Jyoti started developing breasts earlier than most of the girls in her class. At just 11 years of age, when girls around her were running around playing carelessly, she started looking a little different. She was given her first bra which was itchy and tight and Jyoti just did not understand why she had to wear it!
By the age of 14, Jyoti was well adjusted to wearing a bra, but now things were different. Other girls had their struggles with body changes but Jyoti’s life was quite different. She had difficulty in finding clothes that fit her and she couldn’t run around and play basketball with her friends anymore. Worst of all were the stares from strange men, who wouldn’t even try to hide the direction of their gaze; also the whispers from the boys around her made her squirm.
By the age of 17, Jyoti started to crouch forward and walk, she often wore her older brothers clothes and learned how to avoid the gaze of men passing by. Even though Jyoti learned to hide her breasts, she truly wasn’t Ok! She would have unbearable back and shoulder pain by the end of the day and she avoided taking part in any type of physical exercise, as she would develop a rash on the undersurface of her breasts from the sweat. She also could never wear a pretty dress like the rest of her friends.
At 24, Jyoti decided that she had had enough! Unconfident, ashamed and weighed, she reached out for help and met with a Plastic Surgeon.
If you have had a similar experience to Jyoti, let’s understand the steps we can take to help reduce excessively large breasts and getting you started on the path of recovery and relief.
1- The Initial Consultation:
At the first visit, the surgeon will take a short history of the physical and psychological struggles in relation to large breasts. They may ask the woman to undress in order to assess the breasts. They will describe the surgical procedure of reduction and may make some markings on the woman’s chest with a washable marker to explain where the incision marks will be placed.
The surgeon will also explain some of the complications that can occur from surgery such as scarring, infection or opening of the stitch line, risk of bleeding, and potential risk in lactation after pregnancy
While no surgeon will wish upon future surgeries for their patient, the breasts are composed of ducts and fat, which change in relation to age, pregnancy and weight fluctuations. There may be changes in the breast in the years following the surgery which may need revision later on if the patient requires it.
With the above knowledge the individual can take time to weigh the risks and benefits, and thereby agree to the suggested procedures. It is worth noting that breast reductions is one of the most satisfying and least regretted plastic surgery procedures.
2- Secondary Consultations and Surgical Planning:
It is normal for any woman who may be planning on undergoing such a procedure to have apprehensions about the ensuing complications, hence an active discussion with the surgeon is recommended to address these concerns. Only after the woman is completely confident with the decision to proceed with the surgery, should the date of surgery be scheduled.
Prior to surgery, the woman may have to undergo some blood investigations to determine surgical and anaesthetic fitness. It is generally recommended to follow a balanced diet, reduce weight to the normal BMI levels, avoid any alcohol consumption and smoking at least 6 weeks prior to surgery.
3- One day prior to Surgery
Upon admission to the hospital, preoperative check-ups, like allergic testing of drugs will be conducted. The surgeon and anaesthesiologist will meet with the patient and once again explain the risks and complications of the procedure before the consent papers are signed. The surgeon will do markings over the woman’s chest and may take some confidential photos of the breasts in the preoperative state. Any photographs taken will not reveal the woman’s identity and are purely for academic purposes. The patient will be asked to observe a fast overnight for 8 hours from solids and for 2 hours for clear fluids prior to the surgery. They may also be advised to bathe with a cleansing solution to prevent any post operative infections.
4- On the day of the Surgery
The anaesthesiologist will administer general anaesthesia to the patient. Under most conditions, patient will not remember this experience in the post operative time. The surgery can take up to 2-4 hours depending on the size of the breasts.
5- Following the Surgery
After waking up post-surgery, the patient may feel sore and groggy, generally due to the after effects of anaesthesia and pain medication. The patient may have bandages over the chest and may notice some tubes coming from below the arms. The tubes are just a security measure to prevent and note any bleeding from the area. The patient is advised to start eating after 4-6 hours, and can be mobilised gently after 8-10 hours. It is important to note that no pressure should be placed over the arms and the patient should be given assistance in sitting and standing, especially in the initial post operative period.
6- Discharge from the Hospital
The patient will most likely have the tubes removed within 48 hours of the procedure and can be discharged in 48-72 hours after surgery. The patient is advised to wear a customised post-surgical bra or a sports bra following the surgery for the next 12 weeks.
7- First Follow up Visit:
The patient will be asked to visit the surgeon one week after surgery wherein the stitch line will be examined for any problems like infection, discoloration or unusual opening points. The nipple and its colour will also be checked. In such procedures dissolvable stitches are used, so there is no requirement of suture removal. After one week, the patient will mostly be allowed to bathe and there may be no need for further dressings. The patient is advised to avoid outward movement of the arms, lifting heavy weights, or any strenuous activity and household chores. There may be few more post operative visits suggested by the surgeon.
8- Long term Follow up:
Some long term concerns could be delayed wound healing, unsightly scars, asymmetry in breasts and changes in nipple sensation. The best way to deal with any concerns is to discuss them with your surgeon to find an appropriate solution. The patient should note that there could always be some asymmetry to the breasts and with time the shape and size of the breasts can potentially change.
There are many girls like Jyoti who are experiencing issues with their breasts, however, due to it being a taboo in society, these issues are rarely brought forward. Many girls experience psychological and physical distress due to different shapes and sizes of their breasts. Plastic surgeons can help create a platform and a safe space to discuss these concerns and help provide viable solutions.
Submitted by: Dr Priyanka Tandon
Phone number: 9986822189
IAAPS Membership: Have applied on the website, emailed requisite documents and paid dues, registration number is pending.
Disclaimer : The opinions here are personal views of the authors. IAAPS is not responsible. All members may not have the same scientific view point
