Breast Reduction - Your Questions Answered

If your breasts are causing you severe pain or discomfort, a breast reduction can bring you great relief - waiting until after you’ve completed your family will only extend your suffering. It’s worth noting that your breasts will increase in size during pregnancy, further exacerbating your symptoms.

However, because having a breast reduction may impair your ability to breastfeed you must weigh up the benefits of having smaller, more manageable breasts versus possibly having to formula feed your baby.

It’s also possible that you will require secondary breast surgery following pregnancy (if your breasts have significantly increased in size or changed in shape). For this reason, if it is purely for aesthetic reasons you are seeking a breast reduction, then it is better to wait until after having children to avoid revision surgery.

There is a risk of reduced ability to breastfeed with breast reduction surgery, however it can be greatly reduced by leaving the nipple and areola area still attached to the breast tissue beneath.

The experience of your surgeon will make a big difference to the amount of nerve damage sustained. Nerves are vital to breastfeeding because they trigger the release of prolactin and oxytocin, two hormones that affect milk production and letdown.

It is advisable to wait at least 18-months after having a breast reduction before becoming pregnant, giving your nerves time to recover and for full sensation to return.

It is best to wait until you are at least 18 before having breast reduction surgery to be sure your breasts have finished developing. However, we understand there are many younger teenagers with breasts that are causing them extreme discomfort and psychological distress.

At Ocean Clinic Marbella we assess the suitability of each patient on a case-by-case basis, regardless of age. Breast reduction surgery can be an excellent option for some younger patients. However, it’s important to understand that further surgery may be necessary in the future, if the breasts were to grow in size again.

The breasts can be made more symmetric as part of breast reduction surgery. This is achieved by reducing each breast by a different amount. The shape of the nipple-areola complex can also be made symmetric at the same time. However, absolute breast symmetry should not be expected with any type of breast surgery. There are many factors which may contribute to asymmetry, such as your rib cage, which can not be treated with a breast reduction.

Ideally you should wait until you reach your goal weight before having breast reduction surgery. This will give you your best aesthetic result, since losing weight after your surgery could leave you with saggy breasts and/or loose breast skin.

That being said, many large breasted women find it too difficult to exercise, which inhibits their ability to lose weight. If you are unable to be properly active because of your chest size, then it makes sense to have a breast reduction sooner rather than later.

Breast reduction can be carried out via liposuction alone but it is only suitable for a select group of patients. Your suitability for this procedure will depend on the amount of reduction you desire, how much sagging you have and the quality of your skin.

It is ideal for younger patients who only wish to go down one or two cup sizes. Younger people tend to have better skin tone meaning they will enjoy better retraction. Reduction via liposuction can provide these patients with good results without any scarring.

Liposuction will not provide pleasing aesthetic results for patients with a significant amount of ptosis, however it can be useful for reducing weight to alleviate back and neck pain.

There are two main techniques for carrying out breast reduction surgery. The Lejour, used for moderately heavy breasts, involves making an incision vertically from the base of the breast, up to and around the nipple (it mimics the shape of a lollypop).

The second technique, Hall-Findlay, is used for very heavy breasts or those with pronounced sagging, and involves an anchor-shaped scar. The incision goes around the nipple, extends from the nipple down to the base of the breast and then in the breast fold itself.

Scarring will be pink for a number of months but should eventually fade to become unnoticeable.

Usually the nipples remain attached to the breast tissue beneath (the pedicle technique) and simply moved to a higher position. Free nipple graft (complete detachment) is only necessary for extremely large breasts or very low nipples.

This technique is avoided where possible because the nipple areolar complex loses its blood supply. This results in loss of sensation and projection as well as loss of pigment. The nipple becomes either deep pink for darker skin types or pale pink for lighter skinned individuals.

A breast reduction alone will not correct sagging breasts. If you are suffering with breast ptosis (sagging) as well as excess breast tissue, it’s likely that your surgeon will recommend you have a breast lift in combination with your reduction.

The lift moves your breast tissue higher on the chest wall and firms up your breasts, giving them a more youthful look. The breast lift is carried out using the same incisions so there is no additional scarring. Liposuction may also be used as part of your breast surgery to sculpt your breasts into a pleasing final shape.

Breast reduction surgery is performed under general anesthesia. With this type of anesthesia the patient is completely unconscious during the procedure and will stay overnight in the clinic.

A liposuction-only breast reduction can be performed on an outpatient basis, with sedation (twilight sleep) plus local anesthetic.