R Breast Reduction

Overview

R breast reduction cosmetic surgery procedure. Breast reduction can help relieve the physical symptoms associated with large or heavy breasts.

In most of the techniques skin alone tries to keep the breast in its new position which stretches with time and creates a recurrent saggy appearance. Mr Riaz uses a central mound pedicle for nipple/areolar complex and also uses an under layer of skin called dermis in the shape of wings to go around the reduced breast tissue to stabilise or stitch it to the chest. He also uses a technique to prevent recurrent sagginess of the lower part of the breast. In this new modified technique the breast looks more as if it has implants immediately after the operation but once settled it looks natural and youthful.

Breast reduction surgery can deliver excellent functional and cosmetic results. The operation is intended to reduce the size of and lift up the breast. 

Breast reduction can help relieve the physical symptoms associated with large or heavy breasts such as:

• Breast discomfort

• Neck ache

• Backache

• Shoulder pain

• Skin irritations underneath the breast fold

• Problems with clothes

• Indented bra-straps

• Difficulties and discomfort during exercise

On a purely cosmetic level, the operation can help patients who are unhappy with the shape, weight and droop of their breasts, by creating smaller and more uplifted breasts. Many patients with large breasts can be very self-conscious of their appearance and find that they attract unwanted attention. 

INTRODUCTION:

The weight of large or pendulous breasts may cause a variety of medical problems including back and neck pain, skin irritation and shoulder soreness from tight bra straps. Large breasts can also make a woman or a teenage girl feel extremely self-conscious. Breast reduction surgery aims to make the breasts smaller, more shapely and better supported. 

There are many different techniques or breast reduction and so the position of the resulting scars may vary a little. There is always a circular scar around the nipple and a second vertical scar running from the lower most point of the nipple to the fold beneath the breast. In most techniques there is also a horizontal scar in the fold beneath the breasts.

The horizontal scar can usually be kept quite short but its length does vary depending on the original size of the breasts. Some techniques of breast reduction avoid the horizontal scar altogether and Mr Riaz will advise you if you are suitable for this at your consultation. 

Breast reduction is certainly NOT an operation where one size fits all and Mr Riaz provides a very individual approach to try and achieve a bespoke result for each patient. He is particularly known for his artistic approach to achieving a natural look. He will also be honest in informing you if he feels you are not a good candidate for surgery and carefully explain why this is so. 

PROCEDURE

Breast reduction involves reduction of the volume but at the same time it should uplift and reposition the breast tissue on the chest. Mr Riaz prefers to use a technique which achieves an uplift to be performed at the same time.

After the operation, showing the scar lines around areola of the breasts in a ‘T’ shape

Mr Riaz does not like the idea of reducing a large saggy breast into a small saggy breast. After the reduction most of the breast should be sitting above the fold. There are numerous techniques described in the literature. All these techniques leave the patient with a scar around the nipple/areolar complex and a vertical scar and in other techniques there is an additional transverse scar of variable distance in the fold below the breast called a ‘T’ scar. Mr Riaz has used almost every technique over the years and is familiar with pros and cons of different techniques.

Mr Riaz’ preferred technique which he uses these days include dermal wings, which is a strong layer of tissue under the skin and this tissue is usually excised and thrown away after reduction. Mr Riaz makes use of these dermal wings, one at the superior end above the nipple/areolar complex and two on each side, the proportion of breast below the nipple/areolar complex. The breast tissue is stitched to the chest wall using these dermal wings.

Usually in the large breast the distance from the nipple to skin crease below the breast is quite long, ranging from 12-16cm. If the breast tissue after reduction is held in position just by bringing the skin envelope around the breast tissue then due to the longer length of this part of the breast it causes pressure on the skin due to gravity and weight of breast tissue and causes stretching of the skin. This leads to bottoming out of the breast tissue, also called pseudo ptosis and the breasts change into a square shape which does not look like a youthful breast.

Mr Riaz uses plication sutures. We shorten this distance from the nipple/areolar complex to the infra-mammary fold by using multiple layers of sutures. This technique reduces the distance of this area into an ideal for a given patient and reduces the risk of stretching of the skin after the operation and prevents pseudo ptosis. The skin flaps are closed without any tension. This technique takes a slightly longer time to perform. Mr Riaz is more than happy to spend more time to perform this technique to achieve lasting results and many very happy and pleased patients. 

BREAST UPLIFT (MASTOPEXY)

Mr Riaz quite often completes a Breast Uplift or Mastopexy to complement a breast reduction, here he uses the dermal wing technique for the uplift procedure. Skin only is excised and all the breast tissue is preserved and it is repositioned above the fold below the breast to achieve a youthful natural appearance.

This technique is similar, as described under breast reduction. All the breast tissue is secured to the chest with non-absorbable sutures and also the area of dermis below the nipple/areolar complex to the infra-mammary fold is plicated to prevent future stretching of the skin and recurrence of saggy appearance. 

KEY FACTS:

• Removes excess fat and skin from the breasts

• Results in more attractive breasts

• Reduces self consciousness

• Scars will always be there but will become less prominent over time

• Women often cannot breastfeed after this surgery

• Nipples become less sensitive

• Unless your body size fluctuates, they often do not change

• Procedure done under general anaesthetic