Breast reduction involves removal of breast volume to resolve volume related symptoms but also to improve shape of the breast and the position of the nipple areola complex (NAC). A Breast lift (known as a mastopexy) only involves moving the nipple and areola to the correct position. The NAC should sit above the fold of the breast (this is where the breast meets the chest wall at the bottom of the breast and is called the inframammary fold).
A breast reduction reduces the breast size and shape change to create a more youthful breast by removing excess breast tissue and skin. The areola size can also be reduced in a breast reduction.
Breast reduction involves removal of breast volume to resolve volume related symptoms but also to improve shape of the breast and the position of the nipple areola complex (NAC). A Breast lift (known as a mastopexy) only involves moving the nipple and areola to the correct position. The NAC should sit above the fold of the breast (this is where the breast meets the chest wall at the bottom of the breast and is called the inframammary fold).
A breast reduction reduces the breast size and shape change to create a more youthful breast by removing excess breast tissue and skin. The areola size can also be reduced in a breast reduction.
The breast reduction surgery procedure involves making incisions around the areola and also to varying degrees on the breast skin to rearrange skin, tissue and the NAC to recreate a youthful breast. Therefore there are some characteristic scars that are formed.
These are either around the areolar vertically down (like a lolly pop- vertical scar breast reduction) to around the areola, vertically down and in the fold underneath the breast (like an anchor-wise pattern breast reduction). The degree of scarring is determined by the degree of excess skin and tissue that needs to be removed.
The breast reduction surgery is carried out under a general anaesthetic and if performed alone can be conducted as a day surgery, meaning you go home the same day as your surgery.
What is the aim of the breast reduction surgery?
To reduce symptoms related to large breasts, to reshape the breasts and to place the NAC to a more youthful position.
How long will the results last?
There are changes in the breasts, areolar and nipples with age, weight fluctuations, pregnancy and breast feeding. Therefore, surgery timing should be considered carefully if a pregnancy or weight loss is planned.
The results of breast reduction surgery will withstand but the above factors will inevitably have effects on the tissues over time.
It is also important to remember the constant effect of gravity will naturally cause a breast drooping effect (ptosis) over time. This varies from patient to patient and can be difficult to predict.
What happens on the day of surgery?
Prior to the day of surgery you will be given the following information and it is critical to know these details ahead of time:
On the day of surgery you will be checked in by a nurse and all your details will be confirmed and you will be changed into a surgical gown.
Dr Rory will see you before your surgery to run through all the details of the surgery, the consent forms as well as performing all your surgical markings. Your implant sizes will be once again confirmed. Multiple ID checks and procedure confirmation will be performed prior to your operation as safety is a priority.
After your surgery Dr Rory will notify your friends or family to let them know the procedure has finished and put thieir mind at ease. Depending of the procedure he will see you after the surgery and discuss the procedure.
When you are feeling comfortable, the team will then allow you to be discharged as planned that morning. All medicines and instructions will be given to you on your discharge.
You will be discharged from hospital with a soft non-underwired sports like surgical support bra.
How long will the surgery take?
If done in isolation, the surgery takes approximately three to four hours.
This does not include anaesthesia time. In total, the whole procedure may last longer.
Will the procedure be painful?
One of the primary aims of any procedure performed by Dr Rory is to create a pain free experience.
A long acting local anaesthetic agent is placed into the surgical area at the end of the procedure. To make you comfortable a garment or specialized supportive dressings (with nipples exposed) will be applied to help support your new breast shape.
In terms of recovery, there will be some tenderness in the surgical area and some discomfort on movement.
Dr Rory does not use drains, which again makes the procedure more comfortable.
What is the recovery period?
This is a major procedure and so the recovery is three to five days.
During this time you can fully use your arms and are encourage to do so with care. The golden rule is no heavy lifting for one month following the surgery.
What should I consider when recovering from the procedure?
There will be a specialized skin glue placed on the surgical area and a splash proof dressing. This will allow you to shower with care. The garment should be removed before showering.
No heavy exertional activity that will cause excessive sweating. No jerking chest or arm movements in the first seven days. The golden rule is no heavy lifting for one month following the surgery.
The specialized skin glue will peel off at week three to four. At this time, a silicone based strip or gel should be applied to the dry healed scar in order to minimize the final appearance of the scar.
The garment should be worn for four to six weeks after your breast reduction surgery to stop an unwired bra rubbing on your scars.
The final results in terms of shape will be at approximately four months. At first, your breasts will appear fuller at the top and firmer. Over four months, the breasts have softened and become more natural looking (dropped and fluffed). This is the effect of gravity after your breast reduction.
As you attend your wound check appointments you will see the skin glue as purple and very often the skin can appear gathered. This gathering of the skin will flatten over time.
No swimming until all scars are fully healed at approximately four weeks.
Driving can be resumed at one week with care, wrap a towel around the seat belt as padding in the event of an emergency stop.
The final appearance of your scars will be at eighteen months.
What is the cost of the procedure?
If performed alone, the cost of the procedure starts at 65,000 AED (excluding VAT).
The final cost is determined on a case by case basis dependent on degrees of size, complexity and additional procedures. Combination surgeries will lower the price of individual surgeries if done together.
A full surgical no-commitment consultation with Dr Rory will provide all the necessary details for your particular case and comprehensive size planning in terms of % reduction.
What are the risks of the procedure?
These include some discomfort, infection, nipple sensation change, alteration of blood supply to nipples, risk of bleeding, fat necrosis, degrees of asymmetry and delayed wound healing.
Your nipple sensation may increase or decrease, and each side may act independently. Sensation recovers over time. This varies between patients.
As the nipples and areola are moved on their blood supply there is theoretical risk of interruption of blood supply that can lead to some or all of this area dying (undergoing necrosis). This is very rare but more common in smokers. The other problem smokers face is delayed wound healing and poorer quality scars.
Fat necrosis is a phenomenon of fat loosing its blood supply and the oily content of the fat cells can collect or cause firm painful lumps. Again, this is more common in smokers.
Dr Rory is therefore very strict when it comes to smoking and breast reduction surgery. You are advised to stop smoking one month before and after this surgery.
There is also the risk of stretching of the scar and excessive scarring such as hypetrophic or keloid scarring.
Anything in particularly important I should know about the procedure?
It’s a straightforward procedure with very high satisfaction rates if you are willing to accept the scarring which will fade over time. It can completely resolve breast size related symptoms.
The key to the procedure is planning your nipple position and breast shape and a % reduction prior to surgery.
Final appearance takes approximately four months.
It is most commonly performed in conjunction with other body contouring surgeries.
What is the follow up after the procedure?
Each patient has a follow up schedule that is different.
You will be advised by Dr Rory and his team your particular follow up journey.
Typically it involves seeing the team a week after surgery for a wound check, then protective dressings until the glue falls off.
Thereafter, scar checks are performed at the six week point. Follow appointments are then at four and twelve months. This schedule will differ between individuals.
Who is involved in my care?
Dr Rory is the primary physician in charge of all your care. He performs all procedures himself and is meticulous about every aspect of your care.
Once he has performed a procedure on you he is available for you as your on-call doctor.
He will provide you with contact details and will be available for you. If you have any questions or concerns at any time he is available to support you.
He has trained his team around him to an exceptionally high standard from his aesthetic coordinators to aesthetic nurses.
In some instances, for example, for photography, garment fitting, wound dressings, checks or removal of stitches, his highly trained team will perform the care liaising directly with Dr Rory with real time updates.
