Having well-shaped, full breasts is widely regarded as being ideal, but some women feel uncomfortable if they develop very large breasts. Breast reduction surgery may become necessary if the size of the breasts causes physical problems, such as backache or when they lead to emotional distress. A young woman with excessively large breasts is often the focus of unwelcome comments and attention.

Why have a breast reduction?

Women who are not overweight but who have breasts that are large in proportion to their frame may experience the following physical symptoms:

  • Their bra straps cut into their shoulders, causing bruising and soreness.
  • They experience constant and severe backache, usually between the shoulder blades.
  • Their breasts feel heavy and make exercising and moving around difficult.
  • The weight of the breasts does not allow air to circulate underneath the breast tissue, causing soreness and rashes. The skin in this area can become prone to fungal infections.
  • Stretch marks or obvious veins appear on the breasts.

Breast reduction: what to expect

If you have decided that you would like to explore having a breast reduction you will need to come into The Clinic and have a detailed consultation with one of the plastic and reconstructive surgeons who offer this surgery. They will examine you and take account of:

  • Your shape and size and the actual size of your breasts. These are measured carefully and your overall need for breast reduction surgery will be assessed.
  • Whether you have had nipple discharge, cysts, lumps or skin problems that have affected your breasts.
  • Your general health: whether you are being treated for any illness at the moment, if you have any allergies to medicines or foods or have ever experienced contact dermatitis.
  • Any previous breast surgery.
  • Whether breast cancer runs in your family.

We will always be honest with you from a medical point of view, and we will either recommend that you go ahead and have breast reduction surgery or that you take other steps first. For example, if you are overweight, you may need to lose weight first. If you are still in your teens, you may need to wait for your breasts to mature before breast reduction is advisable.

If you smoke, you will be asked to give up at least 6 weeks before your breast reduction and to avoid smoking for several weeks afterwards as this can interfere with wound healing.

Breast reduction surgery

Breast reduction is a more extensive operation compared to breast augmentation and you will normally need to remain in The Clinic for one to 2 nights afterwards. The surgery will be done under general anaesthetic and involves more extensive incisions and the removal of fat and skin from the breasts.

Different consultant plastic and reconstructive surgeons have their own techniques but, generally, the surgeon will cut around the areola, down the breast and then underneath along the natural curve of the breast.

The excess skin and tissue is removed and the nipple and areola are moved to their new position. Skin from both sides of the breast is then pulled down and around the areola making the new breast shape. Excess fat can then be removed via liposuction through the armpit area.

Most techniques used in breast reduction surgery allow the nipples to remain attached to their blood vessels and nerves as they are being moved. In a few cases, generally where the breasts are very large or drooping, they may have to be completely removed and grafted into their new positions.

Recovering from breast reduction

This will take 3-4 weeks and you will feel quite sore at the start. The Clinic will help you with pain relief in the first couple of days, and will advise you about over-the-counter painkillers for when you return home.

The swelling and bruising will go down over the next month, and you should build up to your normal activities slowly without putting any strain on your breasts or back.

Most women return to work after about a month, and it is important to wear a well-fitted and supportive bra. You will have a check-up about a week after you leave The Clinic and then about a month after that to make sure that the incisions are healing well.
The scarring after breast reduction surgery is more extensive than after breast augmentation. You may need to wait 6 months before you see your final, settled shape. The scars will still be visible at that point, but they will fade.

Breast reduction techniques that minimise scarring

Some women who have breast reduction at The London Clinic may be suitable for a procedure called the Lejour technique. A Lejour breast reduction involves smaller, less extensive incisions. The surgery removes excess skin by means of smaller incisions around the areola, and in a vertical line from the areola down to the breast crease. The breast tissue and skin is then moulded and secured with stitching to give a smaller yet still natural breast shape.

This method of breast reduction generally produces better results in younger women who still have a great deal of elasticity in their skin.