Breast reduction. This procedure is often used in combination with a Wide Local Excision to treat breast cancer and allows a large amount of breast tissue to be excised whilst achieving a good cosmetic result.
A mammoplasty is an operation that reduces the size of the breast. There are different types of mammoplasty that use different incisions and a variable amount of size reduction is achieved.
There are a number of reasons to have a mammoplasty. Women may choose this operation to reduce their breasts if they are large and are causing discomfort. A mammoplasty may also be combined with a cancer operation as a way of taking a large amount of breast tissue around a tumour whilst giving a good cosmetic result, this is called a Therapeutic or Adaptive Mammoplasty. Often both breasts will be operated on to get a symmetrical result but the opposite breast may be operated on at a later date especially when the procedure is done for cancer so as not to avoid any delay to further treatment.
You will have a general anaesthetic. The incision will depend on the type of mammoplasty you are having, this will be discussed with you before your operation. The incision may be only around the areola, it may extend from the lower aspect of the areola towards the lower half of your breast or it may also extend across the inframammary fold (fold between the breast and abdominal wall). A variable amount of skin is removed to decrease the overall “pocket” of the breast. A variable amount of underlying breast tissue is removed depending on what is required for you. If you are having a mammoplasty as part of your cancer treatment, the tumour and a cuff of normal tissue around it is removed. The nipple and areola are maintained on a pedicle of breast tissue which is able to supply blood to this area. At the end of the operation, the remaining breast tissue is joined together, the nipple and areola are repositioned and the wounds are closed with dissolvable sutures. You will have a drain in place. Waterproof dressings are placed.
Bleeding. Infection. Decreased sensation of the nipple/areola. Necrosis of the nipple/areola/wound edges. If done as part of a cancer operation there is a 20% risk of needing a further operation to get better margins or take more lymph nodes. Some people will require further operations to achieve symmetry, for example, an operation on the opposite breast.
If required, you will have a tracer injected at Waikato the day before your operation for a sentinel node biopsy. If required, you will have a wire placed by a radiologist on the morning of surgery (for breast cancer that cannot be felt). You will be admitted on the day of your operation. You cannot eat or drink for 6 hours before the procedure.
You will stay in hospital for two nights. You will have a drain in that needs to remain until it is less than 30ml per day. The District Nurse will monitor this and remove it. It is recommended to wear a supportive bra that has no underwire and does up at the front. You will need to take regular pain relief. You will have a follow-up appointment in the rooms in 3 weeks time once your results are available.