Why have a breast reduction?

Breast reduction is a procedure that aims to reduce the size and weight of the breasts, also providing an uplift at the same time. It is the procedure with the highest patient satisfaction rate in plastic surgery!

Large breasts can cause various physical problems but also emotional distress. if the size of your breast is causing any of the problems listed below, a breast reduction might be indicated.

• Neck and upper back ache

• Poor Posture

• Shoulder grooving from bra straps

• Skin inflammation and rashes at the breast fold and tummy (intertrigo)

• Difference in volume and breast shape (asymmetry)

• Droopy Breasts

• Difficulty exercising and performing manual work

• Difficulty finding appropriate clothing or bras

Your first consultation

Your first appointment will take place in a prime central London clinic and will last approximately 45 mins. You will see Mr Orfaniotis who will listen carefully to your wishes and will discuss with you all aspects of breast reduction surgery, in a relaxed and friendly environment.

After the initial discussion, Mr Orfaniotis will undertake an examination and take some important measurements from your upper body. This will allow him to better explain you what is possible to achieve from the surgery based on your individual characteristics. You will be advised on what pattern of scars is best for you; the scar pattern can either be the “anchor”, also known as inverted “T”, type (around the nipple, vertical line, and horizontal line in the fold), or the “lollipop” type ( around the nipple and vertical line only). This will depend on the amount of breast tissue that needs removed and the nipple lift required. Generally, large breast reductions (more than 1-kg total) require an anchor type scar (see photo below). You will then be shown some before and after pictures of Georgios’ breast reduction results.

At the end of your consultation most your questions should be answered and a preliminary plan for surgery will be made. If you decide to book for surgery, a second appointment can be made either face-to-face or virtually. Additionally, pre-operative checks will be organised if necessary, to ensure the safety of the procedure. If you are a smoker it is very important to completely stop smoking 4-weeks before and 4-weeks after the procedure. Your weight must be stable with a Body Mass Index (BMI) ideally below 30.

The Procedure

You will arrive at the hospital 90 minutes before you scheduled time for surgery. Mr Orfaniotis and his team will again ensure everything is clear to you regarding the surgical plan and recovery, answer any last-minute questions, and finally carry out the pre-surgery markings.

Breast reduction surgery is performed under a general anaesthetic (fully asleep) and the duration is of 2.5 - 3 hours. The excess breast tissue and skin is removed, the nipple is lifted in its new position, and the breasts are reshaped and closed with dissolvable sutures. The wounds are further secured with special skin glue and waterproof dressings are applied. The glue is also shower-proof and should flake away after a couple of weeks. A recovery-bra will be worn immediately after surgery. Mr Orfaniotis does not use surgical drains for breast reduction.

After the procedure you will stay in a hospital recovery room for a few hours, where a nurse will look after you. Once you have recovered from the anaesthetic you will be able to go home, or to a temporary accomodation, the same day. Mr Orfaniotis will check you again after the procedure and ensure that you are safe to be discharged. An overnight stay in the hospital however can also be organised if indicated. Before you go home, you will be provided with all the information needed, including emergency contact numbers and pain-killer tablets. As this procedure is under general anaesthetic you will require a companion to take you home and look after you for at least the first 24 hours.

Recovery

During the first week after surgery you will experience some discomfort, which should be manageable with the pain-killers given. You will be able to shower but not bath so the incisions can be kept dry. A non-wired recovery or sports-bra will need to be worn all the time for 6 weeks. Recovery-bras are very important as they “splint” the new breasts into their new shape, and minimise any disruption during the healing period- usually 6 weeks.

At this stage your breasts are expected to be swollen with some degree of bruising. Bruising can be worse if additional liposuction was performed to address the under-the-arm and lateral chest excess tissue. You will however start noticing an improvement in the swelling after the first week, whilst bruising can take a bit longer to settle.

Depending on your job and the progress of your wound healing, you should be able to go back to work 2 weeks post-op. We advise no excessive arm movements, no heavy lifting (nothing more than a full paper bag) for the first 2 weeks. Some light activities can be resumed a few days post surgery, including office work and washing your hair. Patients can drive after 2-weeks as long they are comfortable wearing a seat belt and can react quickly in an emergency situation. Exercise at the gym and heavy lifting should be avoided for the first 6 weeks, although some light exercise can start at 4 weeks.

Aftercare

Aftercare is one of the most important aspects of you cosmetic surgery journey, and this is an area where Mr Orfaniotis and his team are committed to offering an exceptional level of service. Georgios will monitor your recovery very closely and you will feel very supported throughout your journey.

Your first appointment will be 1-week after surgery where a member of our surgical team will check your wounds, change the dressings and provide advice on what to do next. We will provide you with a personalised regime for wound and scar care.

During this initial period Mr Orfaniotis’ team will be available to answer any questions via email, telephone, or arrange an early face-to-face review if necessary. There are certain protocols for our aftercare, however we review our patients on a individual basis and therefore aftercare advice may not be the same for everyone.

Your first clinic appointment with Georgios after the surgery will be between 4- 6 weeks time. Another appointment will be scheduled for 4-6 months time to check your final result, and extra appointments can be made if necessary.

Complications

Breast Reduction surgery is considered very safe, however there are some early and late complications that you should know before proceeding.

Early complications in breast reduction are very rare and include bleeding, infection and delayed wound healing. If bleeding occurs after surgery this will very soon lead to the formation of a hard swelling due to a clot (hematoma) in your breast. It will require a return to the operating theatre to wash out the clot and stop the bleeding. Wound infection is again a rare event, however should it happen, it usually settles with a course of antibiotics.

Wound healing issues may also occur, more commonly where the scars meet at the ‘T” junction, a point situated centrally at the breast fold. Minor wound breakdown usually settles with dressings and wound care and does not compromise the overall outcome. Large wound breakdown is very rare and may require revisional surgery.

The scars usually settle down well and start fading after 2-months. They continue to improve until 12-16 months after surgery when they become completely pale. Some people however genetically form poor quality scars that can be red and lumpy (hypertrophic), or even grow out of proportion (keloid). Patients usually know already when they have scarring issues and there are a number of options available to prevent bad scarring, or to treat them when they occur.

Other Late problems after breast reduction surgery include:

• Altered nipple sensation; loss of sensation normally returns a few weeks after surgery but rarely may be permanent.

• Fat necrosis - a condition where parts of fatty breast tissue loose the blood supply and become lumpy and tender.

• Asymmetry between the two breasts (more common when the breasts were uneven before surgery and/or the creases were not at the same level)

• Bottoming out deformity- when the bulk of breast tissue descends below the level of the nipples.

• Unhappy with size; some patients feel that they did not get the reduction they hoped for, or they had too much tissue taken out.

• Inability to breastfeed (25- 50%)

  
  

• Breast Reduction Details.

  - First appointment: £200

  - Procedure Price: From £9000 - All inclusive price

  - Follow-up: No charge, appointments up to 1 year.

• - Duration: 2.5 -3 hours.

  - Anaesthetic: GA (fully asleep)

  - Length of stay: Day case (Home the same day). Overnight stay option available.

  - Drains: No drains

  - Recovery: 2 weeks to return to work, 6 weeks to return to full activity

  - Support bra to be worn for 6 weeks