22 October 2012

Breast reduction: when less is more

When it comes to breasts, bigger is not always better. For women with large heavy breasts, many daily activities can become a burden and participating in sport is often impossible.


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 and cause serious back problems.  Plastic 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.

“For women with large heavy breasts, many simple daily activities can become a burden and participating in sport is often impossible,” says Cape Town cosmetic surgeon, Dr Stuart Geldenhuys.

“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.”

Why opt for breast reduction?

Dr Geldenhuys explains that 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 is a safe procedure with significant results, which 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;
  • Bra and clothing choices are enhanced;
  • 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;
  • Irritation of the skin underneath the breasts should be resolved;  and
  • The patient will feel more self-confident and comfortable about her body.

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. Bear in mind, that 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 because a bra or bathing suit will cover the scars,” says Geldenhuys.

 “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. The procedure however is a trade off: - smaller breasts (with, in most cases, resolution of the associated discomforts) with aesthetically pleasing proportions for scars.  In my experience this is an easy decision for women with large breasts.”

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.

“A young women with very large breasts, that impacts on her physical and psycho-social wellbeing cannot be expected to wait until her family is complete in order to successfully breastfeed - and typically, in these cases, they don't.”

“However 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.  The procedure can also lead to a better quality of life because many women find it easier and more comfortable to exercise and participate in other physical activities following breast reduction surgery.”

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.”

Catalyst Communications press release

- (Health24, October 2012)

(Photo of woman examining breast from Shutterstock)

Read more:

Are you a breast surgery candidate?

How breast reduction is done
Post-baby boob jobs: pros and cons


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