Breast reduction

Breast reduction (mammoplasty) can reduce the size of your breasts to more comfortable proportions. Breast reduction surgery is performed to reduce the weight or volume of the breasts.  Very large breasts can present a range of practical problems, including:

  • Physical discomfort in the form of back and neck pain.
  • Difficulty finding clothing and swimwear that fit properly.
  • Making it hard to enjoy and participate in some sporting and social activities.
  • A feeling that the size of the breasts is out of proportion with the rest of the body.
  • Unwanted comments and attention.

Breast Reduction: Your consultation

At your consultation Dr Marcellino will listen carefully to your reasons for seeking treatment.  He will then discuss all of the available options with you, advising on the best way of remodelling the breasts to achieve a more comfortable proportion. The procedure he recommends will typically be one of three types:

  • Traditional or ‘anchor’ incision breast reduction
  • Vertical incision breast reduction
  • Scarless breast reduction.

More detailed information on each is provided below. As part of your consultation, Dr Marcellino will also conduct a routine mammogram to ensure that no undetected disease or concern is present. Breast reduction surgery is performed under general anaesthetic and usually takes around three hours to perform.  

Breast Reduction: The procedure  

Traditional or ‘anchor’ incision breast reduction

The traditional procedure for breast reduction involves an ‘anchor’ shaped incision being made around the nipple and breast.  Excess skin and fat are then removed so that the overall breast size is reduced.  Dr Marcellino will then move the areola and nipple to a position higher up the breast (patients with extremely large breasts may have to have the nipple and areola detached and grafted to the higher part of the breast).  Once the nipple is in its new position, the skin is pulled taut around the breast and the incisions are stitched.  

Vertical Incision Breast Reduction

With vertical incision breast reduction (sometimes known as the ‘lollipop’ incision) an incision is made around the areola and vertically down the breast tissue.  Dr Marcellino then cuts away the excess fatty deposits and skin.  As with the ‘anchor’ incision, the nipple can be moved up the breast, but no more than a few millimetres because it is still attached to the breast mould.  The skin around the incision is then pulled tight over itself and stitched up. Breast reduction using a vertical incision is less invasive than the anchor method, but may not be suitable for patients with extremely large breasts (there are certain medical measurements to determine ‘extremely large’).  

Scarless Breast Reduction

Scarless breast reduction is a mammoplasty technique whereby liposuction is used to remove surplus fat and tissue from the breast. Small incisions are made in the crease of the breast or subtly in the armpit. Dr Marcellino then makes a series of tiny incisions in either the crease of the breast, or in the upper outer section of the breast, close to the armpit. Liposuction techniques are then used to drain the excess fat from the breast.  Once all the surplus fat has been drained, the incisions are closed. Scarless breast reduction is more suited to patients who have a larger fat to glandular ratio in the breast.  

Breast Reduction: Before Your Surgery

  • If you smoke it is strongly recommend that you stop 8 weeks before surgery in order to help healing, avoid necrosis and reduce the risk of infection.
  • If you take aspirin or any other medication you should make Dr Marcellino aware of this at your consultation as it may need to be discontinued for a short period of time before and after your surgery.
  • With general anaesthetic you will be asked to follow fasting instructions. This means not eating or drinking for around six hours before the operation. Both Dr Marcellino and your anaesthetist will provide precise advice on this in advance of your surgery.

Breast Reduction: On the Day of Your Surgery

  • Please ensure that you arrive at the hospital in good time ahead of your operation.
  • Dr Marcellino will visit you in your room prior to your surgery, marking your breasts with a pen in preparation for the procedure, also affording you the opportunity to ask any last minute questions you might have. A final consent form will also need to be signed at this point.
  • A personal nurse will be assigned to you to ensure your care and comfort throughout.

Breast Reduction: After Your Surgery

  • After the operation a compressive bandage will be applied to the breast area. In the 48 hours following the operation the bandage will be changed, your wounds checked and a lighter bandage applied. The stitches are intradermic and absorbable so they don’t need removing.
  • Painkillers will be made available to manage any discomfort you feel in the days following your operation.
  • It is important to keep the incisions and breasts dry, and leave all the dressings intact until you return to see Dr Marcellino for your follow-up appointment around seven days after your operation. You can usually take a shower after this period.
  • You will feel tired in the days following your operation. Work and socialising should be fairly limited in this period, which should be set aside for rest and recovery.
  • Dr Marcellino strongly advises that you do not drive for the first two weeks.
  • You’ll need to wear a sports bra night and day for the first sixty days. After this, you will only need to wear it during the day. Please do not wear an underwired bra until you have discussed this with Dr. Marcellino.
  • Strenuous activity, including lifting weights, should be avoided for four to six weeks after your operation.

What to Consider

  • With any cosmetic surgery you should carefully consider your decision and what it is you would like to achieve from your treatment. 
  • It is important that those considering surgery have realistic expectations and are in good health. As with all surgical operations, there are also some potential risks and complications to consider. 
  • Dr. Marcellino will discuss these with you at your consultation, addressing any questions or concerns you may have.
  • Some thought should also be given to practical considerations such as childcare provision in the days after your operation.  Ideally, you will have someone with you to look after you and take care of domestic chores.

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