- Q: Will I be given medication after surgery? What tips do you have for me to ease any discomfort?
Most women say breast reduction is less painful than they had expected. I will use local anaesthetic solution during the procedure this reduces discomfort for the first 6-12 hours after the procedure. In addition to this you will have pain tablets which will effectively manage any pain you may experience.
- Q: What is the "real" recovery time after Breast Reduction
Most woman will be able to do almost any activity after 4 weeks. Some women are able to go back to non physical type jobs at 2 weeks or less. If you work, or can work from home, then you may be able to do some or all of your work earlier. The answer to this question often requires individual guidance based on your personal specific needs. You would be surprised how much individual thought is required.
You might do an office type job but if you have a 2 year old at home who needs to be lifted up 10 times work might be a small issue for consideration but you might need to consider whether you need help around home. Alternatively if your children are older or you don't have children but you are a passionate horse rider again work may be a minor consideration but who looks after your horse for you might be something we need to talk through. (I have had at least one lady back horse riding at 4 weeks).
This is why considering breast reduction is a collaboration between you and your surgeon. Everyone's life is different and you will need to talk about your individual needs.
- Q: Will I have dressings, bandages or stitches after surgery? When will they be removed?
All stitches used are beneath the skin so you will not need to have any sutures removed. The stitches dissolve slowly over 4- 6 weeks following the surgery. You will have special tapes over the suture lines placed at the end of the procedure.
You will have soft supportive crop top garment for support. You can remove this each day and shower normally. You will be able to shower from the first day after surgery.
- Q: How long of a recovery period can I expect, and what kind of help will I need during my recovery? Are there special instructions for eating, sleeping, or bathing?
Your general recovery will progress through stages over a few weeks following the procedure (on average 4 weeks is a good rule of thumb). You will be eating and drinking normally within hours of surgery. There is no dietary restrictions after surgery.
You can shower as soon after surgery as you wish as often as you wish. If you feel anxious about showering we can advise you on alternate strategies.
Sleeping can be the trickiest bit depending on your normal sleeping habits before surgery. If you, by habit, sleep on your back you are in luck because this is the most comfortable position to sleep in for the first few days or weeks. If it is your habit to sleep on your front then you will have to readjust and sleep on your back for the first few nights. You will slowly get more comfortable and get back to normal over 3-4 weeks. You cannot cause any complications by rolling onto your tummy or side in your sleep it just may be uncomfortable and wake you up.
- Q: When can I return to work, resume normal activity, drive and exercise?
You will have a graduated return to normal activities. When you return to work very much depends on the demands of your job. If your job mainly involves telephone and email correspondence which can be done from home you may be able to do part or all of your duties within days of the surgery. If you do a heavy physical job like nursing, personal care attendant, paramedic, hospitality or outdoor work (gardening, construction, manufacturing) you may need up to 4 weeks off work. Most women are able to get back to work in around 2 weeks. One of the goals of your consultation will be to understand the individual demands of your life and give you specific advice on when you will likely be able to resume your normal activities.
Most women can resume driving by around 7-10 days post surgery.
Exercise will be a graduated process. You are strongly encourage to walk from the first day following surgery. This can be increased as tolerated. In most cases the skin wounds will be healed in 10 days. After this you can resume most activities as you feel comfortable. As you would understand activities where you get a lot of bouncing action (jogging, aerobics, dancing) are the activities it takes longest to get back to often around 4 weeks.
- Q: How likely is infection after breast reduction?
Fortunately significant infection is very rare after breast reduction. If you were to have a breast reduction procedure you would be given intravenous antibiotics during the procedure.
It is very rare to see a significant infection after the procedure. As a guide I have never had to readmit a patient to hospital for infection problems after a breast reduction. Nothing is impossible but it would certainly be a rare occurrence.
- Q: Will I be able to have mammograms after breast reduction surgery?
Yes. If you are over 40 years of age we recommend you have a mammogram before proceeding to any breast procedure.
You will be able to resume your normal mammogram sequence following surgery. If you are over 40 we suggest you have a mammogram performed one year after your breast reduction. This becomes a snapshot of the new internal appearance of your breast to assist with your future screening.
Increasingly mammography is a tool used hand in hand with ultrasound. The ability to perform an ultrasound exmination of your breasts will also be unaffected after breast reduction.
In the future it may be that MRI becomes the imaging modality of choice. The ability to perform an MRI is unaffected by having had a breast reduction.
- Q: Will I have scars?
Yes. You will have permanent scars. There are 2 common scar patterns depending on which technique procedure you choose. Most women have scars around the nipple/areola and a vertical scar below the nipple towards the fold under your breast. In addition depending on the size of your breasts and your choice of technique you may have a further long scar in the fold under your breast. If you choose to have your breast size reduced by liposuction alone you will have multiple very small scars (3 or 4 scars 5mm each in length). Liposuction by itself will not usually address significant droopiness of the breasts (ptosis).
Liposuction can also be difficult in younger women because at a young age much of the breast tissue is glandular tissue and is too dense to be able to be removed by liposuction. As you get older a greater amount of the breast tissue is fatty tissue which is amenable to liposuction. The irony of course, is that as you get older the droopiness (ptosis) is likely to be greater. So young woman may not be candidates for liposuction alone because their brests are composed of very dense tissue and older women may not be candidates for liposuction alone because of the severity of the droopiness. We will need to discuss and assess these factors if we meet.
- Q: Are the results permanent, or how long may I expect the results to last?
Yes, for most women the results are permanent. However, if you experience significant weight loss or gain your breasts will change in size in proportion to their new size.
No one escapes gravity so over time (particularly if you have further pregnancies) you can expect some further drooping (ptosis) of the breast tissue. Because your breasts will be much lighter this is likely to be proportionately less than the case if the reduction had not been performed.
Breasts can regrow if you are extremely unlucky. It is most uncommon. If a further reduction is required this can (in most cases) be safely performed but it is a very uncommon occurrence. I have performed 2 repeat breast reductions in my career. In both cases I did not perform the original surgery. In one case the original surgery was performed 34 years prior in the other case 30 years prior. Both women had been very happy with the outcome of their original procedure but experienced considerable further breast growth after menopause associated with generalised weight gain. In both cases a further reduction was performed without complication and achieved the outcome desired by the patient.
- Q: When will I go home from hospital?
We will discuss your individual needs. Breast reduction can be performed as a day procedure if you wish but most patients stay overnight in the the hospital after their procedure.
- Q: Will the rashes under my breasts disappear and can you remove the skin tags?
In most cases the rashes woman experience in the fold under the breasts will resolve after surgery.
If you have minor skin lesions like skin tags they can be removed during the procedure as long as you discuss this with us well before the operation day.
- Q: Will I feel lighter on my front? Will I lose my balance?
You will definitely feel lighter on your front. This is the key positive outcome from breast reduction surgery.
You will notice less dragging on your neck and shoulders too.
You will not lose your balance .
- Q: Will I have a decreased risk of breast cancer after having a reduction?
There are 2 population based studies (from Canada and Scandanavia) which suggest your risk of breast cancer is reduced after breast reduction particularly in the over 50 age group.
Breast reduction does not in any way lessen the need for you to perform regular self examination and have regular mammograms once you turn 50 years of age.
- Q: How painful is the recovery after breast reduction surgery?
Most women tell us after surgery that they had expected the procedure to be more painful than it turned out to be. Individual experience of pain varies, but it is not common for women to require injections of pain killers after this surgery. You may be taking strong tablets for 2-3 days at regular intervals. After this often regular paracetamol or paracetamol with codeine is enough.
- Q: How long after the surgery will I be out of action?
Most women choose to stay in hospital overnight but the procedure can be performed safely as a day case if you prefer. You will be bruised and swollen for 2- 4 weeks but will be able to progressively do many activities.
When can I return to work? It will depend on the type of work you do and the type of breast reduction you have chosen to have. As a general rule if you do desk based work you may get back in 2 weeks if you do heavy physical work you may prefer to take 3 to 4 weeks off work.
When can I drive? Usually within 7-10 days.
Can I lift the laundry basket? It is safe to lift the laundry basket. The hardest thing to do after breast reduction is put your hands up over your head so you may not want to peg the washing on the lne for 2- 4 weeks.
- Q: Can I wear a seat belt after the surgery?
- Q: Do I have to wear a bra after the operation?
When you wake up from surgery you will be in a "crop top" garment. This will be sufficiently supportive and comfortable. Normally you will wear this for 3-4 weeks and then you can get fitted for a bra of your choice.
- Q: How much do you take out?
That is totally dependent on the individual. Breast reducton is about restoring proportion - putting your breasts back in proportion with the rest of your body dimensions so there is a broad range. As an idea an "average " breast reduction is upwards of 700 grams each side (1.4kg in total).
- Q: Can I breast feed after having the surgery?
I have included a special section on breast feeding.