Breast reduction and breast uplift (mastopexy) are a family of procedures with similar principles that allow us to provide reduction, symmetry, projection, uplift, nipple areolar shape – in short: “breast balance”
Reduction mammaplasty or breast reduction removes excess breast tissue from the breast, elevates, shapes and projects the breast, and redrapes the skin, with nipple repositioning to provide a healthy, uplifted and reduced breast aesthetic for femininity, comfort and confidence.Mastopexy, or breast uplift, achieves an elevation, projection and reshaping of the breast, but without significant breast reduction. The two procedures are therefore a ‘continuum’ and part of the same ‘family’ of breast aesthetic procedures.Women of all ages seek breast reduction and/or uplift surgery for a variety of reasons and the changes in both their physical and psychological well-being are always appreciated.
The weight of large or pendulous breasts may cause a variety of medical problems such as back and neck pain, skin irritation and shoulder soreness from tight bra straps. Poor posture is common, not just from the weight of the breast but from postural problems as a result from trying to ‘hide’ a large bust. Large breasts cause lack of self-esteem and extreme self-consciousness. Similarly very pendulous (droopy) breast tissue will cause a drop in breast and nipple position, and loss of self-esteem, particularly outside clothing.
The reasons to choose breast reduction or uplift surgery are often personal and bespoke. The result, a lighter, uplifted breast, will literally ‘lift the weight’ off your shoulders giving the freedom to wear an open choice of clothing, participate in sports and exercise and feel confident, feminine and sexy.
There are many different techniques of breast reduction and/or mastopexy which are dependent on the individual aims for quality of life, the overall height and figure of the patient and the quality of the breast, skin and nipple.
There is always a circular scar around the nipple, and usually a continuous vertical scar running from the nipple to the fold beneath the breast. A transverse scar may also be used which runs along the crease beneath the breast. The length of the overall scars reflects the amount of breast skin removed. Breast scars are visible initially and with excellent scar management these scars can be barely visible after 12 months post-surgery.
During the consultations that lead up to the surgery Jonathan will make measurements at the mirror to determine the correct repositioning of the nipple, and demonstrate the position of the scars.
Every breast demonstrates natural asymmetry and individual proportion relating to your frame, size, and figure. The amount of excess skin, and the reshaping of the breast, is calculated along with the breast ‘height’ to achieve a firmer, higher breast position, with projection and uplift. The aim is to restore the breast to the best anatomical position possible and a size that is in keeping with the patient’s natural body shape. The amount of breast tissue to be removed in breast reduction and the position from which it is taken, is also discussed, with a view to preserving sensation and safe blood supply. The proportions of the nipple and areola are calculated in the design in keeping with the new breast.
‘Breast confidence’ is intimately entwined with feminine sensibility, emotion and wellbeing. Loss of such confidence can therefore be very distressing, just as the restoration of feminine confidence by breast rebalancing surgery is personally and professionally rewarding.The sense of breast ‘disproportion’ is highly personal. The impact may be very physical, such as the heavy pendulous breast causing neck back and shoulder pain and loss of comfortable posture with all the risks of delayed spinal damage later. The skin under the breast can be affected with tendency for skin infections and rashes under the breast crease, with chaffing and excess sweating. The skin on a large breast is expanded and stretch marks are common along with distorted nipples, larger areolas (area around the nipple) and visibility of veins.
Alternatively, the impact may be mostly psychological and emotional, for example where a lax, pendulous, droopy breast causes embarrassment in changing rooms or personal relationships. The impact on personal life, the ability to partake in sport and exercise, and the ability for a freedom of choice in clothing can all be compromised by ‘breast disproportion’. The combination of physical and emotional challenges can cause social exclusion and deep unhappiness.
Increased breast size can occur at specific times of life, related to puberty, motherhood, and menopause, as well as weight fluctuations. Some women may have always had a naturally large or pendulous breasts all their adult life and hormonal changes or weight fluctuations have little affect on their size. There is not a cup size threshold in order to be considered suitable for breast reduction or uplift, the aim is to restore frame and proportion with breast confidence in daily life and body image. Women of all ages seek advice for breast reduction or uplift surgery, and these are some of the most satisfying procedures for life changing impact upon health and wellbeing.
One of the biggest concerns for women thinking of having breast rebalancing surgery is a fear of being ‘put to sleep’ for the operation. There is a guilt factor of putting oneself at risk, particularly with a young family, and fear over recovery time from a long anaesthetic.
In answer to this fear, we have developed very precise daycase general anaesthetic techniques, allied with very precise surgery, to make sure that the anaesthetic time is short but comfortable, the wake up time is quick and without nausea, and the recovery time is fast. The majority of aesthetic breast surgery with Jonathan is now daycase, with effective and comfortable outcomes and excellent patient reported experience.
The day case general anaesthetic technique is so well honed that the majority of our patients request a day case surgery under general anaesthesia for even quite large breast reduction procedures.
– Jonathan Britto –
We understand that it is a big step is for some women to come to a consultation about their breasts. It is your body, is deeply personal, and it matters.
The consultation is usually a 2-3 step ‘analysis phase’ at either our London or Essex clinics. Alternatively we can arrange a video consultation from the comfort of your own home.
1. Discretionary free-of-charge video-call
Jonathan will enjoy introducing himself to you in a free video-call to discuss your request. It would be very useful if you could send us some selfie photographs (to medsec@jonathanbritto.com; held securely as part of your medical record), which will help inform the conversation.
2. Face-to-face consultation
If you would like to receive a detailed written analysis, with a quote for treatment, Jonathan will meet you in clinic for a face-to-face appointment. You are welcome to bring a friend or family member for support. The medical history and physical analysis in the privacy of the consulting room is an essential part of making the treatment plan.
Mr Britto will firstly spend some time going through the options available and explaining the technicalities of the procedure. You will then be examined in a private, warm room providing you with your privacy and dignity and chaperones are provided if you wish. Diagrams and marking on the breast at the mirror are used to fully explain the plan, the technique and the scars which result.
After this meeting you will receive a detailed plan and a written quote, together with a suite of information about our ’twilight’ surgeries, relevant comments from prior patients, and some insights about the psychology and holistic care that is part of our commitment to you.
3. Face-to-face or remote catch up…
Jonathan recommends that you open a “procedure diary” on your phone, into which you can drop any questions that occur to you throughout the day, and after receiving the clinic letter and information from your face-to-face consultation.
This third conversation is to answer any questions you have, and to allow Jonathan to ask you about any reflections he has had to refine your care.
4. In truth, our door is always open, and Jonathan will be very happy to see you face-to-face or remotely if you have further questions about your requested procedure.
Consultation fees: £295 is charged prior to Step 2
Data Security:
Please be aware we use a data security software to encrypt any correspondence that we send you which includes your personal data. These emails may fall into your junk folder, so following your consultations please keep a regular check on this folder.
If you wish to receive un-encryped, ‘open’ email to your inbox – please can be requested via an online, ‘one click’ consent form.
You will leave the hospital with clean dressings, which stay on for a week and are changed in clinic. The sutures (stitches) dissolve and do not need removing. Showering is as normal with a gentle towel and hair dryer onto the skin and dressings. Bathing or swimming should be avoided. An unwired bra or close fitting ‘crop – top’ is worn for 6 weeks (day and night) and physical activity is restricted for one month until the tissues settle in their new position. The best sleep position is on the back, in a bra, to prevent movement of the tissues in position until all has healed. Driving, household chores and professional activity is usually after one week.
Every surgical procedure carries a potential risk, and in breast reduction and uplift surgery this relates to each aspect of the surgery, and each aspect of expectation of outcome. The physical risks relate mostly to poor healing of skin, incision, or nipple. The emotional risks relate to our expectations. All procedures for appearance change risk an ‘expectation gap’, which we shall discuss in detail to make sure that the surgery is a well – planned and appropriate choice.
The risks and responsibilities of each procedure are discussed and documented so that surgery will only proceed on an open and honest understanding.
No change.
it is widely documented and the experience within our practice that successful breastfeeding may occur after breast reduction and/or uplift procedures.
Successful breast feeding is a function of the very individual relationship between mother and child and the dynamics of breastfeeding relate to both emotional and physical factors. Failure to breastfeed after breast surgery may therefore be due to a wide range of influences other than the effects on the breast from surgery.
Nonetheless, both breast reduction and breast uplift rearrange the breast gland tissue and involve movement of the nipple and both of these surgical techniques in the breast will influence breast architecture. As a result breastfeeding may be compromised.
Yes.
Previous surgery to the breast by uplift or reduction does not rule out a further similar procedure. It is helpful to know the details, and the dates of what went before. The techniques of the secondary breast uplift/production can be modified accordingly to preserve the sensation and health of the breast tissues.
The cost of breast reduction and/or uplift surgery is divided into surgical fee, which includes a schedule of follow-up for one year (in practise unlimited), the anaesthetic fee, and the facility fees (hospital or clinic). A full explanation of terms and conditions, including fees for secondary surgery or return to theatre is provided during the ‘analysis phase’.
A breast reduction or uplift provides a feminine natural shape, and repositioning of the nipple to give a youthful appearance. The design of the surgery is unique to each individual patient and Jonathan is meticulous in his planning, and attentive in his listening, to achieve that comfortable, feminine breast to suit height, figure, and the personal activities of daily life that provide health and wellbeing for each individual.
