Breast reduction is a surgical procedure in which the volume of breast tissue is reduced, the breast reshaped, and the nipple repositioned to a higher position. It carries one of the highest patient satisfaction rates of any cosmetic surgery procedure. In addition to the improvement in the cosmetic appearance of the breast, many women notice an improvement in physical symptoms such as skin rashes, shoulder grooving from bra straps, and neck/ back pain (assuming there is no other underlying cause). In addition, clothing selection and participation in exercise tend to become easier, which contributes to the increased self-confidence often seen after this operation.

When I perform a breast reduction operation, my aim is to create smaller, more shapely breasts, in keeping with my patient’s wishes and in proportion to her frame. In so doing, I hope that the surgery improves both physical and psychological symptoms, and to enables my patients live more active, less self-conscious lives. As with all cosmetic procedures I perform, I view the decision to go ahead with surgery, and the planning of that operation, as a process that my patient and I go through together. For that reason, I usually suggest that we meet twice prior to going ahead with surgery.

Many different surgical techniques exist, and the one chosen depends on the existing and desired size and shape of the breast, the patient’s build, and certain technical aspects of the surgery. The aim is to create new, smaller, and more pert breasts, that are in proportion with the rest of the patient’s body. The size of the areola (the darker skin around the nipple) is usually reduced as part of the procedure. In all cases, there will be a scar around the nipple, with a further scar running vertically downwards from this (the ‘lollipop’ scar). In some cases, there will also be a scar running in the crease under the breast (the ‘anchor’ scar). The scars used on both breasts are usually the same, unless there is a significant asymmetry between the breasts to begin with. The proposed scars will be discussed in detail with you prior to your surgery.

Other considerations

A number of different factors determine the size of women’s breasts. These include hormonal influences, body weight, and genetics. Because of this, large breasts trouble different women at different stages in life (e.g. during adolescence & early adulthood, or following menopause or the use of HRT). Traditionally, women were advised to defer breast reduction surgery until after they had completed their families, however I realise that this is not a realistic solution for many of women. I do however advise waiting until the size of the breasts has stabilised before proceeding with surgery, in order to give the best long term result.

Unfortunately having a breast reduction does not make the breasts immune from the effects of time, gravity, and pregnancy! The breasts will gradually droop over time, and weight gain and loss will be reflected in breast size and skin quality. Not uncommonly, women seeking this surgery are somewhat overweight, and my best advice is that if you are significantly overweight, or in the process of losing weight, that you are best to defer surgery until you reach your goal weight. This is not to make the breasts smaller, but rather to make the anaesthetic and operation as safe as possible, and to give the best possible long-term result. Having said that, there is no point losing lots of weight to be at an ‘ideal weight’ for surgery, only to gain it all back later, and for this reason, it is best for surgery to be performed at a stable weight that can realistically be maintained.

Having a breast reduction does not affect your chances of developing breast cancer, or the chances of breast cancer being picked up. For reassurance, tissue removed during surgery is sent for histological analysis. If you are due for a mammogram, this should be done prior to surgery, as it will be uncomfortable and inadvisable to have it done shortly after surgery. Following surgery, it is important that you let the referring doctor and radiographer doing any mammograms know that you have had a breast reduction, as post-surgical changes may be visible on the scan, and are usually readily identified as such so long as the radiologist is aware of your history.

Breast reduction surgery may be funded by the health insurance companies. Exclusion periods apply, so if a patient has recently changed policy or insurer, they  may not be covered.

In cases where a patient meets specific criteria set down by the health insurance companies, it may be possible to have the surgery funded by a health insurer. Following a consultation, during which a patient's eligibility for health insurance cover will be assessed, Ms Fitzgerald can then write to the health insurer requesting pre-approval for the procedure to be covered by insurance. On receipt of this approval, the procedure can then be scheduled.

A GP referral letter is required, where a patient intends to use their insurance to fund surgery.

Where a patient does not have health insurance, does not wish to wait for the approval process, or does not meet the criteria stipulated by the insurance company, this procedure is provided on a self-pay basis.