposuction techniques only. This technique is often known as ‘scarless breast reduction’ since the incisions required can be made in less prominent positions, such as under the arms, where they can not been seen.

Breast reduction recovery time varies from case to case but you should be able to return to your normal day-to-day activities after about two weeks. However, we recommend our patients be sensitive to their body and try not to do too much too soon, ceasing activities after or during which any pain is experienced.

We recommend temporary suspension of activities such as going to the gym, and practicing aerobics and sports that involve using your arms. Any activity that requires lifting your elbows above your shoulders should also be carefully monitored.

All breast reduction techniques require an incision that will result in a scar that will likely be red and slightly raised in the weeks and months after your procedure, before fading completely.

Scar visibility can, however, be greatly impacted by the quality of the surgeon you choose, as well as the level of aftercare you receive. In the hands of a skilled surgeon the scar can be positioned very discreetly, whilst an expert scar minimization team can provide you with the tools and techniques to enhance the healing process. For example, scar the appearance can be reduced by regular moisturisation and massage techniques, all of which our dedicated team will advise our patients in the days following your procedure.

Due to our specialism in liposuction, it is possible in some cases to perform breast reduction using liposuction techniques only. This technique is often known as ‘scarless breast reduction’ since the incisions required can be made in less prominent positions, such as under the arms, where they can not been seen.