Breast Reduction Surgery
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Excessive breast volume (hypermastia) can contribute to upper body discomfort, limited mobility and concerns about appearance. Development of large breasts may occur naturally with normal development, pregnancy, weight gain, and age-related processes. Women looking to reduce their breast volume, improve shape and reduce discomfort associated with larger breasts can request a consultation for breast reduction with a Plastic Surgeon.
Our Surrey breast reduction surgery aims to remove excess breast tissue to make the breast smaller. In doing so, the weight of the breast is lessened and can reduce strain on the neck, upper back, and shoulders. Incisions are designed to also help ‘lift’ the breast, making the overall breast sit higher on the chest with more balanced and youthful proportions.
Breast appearance varies from person to person. During your initial consultation for your breast reduction Surrey plastic surgeon, Dr. Imran Ratanshi, will review your specific concerns and tailor a treatment plan that works best for you. Breast reduction surgery takes 1 to 2 hours. Incisions are planned while upright to account for the natural position of the breast when standing. The incisions enable Dr. Ratanshi to remove the excess volume rearrange the remaining breast tissue to achieve improved contour and lift the breast.
Breast reduction surgery is performed in a hospital or surgical facility under general anesthesia. A board-certified anesthesiologist will provide your anesthesia and will discuss your anesthesia plan with you the day of surgery. Additional local freezing is placed in all incisions to maximize comfort after surgery.
Incisions will reduce the diameter of your areola and remove excess skin and breast tissue in the lower part of your breast. To accomplish a typical reduction, most patients will have a scar that looks like an ‘anchor’ or ‘upside down T”. Your scar will rest at the outer border the areola, extend downward to the lower breast fold, and horizontally across the crease at the bottom of the breast. These incisions enable Dr. Ratanshi to remove the excess breast tissue and rearrange the remaining breast to achieve a lifted, natural appearance. All incisions are closed in layers using dissolving stitches.
Most incisions will heal with a fine line scar. Some with larger breasts may experience scar widening from the pull of the breast tissue on the scar with time. Aftercare instructions and follow-up appointments will be provided by Dr. Ratanshi and his nurse the day of surgery.
Breast reduction surgery requires a general anesthetic. Risks you should be aware of include but are not limited to:
Patients may have surgical tapes on the incisions, along with gauze and a supportive garment to support healing. You can expect early bruising, which takes one to two weeks to settle. Dr. Ratanshi does NOT place drains routinely. You may shower after 3 days. Any surgical tapes, if used, are removed at 2 weeks. Your stitches are dissolvable. You may return to work within 2 to 4 weeks, depending on your activity. You may return to the gym with a sports bra at 4 weeks. You should avoid any swimming, hot tubs, steam showers, baths (showers are OK) or lake/ocean water for 4 weeks assuming normal healing. Swelling takes 6-12 weeks to settle for your final result. Scars will mature over the course of a year.
Breast reduction is a benefit of the British Columbia Medical Services Plan (MSP) for patients who are residents of British Columbia with BC MSP coverage. For very small volume reductions assessed to be cosmetic in nature (i.e. volume unlikely to be contributing to symptoms one would experience with extremely large breasts), a private fee would apply for surgery.
Liposuction or excisional procedures to cosmetically address excess underarm (axillary) fat is not a benefit of MSP. Fees range from $2500 to $5000 + GST depending on the amount of tissue to be removed.
Private options are available for patients without BC MSP coverage or those who are not residents of British Columbia (but live in Canada) but wish to consider elective breast reduction surgery. Surgery takes place in a private surgical facility (not the hospital), and your home Provincial Health Plan is not billed. You must be available to follow-up in person for routine post-operative care or as required. Fees start at $10,500 + GST.
Dr. Ratanshi does not routinely place drains. However, there are some unique circumstances where drains may be required.
While Plastic Surgeons strive for perfect symmetry, it is impossible to make both breasts exactly the same. This is because the natural breast footprint and the chest wall in most women can vary slightly from right to left. Pre-operative measurements and markings help surgeons get as close as possible. For this reason, you may hear your surgeon say that a reasonable goal is to create ‘sisters, but not twins’.
A breast lift (mastopexy) would address your concerns by keeping the volume you have. This procedure removes extra skin only (i.e. not the underlying gland and fat that contribute to volume/cup size). Breast reductions REMOVE extra glandular and fat tissue. This will reduce your cup size. A typical reduction removes between one third to one half of the existing volume.
Your Plastic Surgeon will evaluate if your presenting size is reasonably contributing to your neck and back pain. If your breasts are smaller, they may not be contributing to your concerns and other contributions may need to be discussed with your Family Physician.
No, underarm tissue is not removed as part of a breast reduction. Removal of underarm (axillary) fat rolls is considered cosmetic and is not a benefit of the Medical Services Plan. This area is a common area for fat to accumulate, and there is no breast glandular tissue in the underarm area, as evidenced by what is removed in a mastectomy for breast cancer. For patients with a small degree of underarm fat, minor improvement may occur with breast reduction surgery alone. As the lateral breast is mobilized to a more central position, it can help pull forward some of this fat creating a flatter appearance in the underarm region. For larger amounts of underarm fat, additional liposuction to the area can remove this fat, improving the lateral chest wall contour and overall appearance of your final result. This can be discussed at the time of your consultation for breast reduction surgery.
For women of child-bearing age who undergo breast reduction surgery, you will be able to breast feed but may need to supplement with formula. Breast reduction surgery removes glandular tissue that produces milk. Less gland means less milk. Breast reduction surgery also interferes with the ducts that carry milk, affecting overall production. Some women may experience numbness or loss of erectile function to the nipple which can affect infant latch.
Recurrence of larger breasts can occur with body changes, such as pregnancy, breast feeding, or weight gain. If you experience rapid growth of breast tissue on one side, you should consult with your Family Physician or a Breast Health Clinic for assessment and a possible a mammogram.
Yes. Age, weight changes, pregnancy, and gravity will still cause any breast mass to descend, stretching the skin and supporting ligaments. Fortunately, the rate of descent will be slowed, and your breasts will sit higher for longer owing to the reduced weight.
If you have had a breast reduction in the past, you like your volume when in a support bra, but would like a lift, please refer to our section on mastopexy.
No, unfortunately. You are not a candidate for surgery at this time.
The active use of nicotine products is a strict contraindication to undergo elective breast surgery. Nicotine is a potent vasoconstrictor (i.e. it shrinks blood vessels) and can substantially reduce bloodflow to a healing wound. In extreme cases, healing issues can lead to catastrophic implant exposure. If combined with a mastopexy, nicotine use dramatically increases the incidence of areola or nipple loss.
Dr. Ratanshi requests that patients who consume any nicotine products, including cigarettes, vaping, chewing tobacco, etc. cease completely for at least 6 weeks before they can be considered a candidate for surgery.
Dr. Ratanshi prioritizes patient safety and satisfaction above all. He is a double subspecialty-trained Plastic Surgeon and regularly performs aesthetic and reconstructive breast and body surgery as part of his practice. Dr. Ratanshi aims to utilize the latest evidence-based techniques and technology to deliver exceptional results. Dr. Ratanshi is committed to making your journey to enhanced beauty as comfortable and rewarding as possible.
