12 July 2018
Breast augmentations, women having their breasts reshaped or made bigger are on the whole, accepted as a cosmetic treatment – aimed at making the patient feel happier and more confident with their body.
However, breast reductions are usually sought for different reasons. Over-large breasts can cause all kinds of problems including bad backs, neck and shoulder troubles and depression. They can also restrict the sort of exercises that can be carried out to keep healthy and active.
So news that the NHS is considering making breast reduction a ‘procedure of limited clinical value’ has cause some raised eyebrows from surgeons who would normally carry out the operations.
Mr Jonathan Staiano, a Consultant Plastic Surgeon at Spire Parkway Hospital in Solihull, near Birmingham said: “The majority of cases of breast reduction are to alleviate some of the posture problems over-large breasts can cause.”
“For many women it is the last resort after years of struggling with a bad back or shoulder and neck pain. After having a breast reduction, it is often unthinkable to women to consider having the weight put back in their bra and they wonder how they managed for so long."
“I don’t want to sound controversial, but if men had to carry an extra kilogram or so around their necks, they would soon realise it wasn’t a cosmetic operation!”
Mr Staiano answers some often-asked questions about breast reduction surgery.
Is there a ‘typical’ age of women seeking breast reductions?
When women are young and at their strongest they are often able to ‘carry’ their breasts without it causing back and associated problems. However, as the suppleness of their spine decreases with age they can begin to experience severe pain and it is then they look to surgery.
What other problems can be exacerbated by over-large breasts.
Finding bras that fit correctly can be very difficult which means incorrectly supported breasts become a painful problem in their own right, causing severe pain and discomfort. They can also prevent a person leading a healthy life as exercise – even going for a walk – can be very painful.
There is also the fact that the woman loses confidence in herself as she is so dissatisfied with her body shape. This, as we are all well aware, can in itself lead to depression and a drop in quality of life.
Is there a breast-to-body-size definition of ‘too big’?
There are all kinds of factors – some women have very narrow backs or shoulders which mean that although a bra size doesn’t sound over-large, it is the size of the breasts themselves that cause the problems.
What does breast reduction surgery entail?
Surgery is done under a general anaesthetic (you get put to sleep) and involves removing the weight from the breast, usually from the lower part of the breasts where it is heaviest and hanging. Great care is taken to re-position the nipple higher up on the newly formed breast to give a ‘lifted’ look that is more in proportion and in keeping with the frame.
People sometimes think that the nipple is removed and put back on, but this is very rarely the case and it is usually left attached to the breast but re-positioned to a higher place on the breast.
How long is a typical patient in hospital for?
There is an overnight stay in hospital and patients are often able to go home the next day after surgery. There are supportive dressings in place which are removed after a week and patients are given a postoperative bra to wear for four weeks after this. All the stitches are dissolvable and it can take some weeks and months for the shape to settle and the final result to become apparent.
How is the decision of the new breast size made?
We encourage patients to have at least two consultations and often more to ensure they are completely happy with the plan. We discuss what they would like and balance this with what we feel can be achieved. Bra cup sizes can be unpredictable but we give an idea of what to expect and try to make sure that we are on the same page in terms of expectation which is often the secret to a good outcome.
What is the normal reaction of the patient after surgery?
Almost without exception they are delighted with their new look. Although the new shape is important, most women are more pleased at how having smaller breasts give them much more freedom of movement. Many tell me that as soon as they have recovered from the operation, the first thing they are going to do is join a gym! After years of being held back by their breasts,they are now keen to get their whole body into better shape.
Q: How quickly could I have a consultation, and how much would it cost?
A: It depends on the availability of the consultant you wanted to see, but we pride ourselves on getting you fast access to diagnosis and you can often get a consultation within 24/48 hours. Initial consultation fees vary by consultant, but around £175 is a reasonable guide.
Q: If I need surgery, how quickly could I have it?
A: We have no waiting lists at Spire Parkway, but it depends on the availability of the consultant you want to see. As a guide, and subject to a pre-operation assessment, it could be between one and two weeks.
Q: I don’t have health insurance, can I self-pay?