What constitutes the ideal or perfect female breast is a question with no single correct answer, since it has always depended upon époque, nationality, culture and fashion trends. Whilst the modern western trend leans toward increasing the breast size, often by means of implant surgery, there is today an increasingly prevalent counter-trend of women who believe their breasts to be too large for one reason or another, and who consequently seek to reduce the size of their breasts through Breast Reduction Surgery.

Very large and heavy breasts often cause considerable physical and/or psychological distress. It can be the first thing that people notice about you and the one thing they don’t forget. They can become the source of unwanted attentions and advances, they can make you stick out in any social situation and weigh just as heavily on your mind as they do on your chest. By getting a breast reduction, you’re freeing yourself up, to feel more balanced and whole again. You’ll be able to go to places like the beach and engage in activities and sports that would have been hard or embarrassing to participate in with larger breasts. You can feel confident and in control of your body, instead of feeling dominated and defined by large and heavy breasts. Many times, the physical pain is what ultimately leads women to choose surgery. Pain is typically felt in the lower back, neck, and shoulders, and sometimes as headaches and this type of discomfort can have a ripple effect into other areas of a woman’s life.

“Large, pendulous breasts aren’t just heavy to carry around. They can also affect your self-esteem and get in the way of your normal daily activities and prevent you from participating in sports or wearing the type of clothing you prefer. In my experience, most patients are very satisfied with their decision of having breast reduction surgery and immediately have relief from shoulder and back pain. You can also see how their posture changes as they feel more confident with their body. Nevertheless, I strongly believe in educating my patients about all aspects of the procedure including, pros, cons, and possible risks and complications. The more they know about the procedure and how it would impact their lives, the more confident, calm and prepared they feel about the big change their body is about to undergo.” Says Mr Allen Rezai, a leading Consultant Plastic and Reconstructive Surgeon of Harley Street, London.

In this article, Mr Allen Rezai recommends five things you should know about breast reduction surgery but it does not replace the necessity of a one to one, thorough consultation with a qualified and experienced plastic surgeon, it is only then you can decide whether breast reduction is right for you. Having more information and a clear expectation about what’s next will help you make an informed decision and to better manage your post-op recovery so that you have the best possible experience out of your surgery.

Carrying extra weight on your chest can cause significant physical and psychological distress and many times, due to the negative impacts large breasts have on an individual, patients assume they can reduce the size of their breasts without any limitations. But that is far from the truth. Having an image in mind of the size you want to achieve and discussing it with your surgeon is a good idea. But the truth is that there are limitations as to how much tissue you can remove from a breast, without causing complications. What is important is to ensure that your new breasts are symmetrical, balanced and in proportion to your frame.

When it comes to breast reduction surgery, there are various options, in terms of incision patterns. It is important that you know your options and why one option may be more suitable for you and your circumstance, than the other.

The choice of incision pattern mainly depends on the extent of the reduction. Sometimes with small breast reductions in patients with mainly fatty breast tissue, minimal excess skin and good skin elasticity, liposuction may be employed. However, if you need to remove loose skin and glandular tissue, then a lollipop incision is required, which leaves a scar around areola and a vertical scar from the areola to the inframammary fold (breast crease). For more extensive reductions, the inverted T pattern also known as the anchor or Wise pattern, is used. This has same two incisions as the lollipop and an additional scar that runs along the inframammary fold.

It is important that your options are discussed with you at length during your consultation, especially type of incision pattern that would provide you with the best possible outcome. Consult, 1, 2, 3 or even more experienced and qualified plastic surgeons, until you are satisfied with the reasons why a certain treatment plan is suitable for you. Take your time, do your research and ask questions until everything is clear, it is only then that you can make an informed decision about your surgery.

The impact on your ability to breast feed following a breast reduction surgery will depend upon the extent of the procedure. During breast reduction, breast tissue is removed and the nipple and areola is re-positioned. Milk ducts may be damaged or reduced in the process resulting in a lower milk production. This can in turn make breast feeding harder after surgery.

I always discuss with my patients, the option of waiting to have surgery until they feel their family is complete, not only because of the ability of breast feeding but also because pregnancy and weight gain will most definitely affect the size of their breasts and would require further surgery. But many times, they find the neck and back ache, and other physical and psychological implications with large breasts, unbearable and for them the positives with surgery, outweigh the negatives.

Recovery after Breast Reduction is very individual, and depends on the extent of the reduction. Many are able to return to work and resume their normal daily routine within 10-14 days post-op. However, strenuous activities, exercising, and heavy lifting should not be resumed until 6-8 weeks post-op, after you have the all clear from your surgeon.

In terms of outcome, it takes time for the breasts to settle into their final shape and position. The tissue needs time to recover and settle after surgery, your body needs time to heal but week by week you’ll start noticing positive changes, and the final result will become obvious in six to twelve months. If you do not have any problems with scarring, your incisions should fade into fine lines after one year.

Depending on what stage in your life you have the breast reduction surgery, further surgery may be needed at some point in the future, especially if you have breast reduction in your 20s or before completing your family. Breast size and shape can and most likely will change with pregnancy, breastfeeding or significant weight fluctuations. And sometimes even hormonal changes can cause significantly increase the breast size.

While most patients are happy with their choice of breast reduction surgery, it is important to understand that every woman has a different anatomy and the “perfect” breasts you are imagining may not be realistic on your frame. There are limitations as to how much breast tissue can be removed without increasing the risk of complications. After the surgery, your breasts will not only be smaller, they may also be a different shape, and in a different position on your chest. And there is also the scarring to consider, although in most cases, scars heal and fade into fine lines, sometimes, this is not the case and you may develop keloid (raised) or hypertrophic (wide) scarring. If your body has a tendency to develop such scarring, then it is inevitable regardless of how skilled your surgeon is or what aftercare measures are in place to reduce the risk of scarring. Some skin types are more prone to developing this type of scarring than others, and this can be assessed during your consultation, especially if you have had any previous surgery.

Before you decide on getting breast reduction, it is really important to consider what is it that you want to achieve, the pros and cons, and discuss your expectations with your surgeon to get a clear picture of how your breasts will change.

Unrealistic expectations will lead to disappointment, even if a surgery is extremely successful.

To conclude, we asked Mr Allen to provide a list of what he believes to be the most important considerations to be taken into account when contemplating Breast Surgery and choosing a surgeon. The following was his reply in the form of a simple but comprehensive check-list: