Whilst the vast majority of patients would not want to part with their breast implants, there are various reasons why some want them removed and not replaced. These include capsular contracture, dissatisfaction with the size or appearance of the breasts, rupture or fears that implants are causing health problems. Sometimes when patients get older they feel that they no longer wish implants and the potential maintenance they may require in the future.
You may also want to read my recent thoughts.
What does the surgery involve?
Incisions are made in order to sculpt the breasts into a smaller and perter shape. The incisions can be:
- Around the areola only (the dark skin surrounding the nipple) – this is used in a small mastopexy (uplift) only.
- Around the areolar, vertically down from the areola to the breast crease and horizontally in the breast crease under the breast – this is used for most reductions and mastopexies where more skin needs to be tightened.
Excess breast tissue and skin is removed and the entire breast is reshaped with the nipples moved to a higher and more youthful position. The incisions are stitched up in a way that reduces scarring to a minimum. The surgery takes between two and three hours to complete.
A breast reduction / mastopexy is usually performed under a general anaesthetic (you will be asleep during the procedure). Providing all is well, you can expect to go home the day after surgery.
What are the risks and side effects of surgery?
Complications are infrequent and usually minor. However, no surgery is without risk and you should be aware of any possible problems.
Scars tend to settle remarkably well, however some patients heal with thick scars and this can make them more noticeable.
Bruising and swelling
Swelling is very common and may take a couple of weeks to settle. Bruising is less common.
This can happen if a bleed occurs in the breast pocket, allowing a large blood clot to form. If this does occur, it is likely to happen within four to six hours of surgery. Any increase in swelling or pain should be reported immediately so that treatment can be given. Sometimes patients need to have this blood removed with another short operation.
Infection is rare, but you may require antibiotics if there are any concerns.
Wound healing problems
Wound healing problems are rare. Patients who have diabetes, smoke, are obese or elderly are at an increased risk of delayed healing.
Each breast is slightly different and will continue to be following surgery; remember they are ‘sisters and not twins’.
Following any surgical procedure it is possible to develop a blood clot in your legs, which could potentially break off and move to your lungs. If the blood clot is large enough it could prove fatal. To reduce any risks of this we give you special stockings to wear in bed and a blood thinning injection if you are immobile.
All the risks will be discussed in detail at your consultation. However, if you have further questions or concerns, do not hesitate to discuss these with me. Decisions about surgery must never be rushed and requires personal research.
What happens after the operation?
Your incisions will be closed with dissolvable sutures that do not need to be removed. I use a glue and tape dressing (Prineo) which is waterproof and can be peeled off 3 weeks after surgery, when it starts to lift at the corners. You can shower as soon as you like after surgery and do not require any dressing changes. I recommend that you wear a support bra for 6 weeks. You will need to purchase this before your surgery and I will guide you in the clinic. Details can also be found in the compression garment guide below.
Before you leave the hospital, you will be given a follow up appointment to see the nurses at one week to check your incisions and an appointment to see me in 4-6 weeks. You will not be able to drive yourself home from hospital and, ideally, you should have someone to stay with you for a few days to assist you.
What is the estimated time for recovery, absence from work and return to usual activities?
When you get home, you should take things easy for the first week or so. Most people take 2 weeks off from work. You should be able to drive from 2 weeks, return to the gym for lower body work at 4 weeks and begin upper body exercises at 6 weeks. You will need to wear your support bra for at least 6 weeks.