Breast Reduction Surgery

Before you undergo any plastic surgery procedure at Karidis Clinic, you will have a consultation and a pre-operative assessment with your plastic surgeon. They will listen carefully to your concerns and what you expect to achieve and discuss which procedure, or combination of procedures, is appropriate.

At this stage, they will also ensure you are fully aware of the potential risks and complications inherent in that specific procedure and explain to you what you can expect immediately after surgery, throughout the recovery process, and when you will likely see the final results.

During the pre-operative assessment, the surgeon may take measurements of the area to be operated on and assess your skin tissue quality and the degree of skin laxity. The position of the incisions will also be decided upon.

A full medical history will be taken to ensure you are fit and well and can undergo surgery at this time.

After the initial consultation, there will be a two-week ‘cooling-off’ period before you can decide to proceed with surgery. You are welcome to return for further consultations with your Karidis Clinic surgeon, free of charge, if you have more questions.

If you make the decision to proceed with surgery, you’ll be given advice on how best to prepare for your operation, and you will have a dedicated Patient Coordinator who can answer any queries you may have.

Any pre-surgery tests can occur at the Hospital of St John & St Elizabeth, a leading London private hospital where Karidis Clinic is based. The hospital has recently built a new wing including a diagnostic department with the latest X-ray, MRI, CT and ultrasound technology.

We advise patients to stop smoking as soon as possible as nicotine acts as a vasoconstrictor, which impedes the flow of oxygen-rich blood to the surgical site. This can slow down healing, increase the chance of infection and even cause tissue to die. Smoking also increases the risks of a general anaesthetic, and smokers are more likely to suffer ill effects from an anaesthetic.

You will also be advised when to discontinue taking aspirin or other blood-thinning medication in advance of your operation. You will be asked to fast six hours before surgery.

All Karidis Clinic procedures are performed at the Hospital of St John & St Elizabeth. When you arrive, you’ll be greeted and taken to your stylish and luxurious private room with its spacious ensuite bathroom.

The nursing team will take your blood pressure and relevant vitals, and you will see your Karidis Clinic surgeon, who will make the final mark-ups. Our anaesthetist will also visit you.

Clinical photography will be taken to assist in your care and to enable clinical assessments to be made. These become part of your confidential medical record. These include photographs of the operation site and any distinguishing features and will be taken pre-op and post-op. 

Your procedure will be performed under a general anaesthetic, and once the surgeon has sutured the incision site, you will be taken to a specialist recovery room.

Once the hospital nursing team has ensured your recovery is complete, you will be taken to your hospital room for your overnight stay. The hospital nursing team will be on hand throughout the night, and you will be fitted with compression stockings and a compression device if required.

The following day, you will be visited by your Karidis Clinic surgeon or nurse and then discharged into the care of a friend or family member by the hospital nursing staff.

The pain and discomfort experienced after surgery are unique to the individual patient and the extent of their procedure. However, it should start to subside in the first week and should be easily managed with over-the-counter painkillers.

If necessary, you’ll be advised to wear a specially designed surgical support garment for approximately six weeks after surgery to support you during the healing process.

Depending on the nature of your job, you can usually expect to be able to return to work and normal activities between one to two weeks.

You’ll be given a comprehensive plan for the recovery process, including dates for your cast or suture removal and your check-ups with your Karidis Clinic surgeon. However, we are always on hand throughout this period, and you have access to our dedicated surgical nurse 24/7 if you have any concerns.

Before you go down to theatre, your surgeon will use a marking pen to draw on your breasts in order to determine the exact position and size of your newly operated breasts. Your surgeon will then show you approximately where the new breast and nipple position will be placed.

Breast reduction surgery is possibly one of the most demanding aesthetic procedures, so it’s important to talk to your surgeon and be open about your wishes. Explain to them how little or large you would like to be following your surgery. This will minimise the possibility of having too little or too much removed. 

Your excess breast tissue, fat and skin are then removed. 

During the operation, the nipples are preserved on a stalk of breast tissue and repositioned by moving them to a new higher location, all following the preoperative markings. So as well as a breast size reduction, you’ll also benefit from a breast uplift as well. The nipple is usually positioned in a line level with approximately the middle part of your arm or the level of your under breast crease.

The scar is situated around the nipple and extends vertically downwards to the crease under your breast. A small horizontal scar within this crease is also needed. Although our surgeons’ technique avoids the older type of long anchor scars, these are very occasionally needed to get the best result. Your surgeon will be able to discuss this with you during your consultation and show you precisely where these will be situated. 

Once your surgery is complete, surgical tapes and light dressings are applied over the suture lines. All sutures used are of the dissolving kind and won’t need to be removed. You’ll also then be asked to wear a firm sports bra for support.

Our surgeons don’t use drains routinely, without any adverse effects. This means that you won’t need any drains to be removed from your breasts after the surgery.

Our surgical understanding, techniques and instrumentation have improved over the years and our surgeons take advantage of all these to deliver the best results.

As an added bonus with these new techniques, pain is significantly improved compared to the surgery performed a few years ago. Most of our patients who have breast reduction surgery complain of only mild to moderate discomfort after surgery and this is well controlled with painkillers. Plus, the pain usually improves and dissipates after the first 4-5 days.

Scars are not a complication but a normal event after any surgery. Even though in recent years the scars in breast reduction surgery have become smaller and finer, scars still may take many months or years to settle. However, as the scars are around and below the nipples, these shouldn’t be noticeable even in low-cut clothing or a bathing suit. You should always expect scars to be red, raised, lumpy and even itchy to begin with but with time they should fade and flatten. This is the natural evolution of the healing process. It’s important to keep in mind that this may take up to two years to complete.

Daily massage of the scars during this time period is advised to expedite and facilitate this process. You’ll also be provided with scar-reducing plasters and gel in order to improve the appearance of your scars. No surgeon can predict the final appearance of your scars, but you can have peace of mind that at Karidis Clinic our surgeons have honed their skills and are renowned for their results. 

You’ll need to wear the sports bra continuously for six weeks (apart from when washing) after surgery. It’s also important to avoid any strenuous upper body exercise for at least six weeks.

Learn more about the breast reduction recovery timeline.

Whilst it is true that when a breast reduction is performed by an experienced qualified plastic surgeon the risks are small, nonetheless, specific complications with this procedure can and do occur. As in any procedure, the risk of significant infection is always possible. This is minimised by careful surgical technique and the preventative administration of antibiotics at the time of surgery.

However, despite these measures, mild infection is relatively common and can occur around the incision sites, but usually subsides over a period of about two weeks. Risks such as leg and lung blood clots are very rare. Early mobilisation by moving around as soon after the surgery as possible reduces this considerably.

Our surgeons regularly use anti-clotting measures such as special stockings (TEDS) and compression devices (Flowtron) during your surgery to minimise this. As mentioned already, swelling should be expected after this operation. When mild or moderate swelling is present, the body rapidly reabsorbs this.

Very occasionally (less than 1% incidence), increased bleeding can lead to more significant swelling and the development of a haematoma (a collection of blood under the skin). If this were to happen, surgical drainage to evacuate this would be required.

Ultimately, however, this should not affect the final outcome. As described in the surgical details, during the operation, your nipples are preserved on a stalk of breast tissue and repositioned. In the vast majority of patients, these remain natural, with normal contraction and some sensitivity. Very rarely however the stalk of the breast tissue develops inadequate blood supply to maintain nipple viability and some sloughing of part, or even more rarely, the entire nipple can occur. This complication will mean that prolonged dressing will be required over the nipple area until natural healing occurs.

It’s then possible that some reconstruction of the nipple as a secondary procedure may be required. Thankfully with modern techniques, this complication is very rare (less than 1%).

During the first 2 -3 weeks after surgery, some patients may also experience a minor loss of wound adhesion, suture extrusion, or even chafing of the skin at any point of the incision sites.

One of the most common sites is the point where the vertical scar meets the nipple and or the under-breast crease. This is a temporary complication, which will require regular dressing changes initially. Eventually, a scab develops over this, which subsequently separates after 3-4 weeks. A padded dressing for a period of a few weeks decreases the likelihood of this occurring. However, some distortion of the skin around the scar may ensue. Further revision surgery may occasionally be required if necessary.