Mastopexy or Breast Reduction

Mastopexy or Breast Reduction

General surgery
Surgical procedure information leaflet
Name of procedure: Mastopexy or breast reduction

A mastopexy (or breast uplift) involves the removal of excess skin from sagging or
droopy breasts. The drooping (or ptosis) may occur after pregnancy, weight loss or
with loss of skin elasticity due to ageing. During the operation the excess skin is
removed and the nipple area is moved with its’ own blood supply to a higher position
on the newly created breast form.

A breast reduction involves the removal of breast tissue and skin to form a smaller
breast with the nipple area also being moved to a higher position.

This leaflet explains some of the benefits, risks and alternatives to the operation. We
want you to have all the information you need to make the right decision. Please ask
your surgical team about anything you do not fully understand or want to be explained
in more detail.

We recommend that you read this leaflet carefully. You and your doctor (or other
appropriate health professional) will also need to record that you agree to have the
procedure by signing a consent form, which your health professional will give you.

Benefits of the procedure
The aim of your surgery is to change the cosmetic appearance of your breast(s). The
cosmetic results achieved from a mastopexy or a breast reduction can have an
extremely positive effect of a person’s confidence, self image and self esteem.

Serious or frequent risks
 Everything we do in life has risks. There are some risks associated with this type
of surgery. The general risks of surgery include problems with:
o the wound (for example, infection); and
o blood clots (for example, in the legs or occasionally in the lung).

Those specifically related to breast surgery include problems with the following.
o Scarring
 There will be scarring around the outer edge of your nipple
(areola), down the middle of your breast and along the crease
underneath your breast. These scars usually fade over time.

Scar line down the
middle of breast
Nipple (areola)
Scar line in the crease
underneath breast

o Bruising
 Bruising is very common after surgery and will usually resolve after
a few weeks.
o Nipple loss
 It can sometimes happen, although rarely, that the blood supply to
the nipple fails. If this should happen it is possible that the nipple or
small area of nipple may be lost.
o Nipple sensation
 You may experience a loss or reduction of nipple sensation.
o Breast sensation
 You may experience some numbness but this usually improves
with time.
o Breast feeding
 You will not usually be able to breast feed due to the disruption or
loss of milk ducts.
o Wound breakdown
 There is a possibility of a wound breakdown where the wound
down your breast meets the wound along the crease of your breast
(T junction). If this happens it may be necessary for you to see the
Breast Care Nurse or Practice Nurse for dressings until the area
has healed.
o Fat necrosis
 During the operation areas of fat within your breast are moved.
This can sometimes lead to a loss of blood supply to small areas of
fat and this may be felt as small lumps underneath your scar.
o Haematoma (blood clot)
 This is rare but should it happen it may require a return to theatre
to remove the clot.

Sometimes, more surgery is needed to put right these types of complications.

Most people will not experience any serious complications from their surgery. The
risks increase for elderly people, those who are overweight and people who already
have heart, chest or other medical conditions such as diabetes or kidney failure. As
with all surgery, there is a risk that you may die.

You will be cared for by a skilled team of doctors, nurses and other health-care
workers who are involved in this type of surgery every day. If problems arise, we will
be able to assess them and deal with them appropriately.

Other procedures that are available
There are no alternative procedures available.

Your pre-operative assessment
Before you are admitted for your operation, you may be required to attend for a pre-operative assessment, to ensure that you are fit for surgery. It is important that you
attend for this appointment to avoid delaying your surgery.

Not all patients require a detailed pre-operative assessment and a health
questionnaire is used to determine which patients require a full assessment. The
health questionnaire may be on paper or on a tablet/computer. The information
required includes all medical conditions, regular medications, allergies to medications
and your previous anaesthetic history. The information you give will be reviewed by the
pre-operative assessment team. If you require further assessment you will be given an
appointment to attend the pre-operative assessment clinic.

At the clinic, the nursing staff will confirm the medical information you have previously
given and some further tests may be required, such as a blood test, X-ray, heart or
lung test. If a more detailed assessment or discussion is required, you may see an
anaesthetist prior to your admission for surgery. This may require an additional
appointment.

If you are taking prescribed medicines, please bring a copy of your repeat prescription
to your appointment and a copy of the operation consent form (if you were provided
with a copy at your out-patient appointment).

Following your assessment, the staff will provide you with written information regarding
preparation for your surgery and a point of contact. It is important that you follow the
fasting instructions given on your admission letter.

Being admitted to the ward
You will be admitted on the day of your surgery. You will be welcomed on to the ward
and your details checked. We will fasten an armband containing your hospital
information to your wrist.

You will usually be asked to continue with your normal medication during your stay in
hospital, so please bring it with you.

Your anaesthetic
Your surgery will usually be carried out under a general anaesthetic. This means that
you will be asleep during your operation and you will feel nothing.

Before you come into hospital
There are some things you can do to prepare yourself for your operation and reduce
the chance of difficulties with the anaesthetic.
 If you smoke, consider giving up for several weeks before the operation.
Smoking reduces the amount of oxygen in your blood and increases the risks of
breathing problems during and after an operation. Using a vaporiser instead of
smoking may help the lung and breathing issues but does not significantly
reduce the risk of post-operative wound problems.

 If you are overweight, many of the risks of anaesthesia are increased. Reducing
your weight will help.

If you have loose or broken teeth or crowns that are not secure, you may want to
visit your dentist for treatment. The anaesthetist will usually want to put an
airway in your mouth to help you breathe. If your teeth are not secure, they may
be damaged.

 If you become unwell or develop a cough or cold the week before your surgery,
please contact the pre-operative assessment team on the number provided.
Depending on your illness and how urgent your surgery is, we may need to delay
your operation as it may be better for you to recover from this illness before your
surgery.

Your pre-surgery visit by the anaesthetist
 After you come into hospital, the anaesthetist will come to see you and ask you
questions about:
o your general health and fitness;
o any serious illnesses you have had;
o any problems with previous anaesthetics;
o medicines you are taking;
o allergies you have;
o chest pain;
o shortness of breath;
o heartburn;
o problems with moving your neck or opening your mouth; and
o any loose teeth, caps, crowns or bridges.

 Your anaesthetist will discuss with you the different methods of anaesthesia they
can use. After talking about the benefits, risks and your preferences, you can
then decide together what is best for you.

On the day of your operation
Nothing to eat and drink (nil by mouth)
It is important that you follow the instructions we give you about eating and drinking.
We will ask you not to eat or drink anything for six hours before your operation. This is
because any food or liquid in your stomach could come up into the back of your throat
and go into your lungs while you are being anaesthetised. You may take a few sips of
plain water up to two hours before your operation so you can take any medication
tablets. Please refrain from chewing gum.

Your normal medicines
Continue to take your normal medicines up to and including the day of your surgery. If
we do not want you to take your normal medication, your surgeon or anaesthetist will
explain what you should do. It is important to let us know if you are taking
anticoagulant (blood thinning) drugs.

Your anaesthetic
When it is time for your operation, a member of staff will take you from the ward to the
operating theatre. They will take you into the anaesthetic room and the anaesthetist
will get you ready for your anaesthetic. To monitor you during your operation, your
anaesthetist will attach you to a machine to watch your heart, your blood pressure and
the oxygen level in your blood.

General anaesthetic
General anaesthesia usually starts with an injection of medicine into a vein. A thin
plastic tube (cannula) will be placed in a vein in your arm or hand and the medicines
will be injected through the tube. Sometimes you will be asked to breathe a mixture of
gases and oxygen through a mask to give the same effect.

Pain relief after surgery
Pain relief is important to aid your recovery from surgery. This may be in the form of
tablets, suppositories or injections. Once you are comfortable and have recovered
safely from your anaesthetic, we will take you back to the ward. The ward staff will
continue to monitor you and assess your pain relief. It is important that you report any
pain you have as soon as you experience it.

What are the risks?
The risk to you as an individual will depend on whether you have any other illness,
personal factors, such as smoking or being overweight and surgery that is complicated
or prolonged. General anaesthesia is safer than it has ever been. If you are normally
fit and well, your risk of dying from any cause while under anaesthetic is less than one
in 250,000. The side effects of having a general anaesthetic include drowsiness,
nausea (feeling sick), muscle pain, sore throat and headache. There is also a small
risk of dental damage. Your anaesthetist will discuss the risks with you and will be
happy to answer any questions you may have.

After your surgery
 You will be taken to the recovery room to the general or day care ward. You will
need to rest until the effects of the anaesthetic have worn off. You will have a drip
in your arm to keep you well-hydrated.

 You will be encouraged to get out of bed and move around as soon as possible,
as this helps prevent chest infections and blood clots.

 Your surgical team will assess your progress and answer questions you have
about the operation.

Leaving hospital
Length of stay
How long you will be in hospital varies from patient to patient and depends on how
quickly you recover from the operation and the anaesthetic. Most patients having this
type of breast surgery will be in hospital for 1-2 days.

Medication when you leave hospital
Before you leave hospital, the pharmacy will give you any extra medication that you
need to take when you are at home.

Recovery
How long it takes for you to fully recover from your surgery varies from person to
person. It may take up to 4 to 6 weeks. You should consider who is going to look after
you during the early part of this time. You may have family or close friends nearby who
are able to support you or care for you in your home during the early part of your
recovery period or you may consider going to stay with relatives

Stitches
Your wound will be closed with dissolvable stitches, surgical glue and/or steristrips
(paper stitches). Please keep your wound dry for the first 48 hours.

Drain
You may have a surgical drain to help remove excess fluid from the wound. You will
be shown how to manage the drain or, if required, a district nurse will be arranged by
the ward to contact you once you are home. You will be given instructions as to when
and where the drain is to be removed.

Personal hygiene
After 48 hours you may bathe and shower as normal, but try not to soak the dressing.

Exercise
Please read the exercise sheet in your Information Folder. These exercises can be
started on the second day following your operation and will help to keep your
shoulders supple. Try to go for a daily walk.

Sex
You can continue sexual activity as soon as you feel comfortable.

Driving
You should not drive until you feel confident that you could perform an emergency stop
without discomfort. It is your responsibility to check with your insurance company
regarding your insurance cover after an operation. You do not need to notify the DVLA
of surgical recovery unless it is likely to affect driving and persist for more than 3
months.

Work
How long you will need to be away from work varies depending on:
 how quickly you recover
 how your wounds heal
 whether you need further surgery or other treatments
 whether or not your work is physical
You can usually begin gentle work within a week or two, but you might need to wait a
little longer before resuming more vigorous activity. If you need a medical sick (FIT)
note for work for the first two weeks after your surgery, please ask the nurses on the
ward prior to being discharged.

Emotional support
It is not uncommon to feel a bit ‘down’ after any operation so do ask your doctor or
breast care nurse if you feel you need more psychological support.

Outpatient appointment
Before you are discharged we will give you a follow-up appointment to come to the
outpatient department, or we will send it to you in the post.

Contact details
If you have any specific concerns that you feel have not been answered and need
explaining, please contact the following.

Worcestershire Breast Unit

Telephone: 01905 760261
Email: [email protected]

If your symptoms or condition worsens, or if you are concerned about anything,
please call your GP, 111, or 999.

Patient Experience
We know that being admitted to hospital can be a difficult and unsettling time for you
and your loved ones. If you have any questions or concerns, please do speak with a
member of staff on the ward or in the relevant department who will do their best to
answer your questions and reassure you.

Feedback
Feedback is really important and useful to us – it can tell us where we are working well
and where improvements can be made. There are lots of ways you can share your
experience with us including completing our Friends and Family Test – cards are
available and can be posted on all wards, departments and clinics at our hospitals. We
value your comments and feedback and thank you for taking the time to share this with
us.

Patient Advice and Liaison Service (PALS)
If you have any concerns or questions about your care, we advise you to talk with the
nurse in charge or the department manager in the first instance as they are best
placed to answer any questions or resolve concerns quickly. If the relevant member of
staff is unable to help resolve your concern, you can contact the PALS Team. We offer
informal help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf,
if you feel unable to do so, to resolve your problems and where appropriate refer to
outside help.

If you are still unhappy you can contact the Complaints Department, who can
investigate your concerns. You can make a complaint orally, electronically or in writing
and we can advise and guide you through the complaints procedure.

How to contact PALS:
Telephone Patient Services: 0300 123 1732 or via email at: [email protected]

Opening times:
The PALS telephone lines are open Monday to Friday from 8.30am to 4.00pm. Please
be aware that you may need to leave a voicemail message, but we aim to return your
call within one working day.

If you are unable to understand this leaflet, please communicate with a member of
staff.

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