What is breast reduction surgery? Breast reduction surgery is removing breast tissue thereby lightening the weight of the breasts and sometimes achieving a change in shape also. When we change the shape, we call this a mammoplasty. So, then the name becomes reduction mammoplasty. (For example, when we do augmentations, we call it an augmentation mammoplasty)
Why is it recommended to lose weight before breast reduction surgery, and not after? We know from data provided by our anaesthetic colleagues in international studies that patients with a BMI over thirty have higher risks. There can be anaesthetic risks like DVT (Deep vein thrombosis) clots in the leg or PE (pulmonary embolus) when a clot travels up to the lung and can be fatal. Problems like post operative pneumonia and reflux are also more common.From MY point of view, I know from experience that when women have that little roll of fat under their breasts, the risk of wound infection is higher. So even if they come to me with a BMI of 30, and I see that roll of fat I might still ask them to lose a little more weight. The thing is, that when a woman has had her reduction surgery, she comes back wearing trainers!! Maybe contemplating going to the gym for the first time as her breasts held her back before! Well, the problem then is, that when she loses her other body fat it will also come off her breasts potentially leaving things out of proportion. So here are my two main reasons for personally liking women to be at a static, lower BMI. This is in addition to the very real anaesthetic risks associated with being heavier.
How can I lose weight for my breast reduction surgery in a healthy way? Diet and exercise !! Isn’t that what they always say? Sensibly and slowly, but I find that a lot of my middle-aged ladies carry extra weight around the middle and from personal experience – that responds best to the low carb 8system. Slimming World also comes highly recommended by my ladies. In terms of exercise, I know women say that they find it difficult to exercise. But cardio and weights work best. You can do the following without your breasts being too bothersome. Stationary bike, elliptical trainer and weights – (free weights or machines)
After weight loss, when is it the best time to consider breast reduction? As soon as your weight is static – and you are happy that you are not going to regain – go for it!! Your reward for losing the weight!!!
How should I prepare for breast reduction surgery?I like ladies to prepare fully, read, read, read, there is so much information out there – you have already started here so that is a GREAT start!!! My Instagram page also carries more stories, and you get to see me!
What are the dos and don’ts after breast reduction surgeryI I have a few rules that are non-negotiable. But with good reason BMI lower than or close to 30. No long-haul travel for 6 weeks pre or post op to reduce the risk of thrombosis sports post operatively for 4 weeks in fact anything that puts your blood pressure up. No swimming/ sauna or hot tubs for 6 weeks post op or until I give permission. I particularly hate hot tubs! Bacteria love them!
Should I sleep elevated or wear a special type of bra? You might find it easier in a supported position semi upright for the first night like heavily pregnant women do with a V-shaped cushion or pillows either side. After a week you can sleep how you wish
How else can I care for myself at home? The risk in the first 12 hours is bleeding, but beyond that its actually clotting! So, I have a clear set of instructions as follows. Go home in your surgical stockings until fully mobile. Do not head straight up to bed for a long old nap, like a child, you won’t sleep at bedtime, and we all know everything hurts more at night!! I want you to spend your first couple of days of recovery mobilising at regular intervals. If you feel like you need some TLC, make a comfy nest of fleecy blankets and favourite pillows on your sofa downstairs and surround yourself with your iPad, magazines, nice snacks and chargers! Then every half hour get up and walk to your kitchen, round your garden, even pop to the local shop if you are up to it! AND HAVE a drink, this means you will be up all-day drinking and peeing so come bedtime, you should sleep through!
When will I be able to drive, heavy lift and return to work safely?No driving for 2 weeks. No Sport and weight lifting for 4 weeks.
When can I return back to Work?
Since COVID more and more of us are working from home (not us surgeons!) so you can get straight in front of your laptop whenever you wish. I would please recommend 48 hours for the anaesthetic to leave your system – especially if your job involves looking after other or people’s legal affairs or money!! If you travel into work, I would say two weeks is sufficient. If your work involves heavy lifting, we may need longer or a modified work adjustment.
Post operative surgical bra. I will give you two post operative bras from the hospital and will put you in a binder which is a bit like a stiffer boob tube and expect you to wear both untouched for 5 days. you can bath up to the waist, you can use deodorant, or you can hold the shower nozzle pointed south! this approach reduces swelling and keeps the wounds pristine/ I will unveil the breasts with you on day 5 and then give you a whole set of specific washing instructions. I did say I was very particular!!
