Breast Reduction (Reduction Mammoplasty) Surgery & Cost Guide

Patients may consider breast reduction surgery when their breasts cause physical or emotional discomfort or are simply unhappy with the breasts’ shape and large size.

Reducing the size of the breasts via breast reduction surgery can help to:

• Balance a difference in breast size
• Provide the breasts with a smaller and more aesthetically pleasing look
• Reduce unwanted attention associated with large breasts
• Make movement and exercise easier
• Ease neck, back, and shoulder pain
• Ease skin irritation under the breasts
• Make it easier to fit in clothes like button-up shirts or dresses

You can learn more about the ways this surgery can ease upper-body pain here,

Does breast reduction surgery include a breast lift?

The reduction mammoplasty procedure is often described as a two for one procedure. This is because the standard procedure for reduction is nearly identical to that for a breast uplift. The only difference is that breast tissue is also removed during breast reduction surgery to reduce the size of the breasts. Lifting the breast corrects breast sagging, also called ptosis, as visualised in the diagram below.

How much does a breast reduction cost?

The price of breast reduction surgery can be between £6500 to £9000. On average, you can expect to pay around £6000 for a breast reduction procedure in the UK. There are various factors that could contribute to price fluctuations, such as:

• Surgeon experience
• Chosen Hospital
• Anaesthetist experience
• The complexity of the procedure for your case
• Amount of hours required in surgery for your case
• Additional combined procedure requirement

In order to get a tailored price adapted to each personal case, patients will need to be examined by a surgeon to ensure that the procedure can be done considering their individual needs. A patient's personalised price will be all-inclusive and take into account all your requirements; the tailored breast reduction price will cover:

• Highly rated CQC hospital cost
• Surgeon's experience (BAAPS/BAPRAS)
• Anaesthetist time and expertise
• Any overnight stays that are required
• Follow-up appointments and aftercare

A breast reduction consultation is free with no obligation. The consultation enables patients to ask all their important questions, get to know a surgeon and the surgeon to assess them and make them aware of the possible outcomes of their surgery.

Histology

It is important to discuss with your surgeon if any removed breast tissue for histopathological analysis is needed to rule out anything sinister, such as breast cancer found in the removed breast tissue.

This process involves taking a small amount of breast tissue during the operation and having a lab analyse it. Although studies have shown a very low percentage of breast cancer tissue found in removed breast tissue during a breast reduction, the majority of surgeons would advocate having the tissue analysed. This incurs an extra cost as the tissue needs to be analysed by a specialist consultant histopathologic.

It is also important to discuss with your surgeon if there is any need to get a mammogram prior to surgery. This may be advised if a patient is of a certain age or has an increased family risk of breast cancer. If you go privately to have this done, it will also cost.

Can I have breast reduction surgery on the NHS?

Breast reduction surgery is provided by the NHS but patients need to fit strict criteria. The criteria for each region differ and are governed by the local clinical commissioning group (CCG). It is best to speak to your general practitioner (GP) if you desire a breast reduction to discuss your local CCG criteria.

If the motivation is purely cosmetic and the patient doesn’t fit their local CCG criteria, patients will have to find alternative options and look to the private sector.

Patients are more likely to be considered for a breast reduction procedure with the NHS if their large breasts cause some or all of the following problems:

• Chronic back, neck or shoulder pain
• Reduced mobility, restricted movement or inability to exercise
• Skin irritation or rashes under your breasts e.g. intertrigo
• Psychological distress, low self-esteem and poor self-image

Patients experiencing any of these problems should speak to their GP. They may inform patients that there is a chance to be eligible for breast reduction surgery on the NHS.

What are my finance options for breast reduction surgery?

Breast reduction surgery is available to patients who either intend on self-paying or through a payment plan.

Self-paying patients include those willing to pay with their savings or those who are seeking financial plans from external providers or banks. We also offer a financing option available for patients interested in paying in monthly instalments for their procedure.

Medbelle financing can be paid back over the course of up to 5 years on a monthly basis. Patients are welcome to make additional payments as and when they like.

To be eligible for Medbelle finance, patients need to be:

• Over 18 years of age
• Working a minimum of 16 hours a week
• Living in the UK for the past three years

For more advice on financial planning and funding breast reduction surgery or more information about any of the issues raised on this page, a Patient Care Adviser can help.

Is breast reduction surgery covered by private insurance?

No, unfortunately, private insurance will not cover breast reduction surgery, nor will it cover any of our other cosmetic procedures. We do offer options for financing breast reduction surgery.

Anyone unhappy with the large size of their breasts for physical and/or emotional reasons may benefit from breast reduction surgery as long as they are in good physical and mental health.

Anyone unhappy with the large size of their breasts for physical and/or emotional reasons may benefit from breast reduction surgery as long as they are in good physical and mental health.

Why do patients have breast reduction surgery?

Physical complaints related to large breasts include:

• Neck, back and/or shoulder pain
• Problems finding clothes that fit well
• Indentations or irritation on the shoulders caused by bra straps
• Difficulty moving the upper body or arms
• Inability to sleep comfortably lying flat on their back
• Discomfort during exercise, especially high-impact movements like jumping or running
• Irritated skin where the breast touches the torso
• Interference with specific sports, hobbies or careers

Emotional, mental and cosmetic reasons for breast reduction surgery include:

• Unhappiness with breasts that are unequal in size and/or shape
• Dislike of unwanted attention drawn because of large breasts
• A desire to change the look of the breasts
• Unhappiness, discomfort or dysmorphia related to the size of the breasts

What makes someone an ideal candidate for breast reduction surgery?

As for any major operation, ideal candidates should be physically and emotionally healthy before having breast reduction surgery.

Being in the best possible health can increase the likelihood of being a good candidate for surgery. Great ways to help patients optimise their health for surgery include:

• Getting regular exercise
• Eating a healthful diet low in salt and high in lean protein
• Feeling mentally prepared for surgery & recovery
• Reducing or stopping alcohol consumption
• Stopping smoking
• Stopping any nicotine use in e-cigarettes, patches, or any other form
• Stopping any recreational drug use

Patients wanting support to quit smoking can read this blog article to find out why it’s so important to quit, speak to their Patient Care Adviser and reach out to their local stop smoking service provided by the NHS.

Age and weight restrictions

Weight

The BMI or Body Mass Index is a number calculated using a patient's height and weight. Generally, healthcare providers believe this number can be used as one indicator of a patient's eligibility for surgery. You can calculate your BMI via this site provided by the NHS.

Usually, a patient must have a BMI below 30 or 32 before having any surgery, including a breast reduction. This is because the likelihood of complications during surgery increases when a patient has a BMI higher than this.

Age

In the UK, the minimum age for any elective surgery is 18 years of age. Patient's as young as 16 may be eligible for breast reduction surgery if their guardian or guardians provide consent. However, Medbelle surgeons strongly recommend younger patients wait until they are at least 18 years of age to have breast reduction surgery because the body is still developing and growing until around this age.

Results from breast reduction will likely last longer if the patient is completely physically mature before the surgery is performed. This is because there is a chance the breasts can continue growing after surgery if it is performed when the patient is still growing.

Gigantomastia

Patients with extremely large breasts might have a rare condition known as gigantomastia. Patients suffering from this have abnormally excessive breast tissue growth. Due to the extreme weight of the breasts, the physical symptoms as listed above can be even more intense and can lead to nerve injury affecting nipple sensation.

The exact cause of gigantomastia is unknown, although research suggests it is linked to puberty, pregnancy and hormonal changes. Treatment for gigantomastia is a breast reduction with or without hormone treatment.

The results reported from patients express substantial physical and mental relief. It may be the case that gigantomastia may return for some patients and need a second breast reduction.

Pregnancy, childbirth and breastfeeding

Patients who are pregnant or breastfeeding are not eligible to have breast reduction surgery. Any person who has recently given birth and not breastfeeding must wait at least three to six months before having any breast surgery, including breast reduction.

Waiting a few months allows the body to return to normal after childbirth and pregnancy. This is important as it makes sure the surgeon has a clear idea of the changes and techniques they need to use in order to get the desired results because any residual swelling or injury has had time to heal completely.

If you have surgery too soon after having a child, there is a strong possibility that the results will not be stable and heal in the ways the surgeon predicts. It’s also important to know that breast reduction surgery can potentially impact or completely stop the ability to breastfeed. This is a very important factor to consider before committing to having surgery if you want to have children but have not yet started.

When pregnant, the body goes through physical and hormonal changes in preparation for birth and breastfeeding. Oestrogen levels increase during pregnancy, causing breast size to grow; many patients say that their breasts are about one cup size bigger. This is not the only change for the breasts, they will often feel more tender, and the areolas and nipples will often become darker and larger.

After giving birth, further hormonal changes, including oxytocin and prolactin, will increase milk production, making the breasts feel engorged. When patients stop producing milk, the breasts become smaller and less engorged. The skin only has a certain amount of elasticity, so it’s common for the new shape and position of the breasts to be droopy and feel deflated. The position of the nipples will also be affected and more likely to droop.

For this reason, surgeons often recommend any breast reduction patient finish having children before having surgery. For more information about breastfeeding and breast reduction surgery.

If you have any questions about your eligibility for breast reduction surgery, feel free to get in touch with your Medbelle Patient Care Adviser.

Breast reduction surgery generally lasts one and a half to three hours long depending on some factors, including how much tissue will be removed. It is always performed when the patient is under general anaesthetic, meaning they are given medicine that forces them into a dreamless sleep.

The type of incision the surgeon uses to separate is the technique they will use to remove the excess tissue. This means there are many different procedures your surgeon can choose from in order to get you results catered to your body and the results you want.

It is important to note, although not a standard treatment, some patients with large breasts but good shape and no ptosis (droopiness) may be candidates for liposuction alone to reduce the size of the breast without any significant scarring. However, most patients are not candidates for liposuction only as this doesn’t address the general breast shape and ptosis.

Types of incisions for breast reduction surgery

Reduction mammoplasty surgery requires your surgeon to make incisions on each breast to remove breast tissue and skin. These incisions are where scars will be after you recover from surgery.

While scaring can be a barrier to having surgery, keep in mind that many breast reduction patients report their surgical scars healed extremely well and are difficult to see after recovery (six months to one year after the operation).

The type of incision your surgeon will use during the surgery depends on how much skin and tissue will be removed. The more that is removed, the larger the incision must be.

There are three main types of incisions used for breast reduction:

• Vertical, also called a lollipop incision, goes around the areola and down to the crease of the breast.
  • Suitable for small to moderate reductions but doesn’t address excess skin in the lower pole of the breast
• Inverted-T is also called an anchor incision that goes around the areola, down to the crease of the breast, and then continues across the crease of the breast. The length of the scar at the breast crease also depends on the amount of reduction desired/ amount of excess tissue and skin at the lower pole of the breast
  • Suitable for large reductions
• Circumareolar also called a doughnut incision that goes around the areola.

Suitable for small reductions

It is important to note that some surgeons use postoperative drains that are usually removed 1-2 days after your surgery. This should be discussed with the surgeon preoperatively.

Types of breast tissue removal techniques

A pedicle is a surgical technique that keeps the nipple and areola attached to an amount of breast tissue that remains untouched during surgery.

This method ensures the nipple and remaining breast tissue have a constant connection to a blood supply and nerves while the excess breast tissue is removed.

There are various types of pedicles used during reduction mammoplasty surgery, the three most commonly used ones are:

• Superomedial pedicle at the top/ inner part of the breast
  • The tissue is removed from the lower part and sides of the breast
• Superior pedicle at the top of breast
  • More suitable for minor to moderate breast reductions and shorter distance needed to lift the nipple
• Inferior pedicle at the lower part of the breast
  • Tissue removed comes from the upper part of the breast and the sides of the breast
  • More Suitable for very large reductions

Keeping the nipple and breast tissue attached to the blood supply is associated with better preservation of nipple sensation, less likelihood of complications, and a higher chance of successful breastfeeding after recovery compared to free nipple grafting.

Free nipple graft

The free nipple graft is usually reserved for extremely large reductions or in specific patients with poor vascularity such as after cancer surgery, previous radiotherapy or significant health problems. A free nipple graft requires the nipple and areola to be completely detached from the breast. They are reattached after breast tissue has been removed. Plastic surgeons do not commonly use this method as there is poor preservation of nipple sensation, and the ability to breastfeed is completely stopped. It is usually reserved for patients requiring very large breast reductions.

Breast reduction surgery results are not necessarily permanent

Breast reduction surgery aims to remove excess skin and breast tissue to reduce the size of an individual's breast/s. However, what the surgery cannot offer is permanence. If the patient gains or loses weight, then the results are likely to be affected. The same can be said for pregnancies and breastfeeding.

Having surgery will offer some relief to patients who struggle with large breasts, whether physically or emotionally. To help maintain the results, surgeons recommend patients be at their goal weight for at least three months before surgery and have completed their family before having the procedure. However, many young patients do seek breast reduction before even considering having a family. As long as patients have realistic expectations and understand their breast shape and size will change with future hormonal changes, pregnancy, breastfeeding and the ageing process.

The surgeon will, of course, discuss likely outcomes in consultation.

You cannot guarantee a cup size after your breast reduction surgery.

Cup sizes vary vastly between individuals. What is a D cup for one person is a C for another, and this is not to mention the different sizing of various shops and brands. Having an ideal cup size in mind is a good indication to the surgeon how much you wish to reduce your bust by; however, it's very unlikely the surgeon can guarantee that precise size. Instead, your surgeon may talk in terms of CC (cubic centimetres) or grams to manage your expectations and prepare you for likely results.

Scarring and other changes

Breast reduction surgery is invasive and does require incisions. The placement of the incisions will differ depending on the scale of the reduction, but unfortunately, the incisions are unavoidable. This is one of the many reasons you should select a highly qualified BAAPS/BAPRAS surgeon who has had years of experience performing these procedures.

Patients can help minimise the effects of scarring by following these guidelines:

• Keep the scars out of the sun for up to a year after the breast reduction surgery. UV light will make the scars more prominent and could increase the chances of developing skin cancer on the healing skin.
• Massages and silicone gels and stripes should be used as per the surgeon's recommendation.
• Listening to when the body needs rest and not overexerting during recovery will allow the incision sites to close smoothly.
• Allowing time for the body to heal and the scars to fade more and more.

Surgery is an emotional and physical challenge

Often in the media, surgery is sold as a "quick fix", but undergoing a breast reduction takes its toll on the body and emotions. The surgery can often run smoother and be less stressful for patients when they consider the time and help they’ll need to have the surgery:

• Organising child or pet care
• Taking time off of work, sometimes for many weeks, depending on how physically active the job is
• Relying on friends and family for support during recovery
• Preparing for the surgery, be it losing that last little bit of weight, stopping smoking, raising the last bit of funds to pay for the procedure
• Is the timing for surgery emotionally the right time

The consultation with a surgeon will last anywhere between 15 minutes to an hour and will take place either at their private practice or within a consultation space. Some surgeons often like to have two consultations before surgery.

The surgeon will discuss a number of topics during the consultation. These include:

• Why the patient wishes to have surgery
• The desires and expectations for surgery
• The potential risks & complications related to surgery
• Any personal or family history of breast cancer
• Current and past medical conditions, including allergies
• The results of any biopsies and mammograms previously had
• Any current prescription or over-the-counter medications
• Any current alcohol, tobacco and recreational drug use

When recommending a procedure plan, your surgeon will take into consideration the following factors:

• Current breast shape and size
• The patient’s ideal breast size and shape
• The quality of breast tissue and skin
• The quantity of breast tissue and skin

As with any surgery, there are risks and complications associated with breast reduction surgery. It is essential that you are aware of all these risks before you commit to having surgery.

The surgeon will discuss all relevant breast reduction risks and complications before the patient agrees to have the procedure. The information below should be considered a short overview of possible breast reduction risks and complications:

Infection

An infection develops when bacteria grows in a wound, provoking an immune response. Infection is a breast reduction risk, as it is with any surgery.

Symptoms of an infection can develop within one to two weeks after breast reduction surgery.

It is essential you contact your aftercare/post-op team as soon as you notice any of these symptoms of a low-grade infection:

• Increased pain that is not eased with painkillers
• Swelling
• Warmth or redness that starts at the incision site and grows in size
• Red streaks around the incision site
• Any foul-smelling liquid or pus leaking from the incision
• A fever over 38° C

Signs of infection should never be ignored. For most patients, an infection can usually be easily treated with antibiotics if caught and diagnosed quickly. This is why it is so important to contact your surgeon if you recognise any of these infection symptoms.

If an infection is allowed to progress, it can severely and negatively impact the look of final results from breast reduction and lead to serious health problems like sepsis.

Blood clots

Patients following a breast reduction are at risk of blood clots because of their limited mobility in the days and weeks following surgery.

Clots after surgery usually develop in the so-called deep veins in the legs, arms, and torso but are most common in the legs. When a clot develops in a deep vein, it is called deep vein thrombosis or DVT for short.

If your surgeon believes you are at higher risk of a blood clot after breast reduction surgery, they may prescribe you to wear compression stockings until you are able to go about your normal activities again. Compression stockings aid blood flow to the legs reduce venous stasis, and help prevent clotting just like the compression bra worn while healing from breast reduction surgery.

Though a blood clot is unlikely to form after breast reduction surgery, it is important you are aware of the risk and understand the symptoms.

Symptoms of DVT can present in the leg, arm or torso, depending on where the clot has developed. They are usually confined to the area of the body where the clot has formed.

The symptoms of DVT include:

• Throbbing pain
• Cramping
• Swelling, warmth and redness
• Soreness or skin sensitivity
• Very red or darkened skin

If you develop any of these symptoms in the weeks after your surgery, contact your GP or surgeon immediately.

Tissue necrosis

If the blood supply to areas of the skin, fat, breast tissue or the nipple is lost during breast reduction surgery, the tissue may die. This results in a breast reduction risk called necrosis.

Tissue necrosis is much more likely to develop in smokers than non-smokers. This is one reason it is so important to refrain from smoking or using nicotine products before and after surgery. It is also more likely in patients with a more significant amount of tissue removed and a larger lift of the nipple from its’ original position to the ideal position on the chest/ breast.

Areas of necrosis in the breast may feel lumpy, uneven and hard. Occasionally, this may interfere with the interpretations of breast scans such as mammograms.

If tissue necrosis does occur after your breast reduction, you may need further surgery to remove any dead tissue and repair your breast or breasts.

The most common wound-healing problem occurs at the T-junction. This is at the bottom of the breast where the vertical scar meets the horizontal scar across the breast crease. This is because this area is the furthest away from the blood supply. If a T-junction wound breakdown occurs, it will require management with special dressings for a lengthy period of time or even require revision surgery.

Bruising & bleeding

Bruising and bleeding are a natural part of the healing process after breast reduction surgery. Some light bleeding and bruising may happen in a week or two following surgery.

Abnormal bleeding or bruising may be a sign that you have a bleeding complication like a haematoma.

A haematoma is when there is bleeding in the breast tissue/ operated area. Some small haematomas stop on their own and self-resolve. The body absorbs any excess bleeding. However, in some instances, haematomas are more severe and may require urgent surgical intervention to stop the bleeding and evacuate the clots. Some patients may even require hospital admission and blood transfusions. Contact your surgeon or healthcare professional immediately if you see these symptoms form on or near your breasts after breast reduction.

Excessive scarring

Scarring is a natural part of the healing process after surgery. Scars will naturally form wherever the surgeon makes incisions on the body. Also, there is a large genetic element to how certain patients heal and how they scar. Some patients are more prone to develop hypertrophic or keloid scarring. This can run in families.

For some patients considering breast reduction, the risk of scarring is a major deciding factor. It is important to know that choosing a skilled surgeon is the best way to ensure you are happy with your breast reduction results.

Also, a highly experienced surgeon who is a member of BAAPS/BAPRAS will have up-to-date training on the best methods to reduce the look of scarring after breast reduction surgery.

Depending on the skin quality and predisposition to scarring, there may be fairly obvious scarring on the breasts after breast reduction surgery. Your surgeon may recommend silicone patches and massage once the incisions completely heal.

Keep in mind that the look of scarring can improve for years after surgery as the colour lightens and they blend into the skin.

Keloid scarring

Very thick, raised scars called keloid scars are a breast reduction risk and can form in any patient. If you have ever developed a keloid scar from an incision or injury, you are more likely to develop it again.

Patients with dark skin tones are also more prone to developing keloid scars. More information about dark skin tones and scarring after breast reduction surgery here on the blog.

Common areas for keloid scars are the shoulders, neck, upper chest and anywhere on the head, including the earlobes. However, keloid scars can develop anywhere on the body. Keloid scars are known to grow over time and can be difficult to treat.

If you develop a keloid scar after breast reduction, your surgeon may prescribe steroid injections into the scar, steroid-infused bandages, or even revision surgery.

Altered breast sensation or numbness after breast reduction surgery

The nature of breast reduction means some nerve endings may be disturbed after surgery. This can result in feelings of heightened sensitivity or numbness after breast reduction surgery.

These changes in sensation or numbness after breast reduction surgery can resolve themselves over time as the nerve endings grow back and the breasts heal. However, there is a risk that this numbness or change in sensation may be permanent.

Modern surgical techniques reduce the likelihood of permanent sensitivity or numbness after breast reduction surgery, especially around the breast and nipple. We recommend discussing altered breast sensation with your surgeon if you have concerns.

If you do have altered breast sensation or numbness after breast reduction surgery, you will likely be recommended to wait and see if it improves as your breasts heal.

Pseudoptosis (bottoming out)

Pseudoptosis (pronounced sue-doe-TOE-sis) is the medical term for bottoming out. This means the crease of the breast, where the breast tissue meets the torso, migrates lower than its natural position.

When bottoming out happens after breast reduction surgery, the lower portion of the breast tissue droops downwards. As the majority of the breast volume moves lower on the chest, this results in the nipples looking like they are placed very high on the chest.

Bottoming out after breast reduction is more likely to occur in patients who have an Inverted T style incision and have a large amount of tissue removed during surgery. This can happen to one or both breasts after breast reduction.

While there are no pain or health risks associated with the breasts bottoming out after breast reduction surgery, this complication directly impacts the aesthetic results after surgery.

Bottoming out after breast reduction can usually only be resolved via a revision breast surgery. Most surgeons will only recommend revision breast surgery after the breasts have healed from the initial breast reduction.

Generally, patients must wait up to six to 12 months before they are healed enough to have revision breast surgery.

Seroma

After breast reduction surgery, pockets of clear fluid called seroma can form around incision lines.

Seromas are generally not a harmful breast reduction risk. They are not likely to impact the look of the final breast reduction results. The majority of small seromas heal by themselves as the body reabsorbs the fluid. The surgeon may prescribe having larger seromas drained using a needle and syringe. This is a quick process that can be done during a follow-up appointment.

There is a very small chance that the seroma will not be reabsorbed by the body, which results in a capsule forming around it. Usually, these encapsulated seromas are removed surgically.

Loss of the nipple and areola

The loss of the nipple and areola is a relatively unlikely breast reduction risk. It is more commonly associated with a free-nipple graft breast reduction procedure than more modern techniques.

During a free-nipple graft breast reduction, the nipple and areola are completely removed from the breast and reattached after the tissue is removed. This increases the risk of tissue necrosis and numbness and completely blocks breastfeeding after surgery.

Less invasive pedicle methods that keep the nipple and areola attached to the breast tissue are much more common breast reduction techniques today. While the nipple and areola can still be lost after a pedicle method of breast reduction, it is much less likely to occur.

If the nipple is lost after surgery, reconstructive surgery can be performed once the breast is healed, followed by medical tattooing. While the reconstructed nipple will have no ability to breastfeed, it will improve the aesthetic look of the breast.

Aesthetic issues or unhappiness with results

While your surgeon will do everything in their power to give you the results you want from breast reduction, there is a risk you may be unhappy with the look of your breasts after surgery. There will most likely be subtle asymmetries that are within normal ranges of breast asymmetry. Sometimes, the asymmetry is more pronounced.

The best way to prevent this is by being well-informed about the realities of the procedure and having realistic expectations for your results.

It’s important to keep in mind that it can take up to a full 12 months for final results to be visible as the breasts continue to heal. In fact, aspects like scaring generally continue to improve for years after surgery.

If you are unhappy with the look of your breasts after surgery, you will need to wait at least six months to have any revision surgery. You may even be recommended to wait longer as your healing journey continues.

Histology

Another thing to discuss with your surgeon is the need to send any removed breast tissue for histopathological analysis to rule out anything sinister, such as breast cancer found in the removed breast tissue. Although studies have shown a very low percentage of incidental breast cancer tissue found in removed breast tissue during a breast reduction, the majority of surgeons would advocate having the tissue analysed. This incurs an extra cost as the tissue needs to be analysed by a specialist consultant histopathologist.

It is also important to discuss with your surgeon if there is any need to get a mammogram prior to surgery. This may be advised if a patient is of a certain age or has an increased family risk of breast cancer.

How to prepare for a breast reduction?

It is important to be prepared before having a breast reduction. Preparing well can also help you through your recovery period. Below are some breast reduction preparation tips that may be helpful for you:

Driving

You will not be able to drive straight after your surgery. It is therefore important for you to arrange for a family member or friend to help you get home safely after your operation. We also recommend that they stay with you for the first 24 hours after surgery, as you will still be recovering from the anaesthetic.

Household chores

It may be really useful to get some household chores done before you go in for your operation. Taking the bins out, cleaning and doing a big grocery shop before your breast reduction will give you more of a chance to rest after your operation. It may also be helpful to cook some meals and freeze them so that you do not have to worry about cooking either.

Try to place hard to reach cupboard items such as mugs, crockery and dry food on the kitchen counter. This will prevent you from having to stretch to reach them, which can help your recovery as stretching can place strain on your incisions.

Children & pets

Breast reduction is quite an invasive procedure. It is therefore important that you rest well and do not exert yourself. You should therefore ask your family and friends to help look after young children and pets whilst you are recovering.

Sleep

Sleeping on your back in an inclined position for the first few days after your surgery can help reduce swelling and bruising. You can do this by having lots of extra pillows on your bed.

Clothing & post-operative garment

It may be more comfortable for you to wear clothes that fasten easily from the front in the initial postoperative days. This prevents you from reaching up to pull clothes over your head, which places strain on your stitches. Straining your stitches can increase the time it takes your wounds to heal.

You may also have to wear a post-operative garment after your breast reduction. Your surgeon will give you specific instructions on which garment to wear, how tight to wear it, and how long you must keep it on for.

Diet

Maintaining a healthy diet will help you through your recovery. This includes eating food that is low in salt and sugar, having as many fresh fruits and vegetables as possible, and drinking lots of water and caffeine-free drinks.

Smoking & Alcohol

Smoking, taking recreational drugs and drinking large amounts of alcohol can all have a negative effect on your recovery. It is essential that you stop smoking and using all nicotine products at least six weeks before and after your breast reduction. Smoking lengthens your recovery by delaying the time it takes for your wounds to heal. It also greatly increases the risk of infection.

Medications

It is very important to notify your surgeon of all the prescription and over-the-counter medications that you take. Certain prescription and homoeopathic medications can increase the risk of complications occurring. Your surgeon will discuss your medications and recommend the best course of action to take. Certain homoeopathic medications can increase the risk of bleeding and bruising after surgery; it is usually recommended you stop taking them at least two weeks before your operation. These medications can include:

• St John’s Wort
• Multivitamin preparations
• Medications containing ginger, ginkgo, garlic and cod liver oil.

Your surgeon will give you specific advice for your breast reduction preparation.

Breast reduction aftercare: what to expect after a breast reduction?

Your surgeon will give you advice for your breast reduction aftercare and recovery. They will discuss the following topics:

Post-operative appointment

After your breast reduction, you will most likely need to spend one or two nights in the hospital. Before you leave, however, a post-operative appointment will be arranged for you. This appointment will allow your surgeon to examine your breasts, remove any stitches that are not dissolvable and treat any complications.

Rest well and take time off work

It is normal to feel tired and lethargic following breast reduction surgery. Make sure you listen to your body and rest properly. Your surgeon may recommend that you sleep in an upright position to help reduce the swelling, and it is advised to sleep on your back rather than your stomach for up to six weeks after your breast reduction surgery. It is also advised to take the full week off work if you can.

Keep active and eat well

While it is essential that you let your body rest, you should also begin to engage in light activity in the days after breast reduction surgery to prevent blood clotting. Take short walks around the house or in your local area but do not push yourself. Take your time getting back into any regular sport or workout regimes you may have; your surgeon will have more tailored advice for your specific situation.

Eat high-protein, low-sodium foods to give your body all the right nutrients to recover from surgery. We also advise plenty of fresh fruits and vegetables, as well as lots of caffeine-free beverages and water.

Return to sports & exercise

After you have your breast reduction, you will need to rest well and not exert yourself. You will need to start slowly when you begin exercising again. The general advice is as follows:

• Week 1 – 3

Avoid all sports and exercises for the first three weeks after your breast reduction. Even minor aerobic sports may increase swelling and bruising.

• Week 3 – 6

Three weeks after your breast reduction, you should be able to resume light aerobic exercises such as cycling. You should, however, be careful not to exert yourself too hard.

• After week 6

After six weeks have passed, you should be able to resume more intensive exercise and sports. However, at 6 weeks the wound strength is still around 60% of its original strength. It is important to take precautions to optimise wound healing and prevent complications. Such surgeons recommend taping the incisions for up to 3 months and to utilise silicone tape or ointment for up to 18 months after surgery

After 3 months

Can return to all sports, exercises and heavy lifting again if there have been to complications in your postoperative journey and wound healing process.

Each surgeon will have different advice about when it is appropriate for you to resume sports and exercise after your breast reduction. It is, therefore, very important to follow the advice that your surgeon has personally given you.

Driving

As you will not be able to drive immediately after your breast reduction, you must arrange for a friend or family member to take you home. It may take five days to two weeks before you are able to start driving again, depending on your surgeon’s advice.

Scar care

Breast reduction surgery will leave scarring around your nipples and breasts. These scars will soften and fade over a period of about 12 months but looking after them properly is the best way to ensure you achieve the best cosmetic results.

You should keep your scars out of the sun for the next 12 months and, in the event that you do expose them to sunlight, use a high sunscreen factor. This will help prevent discolouring or darkening the scars.

You should also keep the treatment area clean. Your surgeon will inform you when you can shower and bath again following your surgery. But until that point, use a sponge with soap and water to keep the incisions clean and dry them properly.

The healing wounds may well feel itchy. You should avoid scratching them as much as you can. If you notice they begin to feel too dry, use moisturisers or bio-oil to gently massage them and keep the area hydrated.

After the incisions have fully healed and scabs have completely disappeared, you may wish to have scar massages or use scar gels for between six months to a year. While these are not essential, they can help to get the best cosmetic results from your breast reduction surgery. Silicone gel, cream or sheets are also recommended. They have been clinically proven to help reduce the appearance of scars. It is important that you use these products only after your incision has healed. Massaging is also generally encouraged during the healing process to reduce swelling and mobilise some of the lymphatic fluid in the breast tissue.

Final results

Patients will be able to see an immediate change to their breasts straight after your operation, but it may take six to twelve months before you can appreciate the full cosmetic appearance. It is therefore important to be patient.

Your surgeon will give you specific advice regarding your breast reduction aftercare. It is vital to follow the instructions your surgeon gives you, as this is specific to your recovery.

Recovery timeline

Like any surgical procedure, there is no one-size-fits-all recovery timeline. Every person’s body is different and reacts differently to an operation.

For some patients, they can find themselves ahead of the recommended recovery schedule and notice rapid improvements in mobility and a reduction in pain quite early on. Others may find that they still feel pain for several weeks or even months after their surgery.

Whichever description best fits you and your experiences, you should know that both can be entirely normal. There are many factors that can explain a quicker or slower recovery.

You should inspect your scars and the treatment area regularly to make sure you are not experiencing any surgical complications or infections. Also, make sure you are honest with yourself and honest with your surgeon in any follow-up consultations. That way, you can receive the most personalised and tailored advice for your situation. Nevertheless, in this article, we are providing you with a broad and general journey of recovery. While we understand that it may not always be completely accurate for each patient’s real-life recovery journey, it still presents good general estimates into when you can expect to engage in activities again and when life can return to normal.

Your surgeon may advise you to also continue wearing your special compression bra several months after surgery to optimise wound healing and reduce stress on your incisions and scars.

1-2 days after surgery

• The anaesthetic will still be in your system; you may feel drowsy and lethargic.
• The treatment area and the wounds will be sore.
• Bruising and swelling are to be expected.
• The swelling will lead to a large and ‘projected’ appearance; this will settle over time.
• Bathing and showering must be done very carefully - usually, you will be advised to bathe with warm soapy water and a sponge for the first 72 hours.
• The skin around your breasts may feel tight.
• Wear your post-operative bra (if recommended) during the day and overnight.
• Stay rested during this time.
• Drink plenty of water and clear fluids.

3-4 days after surgery

• Pain medication will likely still be necessary - listen to your body
• Very light activities will now be possible again; short walks around the house are recommended to prevent blood clotting
• Some stretching and movement may now be possible, but don’t push yourself
• Avoid rigorous movement and sexual activities; even sexual arousal can irritate the incisions
• Continue to wear your post-operative bra
• Sleep in an upright positive with plenty of pillow support to help reduce the stress on your breasts and reduce swelling

1-2 weeks after surgery

• Keep your wounds clean and inspect them regularly
• White tape (steri-strips) will be removed within the first ten days
• Mobility remains difficult and possibly painful, do not engage in strenuous exercise or do any unnecessary heavy lifting
• Tingling, swelling and numbness are all still typical symptoms during this time
• Pain medication may still be necessary throughout this time
• You may now engage in sexual activities again
• Continue to wear your post-operative bra

3-4 weeks after surgery

• Pain and swelling will have mostly passed
• You may now stop wearing your post-operative bra, continue to do so if you wish or if your surgeon recommends
• Begin engaging in light activities and exercises like walking, cycling or treadmills
• Continue to avoid ball sports, contact sports or rigorous movement
• Give your scars the proper attention and care: keep them clean, dry and away from sunlight
• Altered sensations on the skin are still possible; your breasts and nipples may still feel numb

6 weeks onwards

• Adjust your sleeping position back to normal if it is comfortable for your breasts
• Pains may still occur, but less frequently and severely than before
• Swelling may also still occur, particularly during your menstrual cycle when swelling and soreness is natural
• Heavy lifting may now be possible; It may now be possible to lift heavier items such as suitcases and grocery bags. Although it is essential not to push yourself, even after six weeks
• Workouts do not rush into things - you could otherwise undo all that hard work throughout your recovery!

3-6 months onwards

• Ball sports and contact sports may be possible, but you should only engage in what feels comfortable for your breasts and for the treatment area
• Numbness and a lack of sensation around the nipple may still occur, it can take up to a year for this to pass
• Swelling may, in some instances, still be apparent
• It can take up to six months to see the final results

If you want to find out more about the breast procedures that we offer please check our Breast Surgery page.

What breast size qualifies for a breast reduction?

Breast reduction is generally reserved for patients with very large breasts who want them to be smaller.

Instead of breast reduction, patients with smaller breasts usually opt for a very similar procedure called a breast lift. This procedure mostly removes skin and lifts the breasts so they look perkier and sit higher on the chest without reducing their size very much.

If you have small or average size breasts for your frame and want them to be smaller, ask your surgeon for their opinion. They will be able to create a procedure plan for you that gets you the results you want no matter what the procedure is called.

Will breast reduction surgery reduce or relieve my pain?

Many patients seek breast reduction surgery because they suffer from neck, shoulder and back pain related to the size of their breasts.

While it is not guaranteed to improve pain caused by large breasts, many patients report a reduction of their upper-body pain quickly after having breast reduction surgery. You can read the real experiences of breast reduction patients in their own words here on our patient story page.

Can breast reduction surgery help me lose weight?

Breast reduction surgery is not a type of weight loss surgery. While some weight is removed from the breasts, other areas of fat on the stomach and back remain untouched during the procedure.

Liposuction can be done in addition to breast reduction to reduce the look of unwanted areas of fat. Keep in mind that this will increase the price of the total procedure and increase the recovery time.

Some breast reduction patients do report that it is much easier to exercise after healing from breast reduction. The increased range of motion and mobility related to smaller breasts encourages many patients to get active and lose weight by eating healthfully and exercising regularly

How many cup sizes can you reduce your breasts through breast reduction surgery?

Cup sizes are difficult to use when estimating breast reduction because there is no standard to this measurement. Most surgeons can reduce breasts significantly during surgery without sacrificing shape for the breasts. The exact amount depends on your frame, breast shape and chest size.

It's also good to keep in mind that while the extent of your breast reduction is up to you, your surgeon cannot guarantee a specific cup size with breast reduction surgery. You should discuss your ideal size with your surgeon. Based on this information, they will suggest a surgery plan that gives you the type of results you want.

Are there any alternatives or things I can do to reduce the size of my breasts instead of surgery?

While there are some breast reduction pills and creams that claim to aid in breast reduction, there is limited to no existing research that suggests they actually work to reduce the size of the breasts. You can learn more about breast reduction pills and creams here on the Medbelle blog.

Some patients do have success reducing the size of their breasts by losing weight, however weight loss alone does not change the look of the breasts and can make the breasts look more saggy and lacking volume.

Breast reduction surgery is long-lasting and also lifts the breasts so they look perky and full.

How long after pregnancy can I have a breast reduction?

It is recommended that patients wait at least 3 to 6 months after pregnancy before having a breast reduction. This is to allow enough time for your breasts to settle before you have your procedure.

If you are considering breastfeeding, you will need to wait until you have stopped breastfeeding and have stopped producing milk for at least three months before moving forward with the breast reduction surgery.

Patients may also want to consider the post-op restrictions they will have in terms of lifting and carrying infants. It's important to discuss your day-to-day with your surgeon in the consultation so you're able to understand what you can and can't do.

Do I have to remove any jewellery before breast reduction surgery?

Yes, all jewellery and body jewellery for piercings must usually be removed before breast reduction surgery. This is especially true for any jewellery in the nipples or implanted subdermally on the breast or chest area.

It is important to remove jewellery before surgery because it can get caught in important tubing, cause malfunctions in equipment, or generally cause an issue for your care team. While it is a small hassle for you, removing body jewellery makes it easier for your surgeon and nurses to do their jobs safely. In some cases, piercings can be safely refitted directly after surgery with either a plastic or silicone piercing retainer or your regular jewellery.

Do I have to remove my nail, eyelash or permanent hair extensions before my breast reduction surgery?

Always ask your surgeon or their nursing staff for their recommendations regarding pre-op grooming. Generally, hair extensions do not need to be removed for breast reduction surgery.

Eyelash extensions are also usually not a problem during breast reduction surgery, but your surgeon and anaesthetist have the final say. Definitely ask them during your consultation or preoperative assessment to find out if they must be removed before surgery.

If you have gel or acrylic nail extensions, you may need to remove the product from one nail to allow a pulse oximeter over your finger. This small device slides over your fingertip and painlessly measures your pulse as well as the oxygen level of your blood during surgery by measuring how light travels through your finger.

This device is very important for anaesthetists as they monitor you during surgery. Any product on the natural nail (including gel, acrylic, or nail polish) can get in the way of accurate readings. However, some pulse monitors can also be fitted to the earlobe, so it is always best to find out the type of monitors the hospital uses during surgery.

Reach out to your Patient Care Adviser if you want clarification on your surgeon’s recommendation regarding hair and nail extensions before surgery.

What kind of post-op garment do I need after breast reduction surgery?

When it comes to post-op garments or bras, it is important to follow the instructions and recommendations of your surgeon.

Your compression garment can be a sports bra or a purpose-made post-surgery garment. Compression garments by the brand Macon are regularly recommended by Medbelle surgeons.

While each surgeon has their favourite brand or type, there are some basic features they agree on.

Generally, you should make sure your post-op garment:

• Does not have underwires
• Does not have padding
• Closes at the front for easy dressing and undressing

If you are purchasing a sports bra to wear as your post-op garment, find one that is one or two sizes larger than your goal cup size to allow for swelling.

On the other hand, if you are purchasing a bra specifically made to be worn after surgery, purchase one in your goal size as the garment is designed to allow for swelling.

Keep in mind a dark colour fabric will hide any blood or fluid stains better than lighter shades.

Will I need to stay overnight in the hospital after my breast reduction surgery?

Your surgeon is the only person who can decide if you require a night’s stay in the hospital after your breast reduction.

They will base this decision on many factors including how much breast tissue must be removed during your surgery, your current health, your age, your weight, as well as the time of day your surgery will take place.

If your surgeon believes you will need a night in the hospital, this will be included in your breast reduction price quote.

It's possible your surgeon could book you as a day-case, but then decide after surgery that it’s medically necessary for you to stay overnight. In this case, you will not be charged for this last-minute change. Medbelle will absorb the cost of your overnight stay for you.

Can I get breast reduction surgery on the NHS?

Breast reduction is not generally offered for cosmetic purposes on the NHS. If you would like to find out more, it's a good idea to book an appointment with your GP, they will be able to advise you on this topic more accurately.

In some instances, it may be possible with a doctors referral if you are having chronic pains as a result of large breasts. However, the waiting times for breast reduction surgery can be as long as 2 to 3 years which motivates many patients to have their procedure with a private surgery provider.

Do I need a GP referral for a breast reduction?

Most surgeons are happy to see patients for an initial consultation for your breast reduction without a Doctor's referral. Generally speaking, most plastic surgeons will not require a GP referral. Your surgeon may, however, contact your GP to get details of your medical history.

What services or appointments are included in the price of my breast reduction surgery?

Your final, personalised price is all-inclusive. You can learn more about pricing for breast reduction here. You will never be blindsided by an extra fee after you accept the final quote given to you by your Patient Care Adviser.

This means your price includes:

• Your consultation(s)
• Preoperative assessment
• Surgical fees
• Hospital fees
• All necessary aftercare

Depending on your surgeon’s recommendations regarding your procedure and the hospital it will take place at, this price may also include:

• A nights stay in the hospital
• Meals in the hospital
• A post-op compression garment

You can learn more about pricing and financing for breast reduction by speaking to your Patient Care Adviser.

What services or appointments are included in the price of my breast reduction surgery?

Your final, personalised price is all-inclusive. You can learn more about pricing for breast reduction here. You will never be blindsided by an extra fee after you accept the final quote given to you by your Patient Care Adviser.

This means your price includes:

• Your consultation(s)
• Preoperative assessment
• Surgical fees
• Hospital fees
• All necessary aftercare

Depending on your surgeon’s recommendations regarding your procedure and the hospital it will take place at, this price may also include:

• A nights stay in the hospital
• Meals in the hospital
• A post-op compression garment

You can learn more about pricing and financing for breast reduction by speaking to your Patient Care Adviser.

Will I still be able to breastfeed after a breast reduction?

As your surgeon is likely to remove some milk glands and ducts during a breast reduction, this can affect your ability to breastfeed postoperatively.

Many women can still breastfeed after surgery, but this depends heavily on the tissue removal technique that your surgeon uses. Certain surgical techniques will have more of an effect on your ability to breastfeed than others. For this reason, it is very important to notify your surgeon if you are planning to breastfeed in the future.

Will breasts grow again if I gain weight after breast reduction surgery?

Yes, there is a chance your breasts will grow larger if you gain weight after surgery. Losing weight can also make your breast smaller. In both of these cases, the look of your breasts after breast reduction are likely to change as your weight fluctuates. This is why surgeons recommend breast reduction patients be at a stable weight before having surgery. Ensuring you’re at a stable weight for your body will ensure your breast reduction results last for as long as possible.

How can I minimise the risk of breast reduction complications?

A breast reduction is a complicated procedure. You should therefore make sure you choose a highly-experienced BAAPS or BAPRAS surgeon to perform your operation.

You can also minimise the risk of breast reduction complications by, reducing your alcohol intake, maintaining an approved BMI and most importantly, you are advised to stop smoking. Patients are recommended to follow their personalised advice from their surgeon who will tell you prior to surgery if you need to stop taking any medications or lose weight. Furthermore, you should be sure to attend all of your post-operative appointments to check you're healing properly and that you're not overexerting yourself in recovery, which could have a negative effect on your results. Following this advice can help you minimise the risk of breast reduction complications.

What effect do smoking, alcohol and drugs have on breast reduction surgery?

Smoking, drinking large amounts of alcohol and taking recreational drugs can all increase the risk of complications occurring during and after your breast reduction surgery. Alcohol can react badly with any pain medication you may be prescribed and it can negatively impact the healing process. Smoking in particular can increase the risk of developing infections and can also delay wound healing. You must therefore stop smoking or using any nicotine products at least 6 weeks before and after your procedure.

All of the information found on our website is sourced from highly reputable experts, government-approved authorities and is widely used by healthcare professionals.

• https://www.nhs.uk/conditions/breast-reduction-on-the-nhs/ NHS
• https://www.nhs.uk/conditions/cosmetic-procedures/breast-reduction-female/ NHS
• https://baaps.org.uk/patients/procedures/7/breast_reduction British Association of Aesthetic, Plastic Surgeons
• https://www.bapras.org.uk/public/patient-information/surgery-guides/breast-reduction British Association of Aesthetic, Plastic and Reconstructive Surgeons
• Understand.com Understand
• https://rarediseases.info.nih.gov/diseases/9450/gigantomastia Rare Diseases
• https://americanpregnancy.org/healthy-pregnancy/pregnancy-health-wellness/breast-changes-during-pregnancy-960/ American Pregnancy