Breast Procedures
Breast Enlargement | Reduction | Uplift | Reconstruction | Fat Transfer | Gynaecomastia Surgery | Inverted Nipple Correction | Areola Reduction
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Breast Enlargement (Augmentation)
What is Breast Enlargement?
Breast enlargement, also known as breast augmentation, is a surgical procedure to increase the size and improve the shape of the breasts, most commonly by inserting implants. It can enhance breasts that have always been small, restore volume lost after pregnancy or weight change, and correct uneven size between breasts.
Why Consider Breast Enlargement?
Enlarge naturally small breasts.
Restore lost volume after pregnancy, breastfeeding, or weight loss.
Correct breast asymmetry.
Improve shape and contour for greater body confidence.
How the Procedure Works
Implant Placement
Implants are usually inserted through a small incision in the breast crease, though the armpit or around the nipple may also be used. They can be placed either in front of the chest muscle (sub-glandular), behind it (sub-muscular), or partly behind both (dual plane), depending on body type and implant size.
Implant types
All implants have a silicone shell and are filled with silicone gel for a natural feel. Implants come in round or teardrop (anatomical) shapes, and with either smooth or textured surfaces. During the consultation, it will be discussed which implants are best suited for your frame and goal.
Surgery details
The operation takes about 1 - 1.5 hours under general anaesthesia. Some patients go home the same day, while others stay one night in hospital.
Recovery & Aftercare
You may feel tightness and tenderness in the chest for the first days after surgery.
Most patients take 1 - 2 weeks off work and avoid strenuous activity for 6 weeks.
Breasts often appear high and firm initially but settle into a more natural position over 2 - 3 months.
Scars start red, fade to purple, and then pale to white over time. Final results are usually seen at 3 - 4 months.
Risks & Limitations
Like any operation, breast augmentation carries risks. Possible complications include:
Bleeding (less than 1 in 100).
Infection (less than 1 in 1000).
Scarring, changes in nipple or breast sensation, or asymmetry.
Capsular contracture (hardening around the implant).
Implant rupture or deflation over time (about 1 in 10 at 10 years).
Rare conditions such as Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL).
Small chance of causing other illnesses / breast implant illness
Changes with age / weight changes / pregnancy / breastfeeding.
Future financial considerations
Most patients are satisfied with their results, but implants are not lifetime devices. Re-operation may be required in the future, either to replace implants or address changes such as sagging.
Breast Reduction (Reduction Mammaplasty)
What is Breast Reduction?
Breast reduction, also known as reduction mammaplasty, is a surgical procedure that removes excess breast tissue, fat, and skin to create smaller, lighter, and better-shaped breasts. The nipples are lifted and repositioned during the surgery, resulting in breasts that are more proportionate to your body. The procedure can also correct unevenness where one breast is much larger than the other.
Why Consider Breast Reduction?
Relieve physical symptoms such as backache, neck pain, shoulder grooves from bra straps, and skin rashes under the breasts.
Improve posture, comfort, and ability to participate in sports and physical activity.
Allow greater choice of clothing and bras.
Reduce unwanted attention and improve self-confidence.
Improve breast symmetry when there is a significant size difference.
How the Procedure Works
During surgery, excess tissue and skin are removed, the breast is reshaped, and the nipple is repositioned. Different techniques may be used, but all leave a scar around the areola, with additional scars either vertically down and/or horizontally beneath the breast (often in a “T-shaped” pattern). The most appropriate technique will be recommended for your breast size, shape, and goals.
Recovery & Aftercare
Breast reduction is performed under general anaesthesia, as a day case or 1 overnight stay
Drains are not used.
Stitches are dissolvable.
A supportive, well-fitted bra (provided) should be worn 24/7 after surgery for the 1st 3 months. The final breast size and especially shape will not be clear for several months.
Tenderness and lumpiness may last for weeks or months, but normal activities such as swimming and sunbathing can be resumed once scars have fully healed.
Risks & Limitations
Like all major operations, breast reduction carries risks. Possible complications include:
Bleeding.
Infection.
Delayed wound healing.
Scarring.
Loss of nipple sensation.
In very rare cases, there may be loss of the nipple or nipple areola complex.
It is recommended to stop smoking or using products containing nicotine before surgery to reduce the risk.
Women should assume that they will be unable to breastfeed following surgery.
Changes with age, weight fluctuations, and pregnancy will still occur.
Scars are permanent but usually fade with time. Their appearance varies from person to person. Very rarely, further small adjustments may be needed.
Breast Uplift (Mastopexy)
What is a Breast Uplift?
A breast uplift, also called mastopexy, is a surgical procedure to lift and reshape breasts that have become droopy due to pregnancy, breastfeeding, weight changes, ageing, or gravity. The operation tightens breast tissue, removes excess skin, and repositions the nipples to sit higher on the breast for a more youthful appearance. The size of the areola (the darker skin around the nipple) can also be reduced.
If the breasts are small as well as droopy, implants can be added during the same procedure to restore both volume and shape.
Why Consider a Breast Uplift?
Restore a firmer, more youthful breast shape.
Improve nipple position and reduce stretched areola size.
Address droopiness after pregnancy, breastfeeding, or weight loss.
Boost self-confidence and comfort with your appearance.
How the Procedure Works
During a mastopexy, surplus skin is removed. The breast tissue is then reshaped into a tighter cone, and the nipple is repositioned higher on the chest. Scars will vary depending on the technique used, but usually involve a scar around the areola and often a vertical line down to the breast crease, sometimes with an additional horizontal scar under the breast (often called an “anchor” or “inverted-T” scar).
If implants are used, they are placed beneath the tightened breast tissue during the same operation to increase fullness.
Recovery & Aftercare
Breast uplift surgery is carried out under general anaesthesia, usually as a day case or requiring one night in hospital.
Drains are not used.
Stitches are dissolvable.
A supportive, well-fitted bra (provided) should be worn 24/7 after surgery for the 1st 3 months. The final breast shape will not be clear for several months.
Tenderness and lumpiness may last for weeks or months, but normal activities such as swimming and sunbathing can be resumed once scars have fully healed.
Risks & Limitations
Like any major surgery, mastopexy carries risks. Effects of breast uplift include:
Bleeding.
Infection.
Delayed wound healing.
Scarring.
Loss of nipple sensation.
In very rare cases, there may be loss of the nipple or nipple areola complex.
It is recommended to stop smoking or using products containing nicotine before surgery to reduce the risk.
Changes with age, weight fluctuations, and pregnancy will still occur.
Scars are permanent but usually fade with time. Their appearance varies from person to person. Very rarely, further small adjustments may be needed.
Breast Reconstruction
What is Breast Reconstruction?
Breast reconstruction is an operation to recreate a breast shape after a mastectomy (breast removal). It can be carried out using an implant, a tissue expander, or your own tissue, such as muscle from your back. The aim is to restore the natural appearance of the breast and improve confidence after breast cancer surgery.
Why Consider Breast Reconstruction?
Restore breast shape following mastectomy.
Improve symmetry when only one breast has been removed.
Support self-confidence and body image.
Provide a permanent alternative to wearing an external prosthesis.
How the Procedure Works
Implant or tissue expander reconstruction
An implant is placed under the chest muscle to recreate the breast shape. If there is not enough skin left after a mastectomy, a temporary tissue expander may be used. This device gradually stretches the skin and muscle by injecting saline into a small valve over a period of weeks. Once the correct size is reached, a second operation replaces the expander with a permanent silicone implant.
Latissimus dorsi flap reconstruction
This technique uses tissue from your own body. The surgeon moves a section of muscle, skin, and fat from your back (the latissimus dorsi muscle) around to the chest to create a new breast mound. Sometimes this flap is combined with an implant for extra volume.
Abdominal free flap (DIEP flap)
Similar to an abdominoplasty, but using the removed tissue from the abdomen to reconstruct one or both breasts. Complex surgery requiring microvascular surgery to keep the transferred tissue alive. This surgery is only performed at the Royal Victoria Infirmary due to the need for specialist equipment and nursing staff.
Recovery & Aftercare
Breast reconstruction is performed under general anaesthesia. Most patients stay in hospital for 1 - 2 days.
After surgery, dressings are applied, and drains may be placed to remove fluid from the wound.
Tiredness is common for the first week, so having help with daily tasks is advised.
Strenuous activity and heavy lifting should be avoided until your surgeon confirms it is safe.
If a tissue expander is used, you will return every 1 - 2 weeks for outpatient appointments to add saline until the breast reaches the desired size.
Risks & Limitations
Breast reconstruction is a major operation and carries risks such as bleeding, infection, scarring, and delayed wound healing.
Implant reconstruction risks:
Tight scar tissue around the implant (capsular contracture).
Need for implant replacement in the future.
Flap reconstruction risks:
Flap failure.
Numbness.
Additional scarring at the donor site.
Results may vary — reconstructed breasts may not exactly match the natural breast in size, shape, or sensation.
Breast Lipomodelling (Fat Transfer to Breast)
What is Breast Lipomodelling?
Breast lipomodelling, also known as fat transfer to the breast, is a technique that uses fat taken from another part of the body, such as the abdomen or thighs, and re-injects it into the breast. It can correct defects left after previous breast surgery or add volume for breast enlargement. This method is minimally invasive, avoids implants, and can be repeated until the desired shape and size are achieved.
Why Consider Breast Lipomodelling?
Correct irregularities or defects after breast surgery.
Increase breast size without using implants.
Achieve natural-looking results with your own tissue.
Benefit from body contouring at the donor site through liposuction.
Choose a relatively safe and low-complication technique.
How the Procedure Works
The procedure begins with liposuction, usually performed under general anaesthesia. Fat is removed from donor areas such as the abdomen, thighs, or flanks. The fat is then purified by spinning it in a centrifuge, separating the healthy fat cells. These are carefully re-injected into the breast to restore shape or add volume.
Surgery usually takes around 90 minutes. Incisions are only a few millimetres long, leaving minimal scarring.
Recovery & Aftercare
Most patients go home within 24 hours, although some may stay overnight. A supportive bra is worn for several weeks to help the breasts settle into shape.
Driving is usually possible after one week.
Most women return to normal activities within 2 - 3 weeks.
Returning to work is often possible after the first week, depending on the type of job.
Light lifting, such as carrying young children, is usually possible after two weeks.
Breasts generally look and feel more natural after a few weeks.
Risks & Limitations
Breast lipomodelling is considered safe, but as with any surgery, complications can occur. These include:
Bruising at the donor site.
Infection at the injection site.
Fat necrosis, where some fat cells die, leading to firm or lumpy areas in the breast.
Gynaecomastia surgery (male breast reduction)
What is Gynaecomastia Surgery?
Gynaecomastia surgery, also known as male breast reduction, is a procedure to treat enlarged male breast tissue. Gynaecomastia itself is caused by an imbalance between testosterone and oestrogen. It can appear naturally during puberty, though it usually resolves on its own, or develop later in life due to ageing, obesity, certain medications, underlying health conditions, or lifestyle factors such as alcohol or drug use. In many cases, the cause is unknown (idiopathic gynaecomastia).
When the condition does not improve with lifestyle changes or medical management, surgery can restore a flatter, firmer, and more traditionally masculine chest.
Why Consider Gynaecomastia Surgery?
Achieve a flatter, more masculine chest shape.
Relieve physical discomfort such as chafing or tenderness.
Reduce self-consciousness and boost confidence.
Correct persistent gynaecomastia that has not improved with lifestyle changes or medical treatment.
How the Procedure Works
Male breast reduction is usually performed under general anaesthesia and takes 1 - 2 hours. Most operations are carried out as day cases, though some patients may stay overnight if more extensive work is required.
Liposuction removes excess fatty tissue through small incisions.
Excision removes firm glandular tissue that cannot be removed by liposuction.
Skin removal or nipple repositioning may be included when there is significant excess skin.
A compression garment is applied at the end of the operation to minimise swelling, reduce bruising, and help the chest settle smoothly into its new shape.
Recovery & Aftercare
First week: Mild to moderate discomfort is common and managed with painkillers. Walking is encouraged, but strenuous activity should be avoided.
Two weeks: Stitches are dissolvable. Bruising and swelling begin to settle. Some patients can return to work if their job is not physically demanding.
Four weeks: The compression garment is usually no longer needed. Most normal activities can be resumed.
Six weeks: Exercise and strenuous activity can be restarted with approval. Final results become more visible as swelling continues to fade.
Risks & Limitations
As with any surgery, there are risks. General complications include bleeding, infection, scarring, and changes in nipple sensation (temporary or permanent). Specific risks of gynaecomastia surgery include:
Haematoma (blood collection under the skin).
Seroma (fluid build-up).
Contour irregularities or chest asymmetry.
Under- or overcorrection.
Poor wound healing.
Very rarely, nipple tethering or necrosis (loss of nipple tissue).
Inverted Nipple Correction
What is Inverted Nipple Surgery?
A small percentage of women have inverted nipples, which can cause embarrassment, self-consciousness, or distress. Inverted nipple surgery is a minor procedure that releases the nipple from the underlying tissue so it sits in a natural, outward position. It can improve both appearance and confidence.
Why Consider Inverted Nipple Surgery?
Correct an inverted nipple for a more natural appearance.
Improve self-confidence and body image.
Address functional issues, including difficulties with breastfeeding (in some cases).
How the Procedure Works
Inverted nipple surgery is usually performed under local anaesthesia, although general anaesthesia can be used. It is typically a day-case procedure, meaning you can go home the same day. The operation can take 30 minutes.
Four small incisions are made around the base of the nipple to release the ducts, followed by a purse-string suture to gather the base of the nipple. Protective foam is worn over the nipple to prevent it from being squashed in clothing.
Recovery & Aftercare
Most patients go home once the anaesthetic has worn off — you will need someone to drive you.
Avoid strenuous activity for at least one week.
Return to work is usually possible within a few days.
Some swelling or bruising is normal; mild pain can be managed with paracetamol.
Avoid padded bras or tight tops for 10 - 14 days to prevent pressure on the nipple.
Everyone heals differently, so follow your consultant’s advice and raise any concerns during follow-up.
Risks & Limitations
While most patients recover quickly, complications can occur. These include:
Recurrence of nipple inversion.
Assume no future breastfeeding.
Loss of nipple tissue.
Scarring.
Infection or pain.
Asymmetry, where nipples look different from each other.
Areola Reduction Surgery
What is Areola Reduction Surgery?
Areola reduction is a cosmetic procedure that reduces the size of the areola — the pigmented skin surrounding the nipple. The aim is to create an areola size and shape that is more proportionate to the breast, improving both appearance and confidence. It may be performed on its own or alongside other breast procedures such as breast augmentation, reduction, uplift, or gynaecomastia surgery.
Why Consider Areola Reduction?
Reduce areolas that are larger than you’d like.
Correct asymmetry between the two areolas.
Address changes caused by pregnancy, breastfeeding, weight fluctuation, or ageing.
Improve the appearance of puffy or raised areolas.
Enhance breast aesthetics when combined with other breast procedures.
How the Procedure Works
Areola reduction typically takes 1–2 hours and can be carried out under local anaesthetic with sedation or general anaesthetic.
Surgical techniques include:
Doughnut technique (periareolar incision): The most common method, involving the removal of a ring of skin around the areola’s edge to reduce its size.
Crescent technique: A crescent-shaped incision at the top or bottom of the areola allows subtle changes in size or position.
Lollipop technique: Used with breast lifts or reductions, this combines a circular incision around the areola with a vertical incision down to the breast crease.
Anchor technique (inverted-T): Used when combined with breast reduction or uplift, adding a horizontal scar along the breast crease.
At the end of surgery, the incision is closed with fine stitches, and a light dressing or surgical tape is applied.
Recovery & Aftercare
Most patients go home the same day. Some swelling, bruising, and tenderness are normal and managed with pain relief.
Days 1 - 3: Swelling and bruising at their peak; a supportive bra should be worn.
Week 1: Stitches are dissolvable. Most people return to light daily activities.
Weeks 2 - 3: Bruising mostly gone, swelling reduced; avoid heavy lifting or strenuous exercise.
Weeks 4 - 6: Resume more vigorous activities and exercise if cleared by your surgeon. Scars begin to fade.
3 - 6 months: Most swelling resolved; scars continue to soften and lighten.
6 - 12 months: Final results visible; scars mature fully.
Supportive bras (non-wired) should be worn day and night during recovery. Patients should avoid smoking, scratching, or applying pressure to the area while it heals.
Risks & Limitations
Areola reduction is a safe procedure, but as with any surgery, complications may occur. These include:
Infection, bleeding, or poor scarring / hypertrophic or keloid scarring.
Asymmetry in size, shape, or position.
Re-stretching with time, changes with age, weight fluctuations, pregnancy, and breastfeeding.
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