Breast reduction – when less is more.

When most women consider breast surgery, they think of breast augmentation. However, bigger is not always better especially for women who have large, heavy breasts that interfere with their daily activities.

Cape Town based surgeon, Dr Stuart Geldenhuys discusses these problems and explains how breast reduction or mammoplasty surgery offers a new lease on life for over-endowed women.

“Breast reduction surgery removes excess breast tissue, fat and skin, to create more proportionate breasts for each woman's body type as well as to alleviate the medical and emotional stress of large, heavy breasts.”says Dr Geldenhuys

Why opt for breast reduction?

Large, heavy breasts can have a very disabling effect - causing symptoms such as shoulder, neck and lower back pain, sores caused by excessive skin rubbing, a decrease in physical performance, shoulder bra strap grooving and many more.

 “Not only can big breasts be extremely uncomfortable, but it is usually difficult for overly-endowed women to find bras that fit and their clothing choices are severely restricted.”

In addition to these physical symptoms, many women with large breasts report psychological effects such as low self-esteem, embarrassment, anti-social behaviour, and in some cases body dimorphic disorder.

“Breast reduction surgery can not only dramatically change a person's life that is dealing with these disabling symptoms but this surgery also yields one of the highest patient satisfaction rates over any other procedure done by plastic surgeons. Numerous published studies corroborate the physical and psycho-social benefits of breast reduction surgery.”

Dr Geldenhuys refers to a recent study, published in the Plastic and Reconstructive Surgery Journal, which examined the effects of breast reduction surgery on lower back pain that revealed a 35% decrease in low back compressive forces after undergoing breast reduction surgery.

Participants also demonstrated a 76% reduction in self-reported disability after having breast reduction surgery.

The study also yielded a most impressive decrease in the frequency of pain, in patients studied before and after the breast reduction surgery. In addition to many physical benefits, many patients report higher self confidence and increase in overall quality of life.

Advantages of breast reduction

Breast reduction may include the following benefits:


•    The breasts will be smaller, aesthetically proportioned and in better balance with regard to the rest of the body;

•    A reduction will lift the breasts slimming and elongating body shape;

•    Indentation marks on a woman's shoulders from bra straps may be eliminated;

•    There will be less strain on the back and neck, which will often result in the disappearance of associated back and neck pain;


Are there possible complications to breast reduction?


Reduction mammoplasty is a safe procedure when performed by a qualified doctor. However, like any surgery, it has some uncertainty and risk. Complications such as bleeding, infection and an abnormal reaction to anaesthetics, are rare but still possible.

What about scarring?

The scar left from this surgery will depend on the technique employed, which directly relates to the size of the breast reduction.  Smaller breast reductions typically require vertical scar (lollipop scar) or inverted ‘T’ techniques which will only be visible when naked
.
 “Larger breast reductions will require longer scars in order to remove more skin and breast tissue, and we typically employ a ‘wise keyhole pattern’ (anchor scar).

The horizontal portion of the scar lies in the crease below the breast where it is well hidden but may protrude along the inside of the breast towards the cleavage or laterally towards the axilla - this may in some cases be visible in underwear. Wherever possible scars are kept to a minimum.

Breastfeeding after breast reduction – is it possible?

“A breast reduction may limit a women's potential to breastfeed - lactation usually does occur but is likely to be insufficient, requiring supplemental feeding,” comments Dr Geldenhuys.

Both hormonal and weight fluctuations, occurring during pregnancy, may result in breast size and shape alterations and therefore where a women is imminently considering having children, breast reduction surgery should be deferred until her family is complete in order to optimize long term breast shape maintenance. 

Breast reduction can be very liberating, both physically and emotionally, for women who have had to go through life making accommodations for their large breasts.
 
Geldenhuys advises that if a woman wants to have breast reduction surgery then she should ideally be at her goal weight as subsequent weight loss after surgery could cause breast sagging.

Reasons to not have the surgery include: medical contraindications to surgery; psychological factors; wanting to breastfeed; not being prepared to accept the possibility of nipple sensory loss or not wanting scars after surgery.

“I encourage women who are suffering physically or emotionally because of overly large breasts to seek the advice of a board-certified plastic surgeon who has experience with breast reduction surgery to see if this procedure might be beneficial for them.”

For further information on the Breast reduction procedure contact Catherine Pate on 082 9221 737 or visit www.plastic-surgeon.co.za


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