Breast Reduction for Macromastia

What Is Macromastia?

Macromastia is a condition where an individual’s breast size is disproportionately large in comparison with their other body dimensions.

Macromastia can cause both behavioural and physical issues, for example, neck and shoulder pain, and reduced quality of life.

How Is Macromastia Treated?

Macromastia can be treated surgically. The surgery is referred to as Breast Reduction surgery. Surgical intervention is one method to reduce the breast size to a more manageable size and improve the life of the individual.

This type of breast reduction is also known as Reduction Mammoplasty.

What Conditions Does Breast Reduction Surgery Help?

Breast Reduction can help treat large breasts and their associated issues. It may also be performed as cosmetic surgery for individuals requiring a different look.

Why Is Breast Reduction Surgery Required?

Macromastia can result in a number of complications due to the additional size and weight of enlarged breasts, which includes shoulder grooving and chronic pain in neck, shoulder and upper back which might require pain killers. This can result in reduced quality of life.

Other issues that can benefit from breast reduction include difficulty finding proper clothes, chronic rash under the breasts, restricted physical activities and poor body image due to the larger breasts.

Who Is Breast Reduction Surgery Suitable for?

Breast Reduction in macromastia is suitable for any individual who is:

Aged 18 and above.
Not suffering from chronic conditions such as hypertension and diabetes.
Has a BMI of 35kg per m2 and weight has been stable over 12 months.
Is experiencing psychological and visible physical issues related to macromastia.

Preparation Before Breast Reduction Surgery

Breast Reduction is an inpatient procedure, In order to prepare for the surgery, the patient should be adequately counselled to ensure that the informed consent obtained is fully understood.

A complete history and physical examination are completed to determine eligibility for the procedure, which will include lab tests and a mammogram. The patient and doctor discuss their expectations and probable final shapes of the breasts after the surgery.

The patient is also advised to stop smoking and use of anti-inflammatory medicines including aspirin before treatment, to reduce chances of bleeding.

Steps in Breast Reduction

Breast Reduction surgery is performed under general anesthesia. The steps include:

Administration of general anesthesia after the patient has been placed in a horizontal position in the operation theatre.
The surgeon proceeds to make a circular incision around the new areola position that extends downwards.
The extra fat, breast tissue and skin are removed to reduce breast size to a predetermined size.
After repositioning the nipple and its surrounding areola, the surgeon finalizes the new shape of the breast and closes up using sutures.
An occlusive dressing or PICO vacuum dressing Is used to cover up the breasts and the patient is shifted to recovery after being awakened from anaesthesia.
In certain cases, a drainage tube may be added to allow removal of excess fluid and blood.

The complete procedure can take 45 to 90 minutes but sometimes up to 4 hours, depending upon breast size and other factors.

What Should I Expect After Breast Reduction Surgery?

Immediately after the procedure, the patient returns to the ward. Once stable, the patient is discharged, on the same day or after spending a night at the hospital. The patient will also be prescribed pain medication as well as antibiotics to be used as instructed.

For the first few weeks, the breasts might be extra sensitive and tender, and there also can be swelling and bruising. The surgeon will advise the patient to limit physical excursions for up to a month and allow the breasts to heal.

The surgeon will also recommend the patient to make timely follow up visits to remove stitches and for monitoring recovery. In certain cases, the patient is also recommended the use of a compression bra to aid in the healing process.

Possible Risk or Complications of Breast Reduction Surgery

Breast Reduction carries all the risks associated with major surgery, such as infection, bleeding and a severe allergic reaction to anesthesia. In addition to these generalized risks, breast reduction surgery can also lead to:

Temporary bruising and more permanent scarring.
Loss of feeling and sensation in the nipples and areolar region.
Added difficulties or complete inability to do breastfeeding.
Symmetrical challenges, between the two breasts, in size and shape, requiring additional surgery to correct.
Delayed wound healing