Mr A. O. Grobbelaar  MBChB  MMed(Plast)  FCS(SA)(Plast)  FRCS(Plast)

Breast Reduction

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Introduction

Breasts that are out of proportion with the rest of the body can cause many problems. Shoulder pain, back pain and chronic infections under the breast have all been attributed to large breasts. Overgrowth of breasts can happen in adolescence or after pregnancy or middle age. The excess breast tissue can be removed and the skin tightened to create a normal size and shape. The nipples are normally lifted to suit the new shape of breast and can be done using different techniques each suitable for a specific patient. The patient normally has a scar around the nipple and a vertical scar from the nipple downwards that joins a scar in the fold under the breast. The appearance of the scars normally resembles a T shape. In some cases it may be possible to avoid the scar in the fold under the breast.  It is not always possible to reduce the breast to a very small size as this may compromise the blood supply to the nipple. Asymmetry in breast size is common and the discrepancy can be addressed during surgery although perfection is not always possible.

Surgery

Breast Reduction

It is normally performed under a general anaesthetic and patients routinely stay in the hospital for at least one night. On the day of the surgery I will come around and do some markings on the breast and we will have a final discussion on the size you would like to be. You will have some plastic pipes (drains) coming out of the breasts after the surgery to remove excess fluid and the breasts will be strapped up. The drains are normally removed after 24 hours. Pain is moderate and can be controlled by pain-killing injections or tablets. The sutures are removed after 10 to 12 days.

Consequences and complications

After breast reduction surgery breast feeding may not be possible. The nipples will be numb afterwards but do normally recover. Infection may happen but is rare. The blood supply to the nipple may be compromised during the surgery and cause it to become sloughy - this is extremely rare. Smokers are at greater risk for healing problems. A blood transfusion is not normally required. You can still have breast screening for cancer afterwards if required. The scars normally settles down to white lines but may be problematic in people with a tendency towards bad scarring.

After the surgery

You should keep the breasts strapped up until the sutures are removed. You can sit in a shallow bath as long as the bandage and breasts stay dry. Heavy exercise should be avoided for at least 4 weeks. Driving needs to be avoided for at least 2 weeks. A soft sports bra should be worn after removal of the sutures for a period of six weeks.

If you require further information or want to schedule a consultation please contact Mr. Grobbelaar's secretary details on the Contact page