Breast Reduction Surgery
In a recent newsletter, Dr Jenaleen Law wrote an article on breast reduction surgery for GPs.
What is Breast Reduction Surgery?
Breast reduction (reduction mammaplasty) is a common plastic surgery procedure that removes excess breast tissue, fat, and skin to make the breasts smaller, lighter, and lifted, whilst creating a shape proportionate to the woman’s body. This procedure can make a significant difference to quality of life. Many patients first present to their GP with symptoms related to large, heavy breasts, and your role in assessment, referral, and ongoing support is key
What are the Indications for Surgery?
Women may seek breast reduction due to:
Physical symptoms – neck, shoulder, and back pain; shoulder grooving from bra straps; skin irritation, rashes or infections in the inframammary fold.
Functional limitations – difficulty with exercising or finding suitable clothing.
Psychological or social concerns – emotional distress, self-consciousness, or lifestyle restrictions.
What Does Surgery Involve?
Surgery is performed under general anaesthesia, and may involve an overnight hospital stay. The surgeon typically makes an incision around the nipple and areola, extending down the breast and often along the inframammary fold. Excess skin, fat, and breast tissue are removed to reduce size, while the breast is lifted and reshaped at the same time. Liposuction is sometimes used, including as an adjunct procedure to remove excess fat along the bra straps and lateral chest wall, helping to improve contour and reduce bulges.
What are the Risks and Considerations?
As with all surgery, risks include bleeding, infection, wound healing problems, and scarring. Breast reduction may cause changes in nipple sensation, difficulty breastfeeding, fat necrosis, and asymmetry. Rarely, nipple or skin loss can occur. Scars are permanent but usually fade. Long-term outcomes are generally very good with high patient satisfaction rates.
What Should I Cover in a GP Consultation before Referral?
Document symptoms and physical findings, including the impact on the patient’s daily life.
Offer conservative measures to alleviate symptoms (supportive bras, physiotherapy, weight loss if appropriate).
Provide counselling and advice on smoking cessation. Smoking impacts wound healing from surgery.
Ensure that patients in the BreastScreen age group are up to date with their screening.
Provide referral to a specialist plastic surgeon for discussion of suitability, surgical technique, and expected outcomes.
What is the GP’s Ongoing Role after Surgery?
After surgery, GPs can perform wound checks, provide reassurance about normal healing such as swelling and bruising, and identify any complications that require early review by the plastic surgeon. In the long term, GPs should monitor for new breast pathology, ensure patients continue routine breast screening, and encourage maintenance of a healthy weight.
What is the Take-Home Message?
Breast reduction surgery is a safe and effective procedure that can provide longterm relief of physical symptoms and significantly improve quality of life. As the first point of contact, GPs play a vital role in recognising candidates, offering supportive advice, and facilitating referral to specialist care.
Dr. Jenaleen Law
Specialist Plastic and Reconstructive Surgeon
MED0001775113
