It's sometimes possible to reduce problems caused by having large breasts without the need for surgery.

The following measures may help:

• If you're overweight, losing weight can sometimes help reduce the amount of fatty tissue in your breasts
• Professional bra-fitting service – for many women with problems caused by large breasts, getting a professional to
fit a correctly-sized bra can reduce discomfort
• Physiotherapy– exercises from a physiotherapist can sometimes help with aches and pains caused by large breasts
• Psychological support and treatment – this can help if your large breasts are causing emotional or mental health issues.

Breast reduction is a surgical procedure to reduce the size of the breasts, patients often seek this procedure if they have pain and discomfort from heavy breasts. It is a functional operation that can significantly improve quality of life in patients. The breast is also lifted and the shape of the breast can be improved.

Even in large reductions I use a superomedial technique to complete the breast reduction and can safely remove up to 1 Kg from each breast. The nipple is lifted superiorly in this technique whilst still attached to glandular breast tissue, the remaining inferolateral portion of the breast is removed. Patients will have an inverted T shaped or anchor scar. In smaller reductions < 500g I do not use drains.

When you wake up after surgery, you'll have dressings on your breasts and drains attached. After 1 to 2 days, the drains will be removed and you'll usually be able to go home.You will be sent home pain with painkillers. your breasts will be swollen, and may feel tender and lumpy after surgery. The swelling may last for around 3 months. You will not see what your breasts look like until the swelling has gone down.

In most patients the scars fade and can take up to a year to fully mature. The scar extends around the nipple complex and continues as an inverted T shaped anchor scar. In some cases patients may experience Keloid or Hypertrophic scars, these may need steroid injections to improve the scars.

• Infection
• Haematoma - often occurs in the first 24 hours and will necessitate a trip back to theatre to stop bleeding
• Inability to breastfeed
• Loss of nipple sensation
• Nipple loss/necrosis (rare)
• Fat necrosis
• Altered size and not achieving desired cup size on reduction
• Asymmetry requiring further surgery

Wound breakdown (often occurs at the T junction) - managed with dressings