Breast Reduction

Virginal hypertrophy: There is a condition well known in medical circles but not so well known to the public. This refers to an uncommon condition where young girls develop very large breasts which grow to sizes disproportionate to their body. There is no established medical treatment apart from surgery. This condition may be treated by reduction surgery. In such cases, surgery may be considered at a relatively young age to address the physical burden and psychological difficulties.

The consultation: Consultation involves getting a full medical history and developmental history of the breasts, particularly to know if they are still growing or have stabilised. Any breast biopsies or family history of breast cancer is also significant. You should inform your surgeon if you have a tendency to decrease or increase the size of your breasts with body weight fluctuations. It may be necessary in this case to reach your ideal weight prior to surgery. An examination of the breasts is done noting the size, presence of any lumps, position of the nipple, and quality of the skin. You will be asked about your desired breast size and any other aspects you would like to improve.

Breast reduction does not appear to increase the risk of developing breast cancer. If there is a history of breast cancer in your family, then we may recommend a mammogram before surgery, and another some months after surgery.

Surgery: The ‘classical’ operation involves an incision which runs around the areola, and then from the lower edge of the areola to the crease underneath the breast. From here, it runs under the natural curve of the breast, lying within the crease (but see below for newer short scar designs). Breast tissue and skin are removed and the nipple areola complex is brought up to its new position, usually attached to the breast tissue underneath. It may therefore maintain its sensation, and the ability to breastfeed may also be preserved; however, this cannot be guaranteed.

The ‘newer’ operations aim to reduce the scars and alter the shape and projection. See below under refinements for details.

Post-Surgery: Pain levels vary after this operation. You will be fitted with a support bra to be worn 24/7 for 2 weeks and for another three weeks during waking hours. Drains, if any, are removed in 24–48 hours, and most women are discharged home the following day. Showering is possible if waterproof dressings are in place. You may be able to return to work within 2 weeks, and exercising may be allowed after a month.

Results: In the first instance, one would note that the operation does involve a considerable number of surgical scars. However, many women with large breasts are satisfied with the reduction in breast size. Patient satisfaction following breast reduction can be high. Unless one loses or gains a significant amount of weight or becomes pregnant, the breast size should remain fairly constant. Gravity and the effects of age will alter the shape of every woman’s breasts with time, and a breast “lifting” procedure may be considered after some years to address these changes. Since the scars will essentially lie in the same place, additional incisions may not be required.

Complications: At the time of your consultation, potential complications will be discussed, including fluid collections, blood collection under the skin, delayed healing, infection and, very rarely, partial or total loss of the nipple due to poor blood supply. Smokers are particularly prone to this complication and should discuss smoking cessation with their surgeon before surgery. Following reduction, minor differences in size or height of the nipple may be evident when comparing the two breasts; these may be adjusted at a later date if required.

Plastic Surgeon in Dubai: Dr. Mohan Rangaswamy, a plastic surgeon in Dubai, performs breast reduction surgery and provides care based on each patient’s individual needs.

Refinements: Dr. Mohan uses short scar methods including ‘vertical scar breast reduction’ or a short T. For added fullness, even in cases of reduction, a small breast implant may be added. Yet another method is to use auto-implant: breast tissue from the lower segment of the breast is shifted to the upper pole, giving more fullness where it is needed. Finally, fat grafting, especially to the upper pole, can add further volume to breasts that have undergone reduction.