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The procedure:

This procedure should be carried out by a surgeon with relevant skills and experience in an establishment registered with the Healthcare Commission.

Breast reduction involves a surgical operation to remove fat, glandular tissue and skin from the breast. The operation usually lasts between two and four hours and takes place under a general anaesthetic, although some surgeons in some cases may use local anaesthetic and sedation.

The surgeon will make an incision around the areola (the brownish area around the nipple), vertically down the breast and then along the natural crease beneath the breast. He or she then removes excess tissue and skin, and moves the nipple and areola into their new positions. Skin from both sides of the breast is then pulled down and around the areola, making the new shape of the breast. Any excess fat can then be removed.

In most cases, the nipples remain attached to their blood vessels and nerves as they are being moved. However, if the breasts are very large, the nipples and areolas may have to be completely removed and grafted into a higher position - this may result in a loss of sensation in the nipples and areola.

You will be required stay in hospital overnight, to take approximately two weeks off work to rest and should avoid lifting and physical exercise for about six weeks. It is important that the breasts are well supported by means of a firm dressing initially and then by a supportive bra. The sutures will be removed between seven and fourteen days and it is important to keep the incision sites out of the sun for one year.

The results:

After a breast reduction, the breasts should appear smaller. The results are usually permanent, but your breasts may subsequently increase in size if you gain weight or if there are hormone changes within your body.

The risks:

General risks associated with surgery - see Considering cosmetic surgery?

Like all surgery, this procedure leaves permanent scars which initially may be lumpy and red but which normally fade close to your natural skin colour over several months. These scars may be more noticeable, eg wider, if you smoke, and may leave a puckered edge on the outside of the scar. The procedure may also leave you with breasts that are not both the same size, asymmetrical nipples, or a permanent nipple loss, or loss of feeling in your nipples or breasts. You may also be unable to breastfeed in the future. Whilst the surgeon will tell you if it is possible to correct any existing asymmetry, this may not always be possible.

• Considering cosmetic surgery?

Before you start:

It may be that your breasts are large due to fatty deposits within them. Reducing your overall weight through healthy dieting or regular exercise could therefore also reduce the size of your breasts.

Also see:

• Nipple reshaping
• Breast uplift