Measurement
The overly large breast is difficult to define. We tend to use the bra size as a simple measure and descriptor of breast and chest size, but accurate bra sizing is difficult. There are laser based instruments which give a more accurate measure of size.
In general terms, assessment remains a subjective and personal matter. It depends on personal perception, and on a large number of other factors, including general body build, height and shape.
National guidelines, which are not entirely
scientific, suggest that significant breast enlargement
exists when the breasts are more than 13% of the body volume;
and when there is more than 500ml of excess breast tissue
per breast.
Health Problems
The overly large breast produces a range of problems, including cosmetic worries and social embarrassment. We are particularly focussed on the physical problems which can greatly reduce the quality and enjoyment of life.
These include back pain and shoulder discomfort and grooving; stooped posture and severe self consciousness; inability to take part in a range of sports and other activities; and association with moderate to severe obesity. They also include irritation , damage and hygiene problems for the skin underneath the breast.
Our Philosophy of Treatment
We start with the philosophy that effective treatment for overly large breasts can produce huge gains in the quality of life, which translate into many fewer health problems in later years. This has huge benefits for the individual lady and for the community and health services as a whole.
In most cases, treatment requires surgery to reduce the size of each breast and reshape it.
Surgery is never to be undertaken lightly, as there is always a small risk associated with any operation, however carefully and expertly it is performed. For this reason, we work as a multidisciplinary team in a highly professional environment to reduce treatment risk to a minimum and to get the best possible results as consultants working together.
Breast Reduction Surgery
Technically, we refer to this as therapeutic reduction mammoplasty (TRM) to emphasise the health gains of the procedure.
We use well established, tried and tested standard TRM operations. While every woman’s breasts are different, most can be effectively treated by a similar procedure.
The diagram shows the general principles
of the operation. It aims to take a wedge shaped segment
of breast, judged by the surgeon during the operation,
from the lower part of the breast, while preserving and
relocating upwards the nipple and areola on its underlying
tissue and blood supply. The resulting effect is a keyhole
shaped scar around the nipple and extending down and beneath
the breast.
The considerations and risks of Therapeutic Reduction Mammoplasty
Appearance, Shape and Size
It is not possible to guarantee in advance the end result precisely. While in general terms we aim to reduce to a C cup, many considerations, such as the need to preserve tissue and nipple blood supply, will determine the final outcome.
This form of surgery also produces a degree of scarring within the breast, which may feel lumpy after the scars have healed. There may be hard knots of tissue deep in the breast, known as fat necrosis.
Sensation
While all care is taken to preserve normal breast sensation, there may be changes in skin and nipple sensation after surgery
Bleeding and Bruising
While all care is taken to stop bleeding during surgery, bruising and blot clots may form immediately or during the first few days after surgery. This can occasionally necessitate a return to Theatre.
Infection
All good care is taken to operate to the highest standards in a sterile environment, protection against infection cannot be guaranteed. Our practices, procedures and working environment are designed to ensure the highest possible standards of hygiene and infection control.
Scarring
The scars are a standard shape but their precise position cannot be guaranteed. We use slowly dissolvable subcutaneous sutures which are invisible under the skin and which do not need to be removed. Scars can take up to a year to mature to their final appearance.
Where surgical problems do arise, we will take all reasonable steps to address and correct them directly. |
