If breast asymmetry was present prior to the surgery , the objective would be to improve this asymmetry as a part of the procedure . Following the surgery the breasts will appear pert ; 3-4 months following the surgery they will look more natural and will behave accordingly . In the majority of patients wearing a bra although is advised , however , it remains a personal preference not to wear one .
In my 19 years of practice as a consultant plastic surgeon I still do not discuss the cup size following the surgery , as accurately predicting a cup size in my opinion is not scientific and could be misleading . There are too many variables to give an accurate answer regarding a post surgery breasts ’ cup in such a scenario . It is , nonetheless , important for me to clearly understand the patient ’ s requirements and plan to achieve them , respecting that this may not always be possible and if so then to explain to the patient the reasons why prior to the surgery . Neither the breast ’ s cup / size nor the cleavage proportions or the symmetry of the breasts could be guaranteed .
Other risks and potential complications include the loss of the skin of the nipple areola complex . This can occur in 1-2 % of patients . If this happens it means a longer recovery period with repeat dressings and possibly further surgical interventions . This is more common in more susceptible patients with conditions like chronic obstructive airway disease . Wound dehiscence is an uncommon occurrence following breast reduction surgery ; however , if it occurs it is treated conservatively with dressings and tends to settle well .
In 2-3 % of patients painful lumps may appear after surgery known as fat necrosis . This latter process in a large number of patients is selflimiting but may take a number of months to resolve . Fat necrosis tends to be more common in the larger fatty breasts especially in the older patients with other comorbid conditions like diabetes .
Swelling is expected after this surgery , which will take up to three to four months to settle , but in some individuals it may take much longer . Fullness in the breasts cleavage area and / or the outer aspect may occur . This swelling is classically called “ dog ears ” and tends to be more common in the larger and wider breasts . In rare occasions , these “ dog ears ” may need to be excised if not resolved , usually after one year .
Numbness of the breasts ’ skin and nipples is expected after this surgery , in most cases the sensation may return to the nipples . Breast-feeding ability is unlikely to be achievable in 50 % of patients
after this procedure ; however , this only applies to patients of childbearing age .
Pain following breasts reduction surgery is usually managed at the time of surgery and as such is mild to moderate in the next 48-72 hours after the surgery . I encourage patients to take painkillers regularly over the first few days following the breasts reduction . It is also important to say that buying expensive bras or bikinis following the surgery is not advisable until the initial swelling has improved and the conformity of the breasts has settled , which is 3 months following the surgery .
Following breast reduction surgery I would expect the recovery period to be 3 weeks in the majority of patients . You are likely to return to driving and work at 3 weeks . The stitches , which are dissolvable , are trimmed and the wound is checked at 10-12 days after the operation .
The wound is expected to stay dry until the first dressing when further instructions would be given . The hospital stay is usually 1 day and drains are used , which are normally removed after 24 hours , however , in some patients they may have to stay longer .
Prior to breasts reduction surgery and in women aged 40 years and above it is recommended to undergo a baseline mammogram . It is also important that smoking ceases 4 weeks prior to the surgery and for a minimum of 3 weeks following the operation . The combined contraceptive pill will have to stop one cycle prior to the surgery and recommence 3 weeks following the surgery , and other precautions must be taken . HRT will have to stop 4 weeks prior to the surgery and recommence 3 weeks after . Majority of herbal remedies will need to stop 3-4 weeks prior to the surgery as they could increase bleeding and bruising .
The information contained in the above paragraphs is by no means exhaustive , and are not to cause concern , however this information is for your benefit in clarifying matters . It is important that you ask questions during your preoperative consultations , and after your surgery . This will further clarify any queries you may have . It is also important to reiterate that most of these risks and potential complications are uncommon in the majority and some are very rare .
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